All the uninsured citizens of the District of Columbia looking for private health insurance plans can avail health insurance coverage only through the DC-run health insurance marketplace called DC Health Link, as there is not an off-exchange option in DC. People of this state do not have the option to either buy a health plan outside of the exchange or directly from a health insurance company. The District of Columbia state’s exchange is one of the three exchanges that have permanently extended open enrollment. DC health insurance regulators for 2021 health coverage have approved an overall average price increase of 0.2% for individual market plans. Open enrollment for health insurance coverage in 2021 ran from November 1, 2020, to January 31, 2021. DC health Link due to the COVID pandemic is allowing uninsured people to enroll outside of the open enrollment period and it will continue through the end of the public health emergency period in the District. Uninsured residents of the DC can enroll in health coverage through DC Health Link using this special enrollment period.
Vital Stats Related to Individual Plans in DC
- The total population of the District of Columbia is 670,000.
- Two health insurance carriers are offering ACA-compliant health plans in 2021.
- Residents of the District of Columbia can enroll through DC Health Link, a state-run health insurance exchange.
- The District of Columbia was one of the states that immediately adopted ACA’s Medicaid Expansion.
- The Benchmark plan or the second-lowest-cost Silver plan for a 40-year-old in DC in 2021 cost $415.
- 4% of the total residents of DC are uninsured.
- The Affordable Care Act along with various reforms made by the DC has been instrumental in reducing the uninsured rate in the state.
- DC’s individual mandate requires the District to maintain minimum essential coverage for each month of the year, as individuals who do not have essential health insurance coverage or do not qualify for an exemption will be penalized.
- Only 6% of the DC Health Link enrollees were receiving subsidies in 2020 compared to 86% of exchange enrollees nationwide, this is mainly because of the District’s generous Medicaid eligibility that extends coverage to most of the residents of the state.
Types of Individual Health Plans
The private individual health plans offered on the DC Health Link, a state-run health insurance exchange, are categorized based on the levels of cost-sharing between the insurer and the insured. This indicates the amount paid by the insured and the amount that the insurance company contributes toward the insured’s covered healthcare expenses. There are five metal levels of plans available in DC, each named after a metal, Platinum, Gold, Silver, Bronze, and Catastrophic. The health plans of higher metal tiers like Platinum and Gold have high monthly premiums but provide better coverage to the insured. The plans of the higher metal-tier like Platinum and Gold will be ideal for individuals who frequently avail healthcare services because the higher metal-tier plans offer better coverage and also have low out-of-pocket expenses. Whereas health plans of lower metal tier like Bronze have lower monthly premium and suit to individuals who rarely visit doctors for healthcare services because these plans have high deductibles.
Average Cost of Health Insurance in DC by Metal-tier in 2021
|Metal Tier||Monthly Premium|
Private Individual Health Plans Options Available at DC Health Link
DC Health Link offers different types of health insurance plans from which individuals can choose a plan that meets their healthcare needs and budget. Under the Affordable Care Act, health insurance plans in DC are more affordable for most of the residents of the District, especially for individuals with the lowest incomes since they qualify for the subsidized healthcare costs. Residents of the DC can obtain health coverage through the District of Columbia exchange, or through public programs like Medicaid and CHIP, directly from a private health insurance carrier, or through an online health insurance marketplace. The online health insurance marketplace allows people to compare plans and benefits and obtain health coverage at the lowest cost. District of Columbia provides access to several health insurance options and there is something for everybody irrespective of their healthcare need and budget.
Some of the popular Individual Plans available at DC Health Link are:
- BlueChoice HMO Standard Platinum Plan
- BlueChoice HMO Standard Gold $500
- BluePreferred PPO Standard Gold $500
- BluePreferred Standard Silver $4,000
- BlueChoice HMO Standard Bronze $7,500
Health Insurance Carriers available in DC
- Kaiser Permanente