Delaware Health Insurance

 

Health insurance in Delaware

● The Delaware health insurance marketplace is a partnership between the state and HHS, with residents enrolling through Healthcare.gov.

● Open enrollment for 2021 health plans runs from November 1 to December 15, 2020. Outside of that window, you need a qualifying event to register or make changes to the plan.

● Short-term health insurance plans are available in Delaware with initial plan terms of up to three months.

● An insurer offers coverage through the Delaware health insurance marketplace.

● The average premium for the individual marketplace fell by 19% in 2020, thanks in large part to the state's new reinsurance program, and will fall again, by 1%, by 2021.

● Just under 24,000 enrolled in 2020 coverage through the Delaware health insurance marketplace.

● Delaware implemented the ACA's Medicaid expansion in 2014.

● Medicare enrollees make up about 22 percent of the state's population.

This page is dedicated to helping consumers quickly find health insurance resources in the state of Delaware. Here you will find information about the many types of health insurance coverage available. You can find the basics of the Delaware health insurance marketplace and the next open enrollment period; a brief overview of Medicaid expansion in Delaware; a quick look at the availability of short-term health insurance in the state; statistics on state-specific Medicare rules; as well as a collection of health insurance resources for Delaware residents.

Delaware Health Insurance marketplaceplace

The Delaware Health Insurance marketplace/Exchange is a place where people can enroll in health insurance if they are not eligible for Medicare or employed by a company that offers employer-sponsored health benefits. The marketplace offers enrollment in individual/family health plans (for example, self-purchased) and Medicaid (some forms of Medicaid coverage are instead obtained directly from the state Medicaid office).

Delaware's health insurance marketplace, Choose Health Delaware, is operated in partnership with the federal government, meaning people use HealthCare.gov, the federally run enrollment website, to enroll in individual/family health insurance plans in Delaware. Given the state's small population, state officials viewed this model as more financially prudent.

23,961 people enrolled in medical insurance plans through the Delaware health insurance marketplace during the open enrollment period for 2020 coverage.

Highmark is the only insurer offering plans in the Delaware exchange. Highmark's average premiums have fallen by 19% for 2020, thanks in large part to the state's new reinsurance program. Average premiums fell again in 2021, but only by about 1%.

Delaware has expanded Medicaid under the Affordable Care Act, and low- and low-income residents can enroll in Medicaid through the health insurance marketplace if they are eligible.

Open enrollment period and dates in Delaware

Delaware open enrollment period and dates

Open enrollment in Delaware for 2021 health plans runs from November 1, 2020 to December 15, 2020, with all plans starting January 1, 2021. Changes to the membership and plan are only possible outside the window from November 1 to December 15 if a person has a qualifying event.

Medicaid expansion in Delaware

Delaware is among the states that expanded Medicaid coverage under the Affordable Care Act, starting in January 2014 (half of the states expanded Medicaid at that point; many more have expanded Medicaid coverage since then, but there are still 14 that haven't expanded Medicaid since 2020).

But enrollment in Delaware's Medicaid and CHIP plans is only about 6 percent higher than in the fall of 2013, before the Medicaid expansion took effect (as opposed to a national average of 28 percent more). But

The median income of Delaware households is above the U.S. average, so relatively few people in the state are eligible for Medicaid.

Enrollment in the Medicaid and CHIP plans continues throughout the year. Visit the Delaware Medicaid and Medical Care Division website for information about Delaware's state Medicaid program and healthy children's program.

Short-term health insurance in Delaware

Delaware limits short-term health insurance plans to three months and prohibits renewals.

Delaware health ratings

In 2019, the State Health System Performance Scorecard ranked Delaware 27th in the nation for overall health. Check out Delaware's scorecard for state performance for a detailed look at its performance. Low percentages of uninsured adults and children and few adults at risk without a routine medical examination in the past two years have been among the positive indicators.

The 2019 edition of America's Health Rankings placed Delaware in 30th place. While a relatively low uninsured rate and strong public health funding have strengthened Delaware's overall ranking, several measures have positioned themselves in the bottom half.

You can see county-level health rankings for Delaware from the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin.

How did Obamacare help Delaware?

Delaware already had a below-average uninsured rate before the ACA was implemented, with 9.1% of the state's population uninsured in 2013 (compared to 14.5% nationally). In 2018, the uninsured rate in the state had fallen to 5.7%, according to U.S. Census data.

As of 2020, there are more than 22,000 Delaware residents with private health coverage through the state exchange. Most of these subscribers - more than 19,000 - receive premium grants that reduce monthly premium costs and make coverage more affordable and affordable. And everyone with ACA-compliant plans (including all exchange enrollees, as well as people with out-of-stock coverage and small business health coverage that has been in place since 2014) have coverage for the ACA's essential health benefits with no life limits or annual benefits.

Medicare coverage and enrollment in Delaware

Medicare, a program run by the federal government, currently covers more than 62 million elderly and disabled Americans. Nearly 22% of Delaware's population is enrolled in Medicare coverage. Among the state's Medicare beneficiaries, 86 percent qualify by age only (i.e. at least 65) while 14 percent qualify because of a disability.

Delaware residents can enroll in private Medicare advantage plans instead of Original Medicare. But fewer than one in five Delaware Medicare beneficiaries are enrolled in Medicare Advantage, compared to about 40 percent nationwide.

About three-quarters of Medicare beneficiaries in Delaware have part D medical coverage for prescription drugs -- mostly in the form of standalone drug plans -- but some have Part D coverage built into their Medicare Advantage plans.

Delaware Health Insurance Resources

● Delaware Healthy Children's Program

● Delaware Department of Insurance (oversees and regulates companies that provide health insurance in Delaware, as well as agents and brokers who sell health coverage in the state).

● Delaware Medical Assistance Portal (Medicaid coverage for various low-income populations in Delaware who need assistance with their health care costs)

● Delaware Medicare Assistance Bureau (free advice and information for Medicare beneficiaries and their caregivers)

● Medicare Rights Center (a national website and call center that can provide a variety of Medicare-related advice and assistance)