Medicaid expansion in Delaware
of Federal Poverty Level
Over the years, Delaware has successfully contracted with managed care organizations (MCOs) to lower Medicaid costs and used the savings to make Medicaid available to more people. In January 2014, Delaware adopted Medicaid expansion through the Affordable Care Act (ACA), and total enrollment in Delaware’s Medicaid/CHIP program grew by almost 25,000 people from 2013 to August 2018 — a net enrollment growth of 11 percent.
Not coincidentally, the uninsured rate in Delaware has dropped from 9.1 percent in 2013 to 5.4 percent in 2017.
Who is eligible for Medicaid in Delaware?
The following eligibility levels apply to Delaware’s Medicaid program.
- Children birth to 1 year with family income up to 212 percent of the federal poverty level (FPL)
- Children 1 to 5 years with family income up to 142 percent of FPL
- Children 6 to 18 with family income up to 133 percent of FPL
- Pregnant women with family income up to 212 percent of FPL
- Parents with family income up to 138 percent of FPL
- Childless, non-elderly adults with family income up to 138 percent of FPL (Medicaid expansion population)
- Elderly and disabled individuals with special requirements and who meet certain income limits. Use Delaware ASSIST (Application for Social Services and Internet Screening Tool) to see if you qualify.
How does Medicaid provide financial assistance to Medicare beneficiaries in Delaware?
Many Medicare beneficiaries receive Medicaid financial assistance that can help them with Medicare premiums, lower prescription drug costs, and pay for expenses not covered by Medicare – including long-term care.
Our guide to financial assistance for Medicare enrollees in Delaware includes overviews of these programs, including Medicaid nursing home benefits, Extra Help, and eligibility guidelines for assistance.
How do I enroll for Medicaid in Delaware?
- You can apply for Medicaid online at HealthCare.gov or through Delaware ASSIST.
- You can fill out a paper application and return it by mail. Call 1-800-372-2022 or 302-255-9500 to have an application mailed to you.
- Call 1-800-372-2022 or 302-255-9500 to be directed to the nearest DSS office.
- To apply for long-term care, call the Medicaid Central Intake Unit at 1-866-940-8963 or the Long Term Care office for your county.
Delaware Medicaid enrollment numbers
As of August 2018, total enrollment in Delaware’s Medicaid/CHIP programs had grown by 11 percent since 2013, with net enrollment up nearly 25,000 people. Nationally, Medicaid/CHIP enrollment grew by 27 percent from 2013 to August 2018 (including the 19 states that hadn’t expanded Medicaid at that point), but Delaware’s median household income is higher than the national average, so fewer people are eligible for coverage intended for low-income households.
Delaware Medicaid history
Delaware originally implemented Medicaid in October 1966.
Starting in 1996, the state began converting much of its program to managed care. The managed care program is called the Diamond State Health Plan (DSHP).
Initially, DSHP primarily covered low-income children and adults. As of 2018, Delaware covered about 84 percent of its Medicaid beneficiaries through managed care.
In April 2012, Delaware received approval to move some of its long-term care and dual eligible (those who qualify for both Medicaid and Medicare) populations to managed care. This program is called DSHP Plus.
As of August 2018, 248,310 Delawareans were covered by Medicaid/CHIP.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.