Delaware health insurance Marketplace guide

In order to sign up for private health coverage through the Marketplace in Delaware, you must:

• Live in Delaware and be lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare

By those rules, most Delaware residents qualify to use the Marketplace.⁴ But a more important question for most people is eligibility for financial assistance, and there are a few additional parameters to qualify for subsidies in the Marketplace. To be eligible for income-based Advance Premium Tax Credits (APTC) or cost-sharing reductions (CSR), you must:

• Not be eligible to enroll in affordable health coverage offered by an employer. If you have access to an employer’s plan but it seems too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁵
• File a joint tax return with your spouse, if you’re married.⁶ (with very limited exceptions)⁷
• Not be able to be claimed by someone else as a tax dependent.⁶

In addition to those basic parameters, eligibility for Marketplace subsidies depends on your household income and how it compares with the cost of the second-lowest-cost Silver plan in your area (the cost of this plan will depend on your age and location).

The open enrollment period for 2026 individual market coverage ended on January 15, 2026 in Delaware.⁸ 

After that date, you can only enroll in coverage with a 2026 effective date if you’re eligible for a special enrollment period. Most special enrollment periods are triggered by specific qualifying life events, such as giving birth or losing other health coverage. But Native Americans can enroll year-round, without a qualifying life event. 

The next open enrollment period, for coverage effective in 2027, will run from November 1, 2026 to December 15, 2026. This is a shorter enrollment window, due to a federal rule change. All plans selected during open enrollment will take effect January 1.

Enrollment in Delaware Medicaid/CHIP is available year-round.

To enroll in an ACA Marketplace plan in Delaware, you can: 

• Visit HealthCare.gov to compare plans, see your subsidy eligibility (if applicable), and enroll in the plan that best meets your needs. 
• Use the state-based Choose Health Delaware website to learn about the available health plans. You’ll be directed to the HealthCare.gov platform in order to enroll. 
• Purchase Marketplace coverage with the help of an insurance agent or broker, Navigator, or certified application counselor. These individuals can provide help online, over the phone, or in-person.
• Enroll via an approved enhanced direct enrollment entity.⁹ 

You can reach HealthCare.gov’s call center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, except holidays.

The Affordable Care Act (ACA) created income-based subsidies that can help lower your premium payments each month. These subsidies are available to Delaware residents who meet the eligibility requirements and enroll in Marketplace coverage.

During the open enrollment period for 2025 coverage, more than nine out of ten Marketplace enrollees in Delaware were eligible premium subsidies. The subsidies reduced their average health insurance premiums by $586/month. After subsidies were applied, the average Delaware Marketplace enrollee’s premium was about $217/month, including those who weren’t eligible for a subsidy.¹⁰

Source: CMS.gov¹¹

Reinsurance: Delaware has a reinsurance program, which has helped to keep full-price premiums lower than they would otherwise have been over the last few years. Although the majority of Delaware’s Marketplace enrollees qualify for premium subsidies, the reinsurance program keeps coverage more affordable than it would otherwise be for those who aren’t subsidy-eligible.¹² (The number of people who aren’t subsidy-eligible increased in 2026, due to the return of the “subsidy cliff.”)

Cost-sharing reductions: If your household income is no more than 250% of the federal poverty level, you may also be eligible for cost-sharing reductions (CSR), as long as you select a Silver-level plan. These subsidies result in lower out-of-pocket costs, including deductibles. Thirty percent of Delaware’s Marketplace enrollees were receiving CSR benefits as of early 2025.¹³

Medicaid/CHIP: Depending on your income and circumstances, you may be able to enroll in free or low cost health coverage through Medicaid or CHIP (Delaware Healthy Children). Check to see if you meet the eligibility criteria for Delaware Medicaid/CHIP. 

Insulin cost-sharing cap: Delaware caps insulin out-of-pocket costs at $35/month for people with state-regulated health insurance, which includes Marketplace plans.¹⁴ And cost-sharing for specialty drugs is capped at no more than $150/month for Delaware residents enrolled in state-regulated health plans.¹⁵

Three insurers offer plans in the Delaware Marketplace for 2026:¹⁶

• AmeriHealth Caritas
• Highmark BCBSD
• Celtic

Aetna offered coverage in 2025, but exited the market at the end of 2025.

The following table shows each Delaware Marketplace insurer’s approved rate changes for 2026 individual/family health plans,¹⁶ amounting to a weighted average rate increase of 27.7%.¹⁷ But that’s calculated before subsidies are applied, and most people get subsidies. Because Congress didn’t extend the federal subsidy enhancements that expired at the end of 2025, after-subsidy premium increases were much larger (see examples below).

Source: Delaware Department of Insurance¹⁶

Here is the 2025 market share for each carrier that is continuing to offer coverage in 2026, according to their filings:¹⁸

• AmeriHealth: 5,782 enrollees
• Celtic: 10,619 enrollees
• Highmark: 32,425 enrollees

It’s important to keep in mind that average rate changes are calculated based on full-price premiums, and most enrollees do not pay full price: As of 2025, more than nine out of ten Delaware Marketplace enrollees were receiving premium subsidies that reduced their monthly payments.¹⁹

But after-subsidy premiums increased substantially in 2026, because Congress did not extend the subsidy enhancements that had been in place since 2021. When the subsidy enhancements expired at the end of 2025, Marketplace coverage became much less affordable in 2026, and fewer people enrolled (details below).

Here are some examples of the sort of net premium increases that people saw in Wilmington, Delaware, due to the expiration of the federal subsidy enhancements:²⁰

• 40-year-old earning $40,000:
  • Lowest-cost plan in 2025 was $32/month
  • Lowest-cost plan in 2026 is $138/month
• 60-year-old earning $63,000:
  • Lowest-cost plan in 2025 was $186/month
  • Lowest-cost plan in 2026 is $994/month (due to the subsidy cliff)

For perspective, here’s an overview of how average full-price premiums have changed in Delaware over time:

• 2015: Average increase of 3%²¹
• 2016: Average increase of 22%²²
• 2017: Average increase of 30%²³
• 2018: Average increase of 25%²⁴
• 2019: Average increase of 3%²⁵
• 2020: Average decrease of 19%²⁶ (reinsurance program took effect)
• 2021: Average decrease of 1%²⁷
• 2022: Average increase of 3%²⁸
• 2023: Average increase of 5.5%²⁹ (plus two new insurers)
• 2024: Average increase of 3.1%³⁰ (plus one new insurer)
• 2025: Average increase of 8.5%³¹

44,663 people selected Delaware Marketplace plans during the open enrollment period for 2026 coverage.³²

This was a drop of almost 16% from the year before, when 52,931 people enrolled in private health plans through the Delaware Marketplace during the open enrollment period for 2025 coverage.³³ 

The 2025 enrollment was a significant record high. Enrollment in Delaware’s Marketplace grew every year from 2019 through 2025 (see chart below). The enrollment decline in 2026 was due to the expiration of the federal subsidy enhancements at the end of 2025, and the resulting higher net premiums. 

Source: 2014,³⁴ 2015,³⁵ 2016,³⁶ 2017,³⁷ 2018,³⁸ 2019,³⁹ 2020,⁴⁰ 2021,⁴¹ 2022,⁴² 2023,⁴³ 2024,⁴⁴ 2025⁴⁵

The enrollment growth in recent years, illustrated above, was due in large part to the subsidy enhancements created by the Amerian Rescue Plan and Inflation Reduction Act.

The enrollment growth in 2024 and 2025 was also partially due to the “unwinding” of the pandemic-era continuous coverage rule for Medicaid, which prevented Medicaid disenrollments for three years. By April 2024, nearly 15,000 people in Delaware had transitioned from Medicaid to a Marketplace plan.⁴⁶

HealthCare.gov
This is the Marketplace enrollment platform in Delaware. Residents can use it to enroll in individual/family health plans and receive income-based subsidies. You can contact HealthCare.gov at 800-318-2596.

Choose Health Delaware
Delaware’s partnership exchange/Marketplace. Helps consumers learn about coverage options in the Marketplace, and directs them to HealthCare.gov for enrollment. 

Quality Insights, Inc.
Delaware’s federally funded Navigator organization, helping residents find affordable coverage through the Marketplace and the state’s Medicaid/CHIP program.

Delaware Health and Social Services
Administers Medicaid and Delaware Healthy Children (CHIP), as well as other social services programs. 

Delaware Department of Insurance
Regulates and oversees the insurance industry in Delaware, and assists consumers and businesses with insurance-related questions and concerns. 

Delaware Medicare Assistance Bureau
A resource for Delaware Medicare beneficiaries and their caregivers. Provides information and assistance with questions related to Medicare eligibility, enrollment, and claims.