Frequently asked questions about health insurance
coverage options in Delaware
Delaware’s health insurance marketplace, Choose Health Delaware, is operated in partnership with the federal government, which means that 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 deemed this exchange model as most financially prudent.
Read our guide to Delaware’s health insurance marketplace.
For 2022 coverage, the open enrollment window runs from November 1, 2021 through January 15, 2022. This is an excellent opportunity to take advantage of the American Rescue Plan’s enhanced premium subsidies, which will still be in effect throughout 2022.
Outside of the annual open enrollment period, you need a qualifying event to enroll or make a change to your plan. For 2021 coverage, you may still be able to enroll if you’ve experienced a qualifying event or if you have received unemployment compensation at any point in 2021.
Highmark is the only insurer that offers plans in Delaware’s exchange.
Read more about Delaware’s health insurance exchange/marketplace.
For 2022 coverage, Highmark has implemented an overall average rate increase of 3%.
During the open enrollment period for 2021 coverage, 25,320 people enrolled in medical insurance plans through Delaware’s health insurance marketplace.
In addition, almost 5,900 people enrolled in coverage through Delaware’s exchange during the COVID/American Rescue Plan special enrollment period that ran for six months in 2021.
Delaware already had a lower-than-average uninsured rate prior to ACA implementation, with 9.1% of the state’s population uninsured in 2013 (as opposed to 14.5% nationwide). By 2018, the uninsured rate in the state had dropped to 5.7%, according to US Census data, although it increased to 6.6% in 2019 (the uninsured rate increased nationwide under the Trump administration; Delaware is not unique in terms of this increase).
As of 2020, there were more than 22,000 Delaware residents with private healthcare coverage through the state’s exchange. Most of these enrollees — more than 19,000 — were receiving premium subsidies that reduce their monthly premium costs and make coverage more accessible and affordable. And everyone with ACA-compliant plans (including all of the exchange enrollees, as well as people with off-exchange coverage and small business health coverage that took effect since 2014) has coverage for the ACA’s essential health benefits without any lifetime or annual caps on the benefits.
Delaware is among the states that expanded Medicaid coverage under the Affordable Care Act, effective as of January 2014 (half the states expanded Medicaid at that point; several others have expanded Medicaid coverage since then, but there are still 14 that have not expanded Medicaid as of early 2021).
But enrollment in Delaware’s Medicaid plans and CHIP is only about 13% higher than it was in the fall of 2013, before Medicaid expansion took effect (as opposed to a nationwide average of 38% higher). Delaware’s average household income is higher than the U.S. average, so relatively few people in the state are eligible for Medicaid.
Enrollment in Medicaid plans and CHIP continues throughout the year. Visit the Delaware Division of Medicaid and Medical Assistance website for information about the state Medicaid program and the Delaware Healthy Children Program.
Read more about Medicaid coverage expansion in Delaware.
As of January 2021, 217,211 Delaware residents were enrolled in Medicare, amounting to about 22% of Delaware’s population. Of the state’s Medicare beneficiaries, 86% qualify based on age alone (ie, being at least 65) while 14 percent qualify due to a disability.
Delaware residents can enroll in private Medicare Advantage plans instead of Original Medicare. But fewer than one in five Delaware Medicare Beneficiaries is enrolled in Medicare Advantage, versus about 40% nationwide.
More than three-quarters of Delaware’s Medicare beneficiaries have Medicare Part D prescription drug coverage — mostly in the form of stand-alone drug plans, but some have Part D coverage integrated with their Medicare Advantage plans.
Read our overview of Medicare enrollment and coverage options in Delaware.
- Quality Insights Inc. and Westside Family Healthcare Inc. (these are Delaware’s federally funded Navigator organizations).
- Delaware Healthy Children Program
- Delaware Department of Insurance (oversees and regulates the companies that provide health insurance in Delaware, as well as the 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 healthcare costs)
- Delaware Medicare Assistance Bureau (free advice and information for Medicare beneficiaries and their caregivers)
- Medicare Rights Center (a nationwide website and call center that can provide a variety of advice and assistance related to Medicare)