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.
The open enrollment window for individual/family health coverage in Delaware runs from November 1 through January 15. Outside of the annual open enrollment period, Delaware residents need a qualifying event to enroll or make a plan change.
Learn more about enrollment options in our comprehensive guides:
As of 2022, Highmark is the only insurer that offers plans in Delaware’s exchange. But Aetna and AmeriHealth are joining Delaware’s market for 2023 (with plans available for purchase as of November 2022), bringing the total number of participating insurers to three.
Aetna had previously participated in the Delaware marketplace, but exited at the end of 2017, leaving Highmark as the only participating insurer from 2018 through 2022. In 2021 and 2022, Delaware was the only state in the country that had just a single insurer offering coverage in its exchange.
Read more about Delaware’s health insurance exchange/marketplace.
For 2023, Highmark has proposed an average rate increase of 5.5%. The two other insurers that will offer 2023 coverage are both new to the exchange, so they don’t have any applicable rate change.
For 2022 coverage, Highmark implemented an overall average rate increase of 3%.
Highmark’s average premiums dropped by 19% for 2020, thanks in large part to the state’s new reinsurance program. Average premiums decreased again in 2021, but only by about 1%.
32,113 people enrolled in private health plans through Delaware’s health insurance marketplace during the open enrollment period for 2022 coverage. This was by far a record high for the state’s exchange. The larger enrollment was driven in large part by the American Rescue Plan‘s subsidy enhancements (which have been extended through 2025 under the Inflation Reduction Act).
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 2022, more than 32,000 Delaware residents had enrolled in private healthcare coverage through the state’s exchange. Most of these enrollees — more than 28,000 — 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 a dozen that have not expanded Medicaid as of 2022).
Enrollment in Delaware’s Medicaid plans and CHIP is about 35% higher than it was in the fall of 2013, before Medicaid expansion took effect (as opposed to a nationwide average of 55% 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.
Under new state regulations, Delaware limits short-term health insurance plans to three months in duration, and prohibits renewals.
Read more about short-term health insurance in Delaware.
As of May 2022, nearly 227,000 Delaware residents were enrolled in Medicare, amounting to more than 22% of Delaware’s population. Of the state’s Medicare beneficiaries, 89% qualify based on age alone (ie, being at least 65) while 11% qualify due to a disability.
Delaware residents can enroll in private Medicare Advantage plans instead of Original Medicare. But fewer only a little more than a quarter of Delaware Medicare Beneficiaries are enrolled in Medicare Advantage, versus about 46% 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)
