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.
Enrollment rules are different in 2021, due to the ongoing COVID pandemic and the newly enhanced premium subsidies created by the American Rescue Plan. Although enrollment outside of the fall enrollment period (November 1 to December 15) normally requires a qualifying event, there is a COVID-related enrollment window that continues through August 15, 2021.
During this window, which does not require a qualifying event, uninsured residents can sign up for coverage, people with off-exchange coverage can switch to on-exchange coverage, and current exchange enrollees can switch plans in order to better take advantage of the larger premium subsidies.
Highmark is the only insurer that offers plans in Delaware’s exchange.
Read more about Delaware health insurance companies and 2021 premiums.
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%.
During the open enrollment period for 2021 coverage, 25,320 people enrolled in medical insurance plans through Delaware’s health insurance marketplace.
But there’s an extended opportunity for enrollment in 2021, through August 15, due to the ongoing COVID pandemic. During the first two and a half months of this window (mid-February through the end of April), 2,766 Delaware residents enrolled in plans through the exchange.
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.
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 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.
- 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)
