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.³ 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.⁴
• File a joint tax return with your spouse, if you’re married.⁵ (with very limited exceptions)⁶
• Not be able to be claimed by someone else as a tax dependent.⁵

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 to sign up for 2027 ACA-compliant individual and family health plans in Delaware is expected to run from November 1, 2026 through January 15, 2027.

HHS previously finalized a rule change that would have shortened the enrollment window starting in the fall of 2026, ending it in mid-December. That provision was overturned by a judge in June 2026, but HHS soon appealed the judge’s ruling.⁷ So as of early August 2026, there was still some uncertainty regarding the open enrollment schedule for 2027 coverage

But regardless of the outcome of the appeal, consumers should plan to enroll by December 15. Even if open enrollment continues until mid-January, December 15 is the last opportunity to pick a plan with a January 1 effective date.

Outside of open enrollment, you can only enroll or switch plans 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. 

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.⁸ 

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 2026 coverage, more than eight out of ten Marketplace enrollees in Delaware were eligible for premium subsidies. The subsidies reduced their average health insurance premiums by $720/month. After subsidies were applied, the average subsidy-eligible Delaware Marketplace enrollee’s premium was about $172/month.⁹

Source: CMS.gov⁹

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.¹⁰ (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. Nearly 23% of Delaware’s 2026 Marketplace enrollees were receiving CSR benefits.⁹

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.¹¹ And cost-sharing for specialty drugs is capped at no more than $150/month for Delaware residents enrolled in state-regulated health plans.¹²

Two insurers will offer 2027 plans through Delaware’s Marketplace:¹³

• AmeriHealth Caritas
• Highmark BCBSD

Three carriers offer plans for 2026, but Celtic/Ambetter is exiting the Delaware Marketplace at the end of 2026.¹⁴ Enrollees with Celtic/Ambetter coverage will need to select new plans for 2027, during the open enrollment period that begins November 1, 2026.

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

The following table shows Delaware Marketplace insurers’ proposed rate changes for 2027 individual/family health plans,¹³ calculated before subsidies are applied:

Source: Delaware Department of Insurance¹⁵

The unweighted average proposed rate increase for 2027 is 16.9%. Highmark BCBSD has 23,790 members as of 2026. AmeriHealth’s redacted filing does not show its membership, and it’s unclear how many Ambetter/Celtic enrollees will need to select new coverage. There were a total of 36,282 Delaware Marketplace enrollees as of early 2026.¹⁶ Some people also have off-exchange coverage, but Highmark (which has the larger percentage rate increase for 2027) has a market share that is likely more than half of the total individual market in Delaware.

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 2026, more than eight out of ten Delaware Marketplace enrollees were receiving premium subsidies that reduced their monthly payments.⁹

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). The same rules will continue to be used in 2027, but enrollees won’t experience the same level of “sticker shock” that they did in 2026.

Here are some examples of the sort of net premium increases that people saw in Wilmington, Delaware in 2026, due to the expiration of the federal subsidy enhancements:¹⁷

• 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%¹⁸
• 2016: Average increase of 22%¹⁹
• 2017: Average increase of 30%²⁰
• 2018: Average increase of 25%²¹
• 2019: Average increase of 3%²²
• 2020: Average decrease of 19%²³ (reinsurance program took effect)
• 2021: Average decrease of 1%²⁴
• 2022: Average increase of 3%²⁵
• 2023: Average increase of 5.5%²⁶ (plus two new insurers)
• 2024: Average increase of 3.1%²⁷ (plus one new insurer)
• 2025: Average increase of 8.5%²⁸
• 2026: Average increase of 27.7%²⁹

44,663 people selected Delaware Marketplace plans during the open enrollment period for 2026 coverage.⁹

This was a drop of almost 18% 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.³⁰ 

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: 2014,³¹ 2015,³² 2016,³³ 2017,³⁴ 2018,³⁵ 2019,³⁶ 2020,³⁷ 2021,³⁸ 2022,³⁹ 2023,⁴⁰ 2024,⁴¹ 2025⁴² 2026⁹

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.⁴³

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.