There is no reason for you to go without health insurance coverage in Delaware. The state has a range of options available so that you and your family can access the medical services you require.
Delaware residents can find affordable health insurance through the federally-facilitated marketplace. Insurers on the marketplace meet ACA standards and are available through HealthCare.gov during the annual Open Enrollment Period.
Previously, there were two health insurance companies on the marketplace, but since 2018, just one remains: Highmark BCBSD of Delaware.
Although Highmark is the only insurer available to Delaware residents, it offers various policies that allow you to match a plan to your healthcare needs.
Highlights and Updates
- Delaware has a federally facilitated marketplace. Residents enroll through Healthcare.gov.
- The 2021 Benefits Open Enrollment period was from May 3 – May 19, 2021. (Plan Year July 1, 2021 – June 30, 2022.)
- There is an extended opportunity for enrollment in 2021, through August 15, due to the ongoing COVID pandemic.
- Delaware limits short-term health insurance plans to three months and prohibits renewals.
- Average premiums decreased again in 2021, but only by 1%.
- The Delaware marketplace only has one insurer.
- During the OEP for 2021 coverage, 25,320 people enrolled.
- More than 8 out of 10 people who enrolled in Delaware received help paying for their insurance.
How to Buy Health Insurance in Delaware
If you don’t receive health insurance from the federal government or an employer, you can purchase a plan on the Delaware marketplace. Health insurance in the marketplace is broken down into three main metal tiers: Bronze, Silver, and Gold.
All tiers provide the same minimum benefits, but higher metal tiers cover a more significant percentage of expenses and have lower deductibles. However, the increased coverage of Gold plans comes with a more expensive monthly premium. The best tier for you depends on your household income and expected medical costs.
How To Apply For Health Insurance in Delaware
To obtain a health insurance plan that meets government requirements within the Affordable Care act, shop the Health Insurance Marketplace. Choose Health Delaware is the state’s free official program that helps individuals and businesses learn more about the low-cost, high-quality health coverage available through the Health Insurance Marketplace.
Health Insurance Carriers In Delaware
Unlike other states, Delaware has just one health insurance company on the marketplace: Highmark Blue Cross Blue Shield Delaware. Naturally, this limits the number of options, but Highmark offers multiple policies within metal tiers.
Silver plans – the most popular metal tier – have three different plans, each with separate deductibles and out-of-pocket maximums. The variety of policies gives you the flexibility to find a plan that matches your financial situation.
How Has Obamacare Helped Delaware’s Uninsured?
Before the Affordable Care Act (Obamacare) was introduced, Delaware already had a healthy uninsured rate below the national average. Since the ACA was put into place, the uninsured rate has decreased further, dropping from 9.1% in 2013 to 6.6% in 2019.
Delaware Health Insurance Costs Overview
Each metal tier has different premiums and out-of-pocket costs associated with it: the higher the coverage, the more expensive the premium.
The following premiums are based on an average 40-year-old. Because Delaware has just one insurer, plans are available in all areas.
How Much Does Health Insurance Cost in Delaware?
According to the KFF, the average benchmark premium in Delaware is $540 in the year 2021.
What is the Cheapest Health Insurance Plan in Delaware?
Every year, health insurers on the marketplace adjust plan premiums, deductibles, and out-of-pocket costs. Delaware residents should be aware of pricing changes to ensure they don’t enroll in an overpriced plan.
With 11 plans available to those living in Delaware, the lowest monthly premium is estimated at $382.63. The highest estimated monthly premium currently sits at $669.31.
These, along with health insurance coverage averages covered below, are calculated through the healthcare.gov site.
Prices are estimates – fill out an application to see exact prices
Cheapest Delaware Health Insurance Coverage by Metal Tier
Of the two platinum plans available to those living in Delaware, the lowest estimated monthly premium is $635.86.
Shared Cost Blue EPO Platinum 0
Estimated monthly premium: $635.86
Deductible: $0 Individual total
Out-of-pocket maximum: $5,000 Individual total
Of the three gold plans available to those living in Delaware, the lowest estimated monthly premium is $494.51.
Shared Cost Blue EPO Gold 0
Estimated monthly premium: $494.51
Deductible: $0 Individual total
Out-of-pocket maximum: $7,500 Individual total
Of the three silver plans available to those living in Delaware, the lowest estimated monthly premium is $499.22.
Health Savings Embedded Blue EPO Silver 3450 HSA
Estimated monthly premium: $499.22
Deductible: $3,450 Individual total
Out-of-pocket maximum: $6,900 Individual total
Of the three bronze plans available to those living in Delaware, the lowest estimated monthly premium is $382.63.
Shared Cost Blue EPO Bronze 3800
Estimated monthly premium: $382.63
Deductible: $3,800 Individual total
Out-of-pocket maximum: $8,500 Individual total
Delaware Health Insurance Costs by Occupation
What Is the Average Cost of Health Insurance for a Student in Delaware?
Children are allowed to stay on their parent’s insurance plan until age 26, whether or not they are enrolled in school. Some Delaware colleges and universities may require that students have health insurance coverage. You should check with the admissions office to determine if health insurance coverage is needed.
What Is the Average Cost of Health Insurance for Self-Employed In Delaware?
Those who are self-employed in Delaware must purchase individual or family plans for themselves. This means that the average cost of health insurance for the self-employed in Delaware varies by their needs.
What Is the Average Cost of Health Insurance for Small Business Owners in Delaware?
Small business owners who do not offer group coverage due to minimum contribution (or minimum participation) requirements must purchase individual and family plans for themselves and their families. This means that the average cost of health insurance for small business owners in Delaware varies by their needs. Currently, 23.8% of Private-Sector firms with fewer than 50% of employees offer health insurance for those in Delaware. (Source)
Delaware Health Insurance Costs by Number of Participants
Every year, thousands of Delaware households search for family health insurance. In fact, over two-thirds of the state is made up of family households. For Delaware families, finding a dependable healthcare plan can provide the ultimate peace of mind, which is why it is important to do your research.
What Is the Average Cost of Health Insurance for Families in Delaware?
Health insurance costs vary on the number of family members insured under the policy and their ages. Utilizing the Health Insurance Marketplace Calculator for a family of four (aged 30 and two children aged 10 and 9), the average cost for a silver plan is $505 per month or $6,058 per year. Without financial help, your silver plan could cost $1,604 per month ($19,253 per year). However, using the Average Household Income in Delaware ($87,925.00), you are likely eligible for financial help.
For any marketplace plan in 2021, individual consumers can’t pay more than $8,550 in out-of-pocket medical costs, and families can’t pay more than $17,100. (source)
What Is the Average Cost of Health Insurance for Individuals in Delaware?
According to the most recent figures from the U.S. Department of Health and Human Services, the overall average monthly premium in Delaware in 2020 was $668, with the average premium reduced to $192 per month after tax credit. For the 86% of those who received financial assistance, the average premium was $110 per month after tax credits. (source)
What Is the Average Cost of Health Insurance for a Child in Delaware?
The average cost depends on the policy, location, household income, and family size. Children aged 14 and younger are covered at the same rate. After the age of 14, the child’s premium increases year over year.
Other Types of Delaware Health Insurance Coverage
Catastrophic Health Insurance in Delaware
There is one catastrophic health insurance plan in Delaware: Major Events Blue EPO 8550 – 3 Free PCP Visits. Catastrophic plans have low monthly premiums, but their deductibles are very high. They may be an affordable way to protect yourself from worst-case scenarios, but you pay most routine medical expenses out of pocket. For a 31-year-old, be expected to pay $276.04 a month or $282.94 if you are a smoker. (source)
Short Term or Temporary Health Insurance in Delaware
Until December 1, 2018, Delaware followed the federal regulations, which allowed short-term health insurance plans of up to 12 months. However, the state has since enacted new rules that limit short-term health insurance plans to three months and prohibit renewals.
Individuals are not allowed to enroll in back-to-back short-term plans. Instead, they must wait one year until they can enroll again. Three insurers offer short-term health insurance in Delaware with maximum terms of three months:
- UnitedHealthcare (Golden Rule)
- Companion Life
- Standard Life
Low-Income Health Insurance in Delaware
To qualify for Medicaid, your household income must be under a particular amount depending on the size of your family. There are also specific programs for individuals who meet certain medical or disability tests or qualify due to age or pregnancy. To find out more, visit DMMA Programs & Services.