Many Delaware residents obtain health insurance by signing up for Medicare. Medicare is a federal program that offers health insurance for people who are at least 65 years old, although those under 65 with certain disabilities may qualify as well. The Delaware state government also offers various assistance programs to assist Medicare beneficiaries.
Delaware Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2023 Medicare trends in Delaware:
- Currently, 226,711 Delawareans are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased from $14.25 in 2022 to $12.66 in 2023.
- There are 33 Medicare Advantage plans available in Delaware.
- 100% of Delawareans with Medicare have a Medicare Advantage plan.
- There are 22 different Medicare prescription drug plans offered in Delaware for 2023.
- The lowest monthly premium for a Medicare prescription drug plan is $7.60.
Medicare Offered in Delaware
Medicare is a government-sponsored health care program that offers financial assistance to American citizens ages 65 and over or those with disabilities.
The primary coverage comes from Original Medicare, Part A, and Part B. Medicare Part A covers inpatient care in hospitals, critical access hospitals, and skilled nursing facilities. Hospice care and some types of home health care are included as well.
Medicare Part B covers doctor services and outpatient hospital care, and some health care services that are not covered in Medicare Part A. These services include physical therapists and the use of durable medical supplies.
Medicare Part A does not typically require premiums, although in some cases, it may be required. Medicare Part B does require premiums based on the beneficiary’s income. Both Medicare Part A and Part B may also require the beneficiary to pay for out-of-pocket expenses. These include deductibles, copays, and coinsurance costs.
Also known as Medicare Part C, these Medicare Advantage Plans can take the place of Original Medicare. These are also available from private carriers with approval from Medicare. These plans provide the primary benefits included in Original Medicare, plus additional benefits such as coverage for health care services that are not covered by Medicare Part A and Part B.
In 2023, companies offering Medicare Advantage plans in the state include:
- Aetna Medicare
- Highmark Inc.
These Medicare Advantage plans are based on medicare.gov and their overall rating of plan quality and performance, found here.
Medicare Supplement Plans
Medicare authorizes some private health insurance companies in Delaware to provide supplemental plans for Original Medicare. These plans, also called Medigap, can cover extra health care services that Original Medicare does not include. Plans may also cover the costs of deductibles, coinsurance, and copays.
Delaware Medicare Enrollment
Delawareans are eligible for Medicare if they are a U.S. citizen and above 65 years old, or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool to see if you qualify.
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Starts November 1st
- Ends January 15th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts January 1st
- Ends March 31st
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
Delaware Enrollment Tips & Advice
Medicare and health insurance can be complicated. The state of Delaware acknowledges this problem by running the State Health Insurance Assistance Program (SHIP).
How Do I Enroll in a Medicare Plan?
If you’re not sure about your Medicare coverage, talk to one of our licensed agents so that they can find the plan best suited for you. We’ll find a plan that suits your needs and your budget.