Delaware Health Insurance Exchange Options and Costs Explained

Delaware's health insurance exchange offers a range of options to suit different needs and budgets.

There are two main types of plans available: Silver and Gold. The Silver plan has a lower premium but higher out-of-pocket costs, while the Gold plan has a higher premium but lower out-of-pocket costs.

The exchange also offers a Bronze plan, which has the lowest premium but the highest out-of-pocket costs. This plan is best for people who are relatively healthy and don't anticipate needing many medical services.

Silver plans have a lower premium, with a monthly cost ranging from $350 to $500 for a 40-year-old non-smoker.

Delaware's Marketplace saw a significant record high in enrollment for 2024 coverage, with 44,842 people selecting private health plans.

This is a notable increase from the previous year's record high of 34,742 people who chose private plans through the Delaware Marketplace.

The enrollment growth in 2024 can be attributed in part to the "unwinding" of the pandemic-era continuous coverage rule for Medicaid, which allowed nearly 15,000 people in Delaware to transition from Medicaid to a Marketplace plan by April 2024.

Delaware's Medicaid program has undergone changes, with a focus on expansion and enrollment growth.

The state's Medicaid enrollment has likely been impacted by the transition of nearly 15,000 people from Medicaid to a Marketplace plan.

To enroll in a Delaware Marketplace plan, you can visit HealthCare.gov, use the state-run Choose Health Delaware website, or work with an insurance agent or broker.

You must live in Delaware and be lawfully present in the United States to sign up for private health coverage through the Marketplace. Incarceration and enrollment in Medicare are also disqualifying factors.

To qualify for financial assistance, you must not be eligible for employer-sponsored health coverage, Medicaid, or CHIP. You must also file a joint tax return with your spouse (with limited exceptions) and not be claimed as a tax dependent.

Eligibility for subsidies depends on your household income and the cost of the second-lowest-cost Silver plan in your area. In 2024, more than nine out of ten Marketplace enrollees in Delaware received premium subsidies, which reduced their average health insurance premiums by $588/month.

The reinsurance program in Delaware has helped keep full-price premiums lower, and cost-sharing reductions are available for those with household incomes no more than 250% of the federal poverty level, selecting a Silver-level plan.

Here are the basic parameters for eligibility for financial assistance in the Marketplace:

You can choose from health insurance plans offered to individuals and groups by private insurance companies.

As of early 2024, more than nine out of ten Marketplace enrollees in Delaware were receiving premium subsidies, which reduced their average health insurance premiums by $588/month.

The average Delaware Marketplace enrollee’s premium was about $188/month, including those who weren’t eligible for a subsidy. This is thanks in part to the state's reinsurance program, which has helped keep full-price premiums lower over the last few years.

Cost-sharing reductions are also available for those with household incomes no more than 250% of the federal poverty level, resulting in lower out-of-pocket costs, including deductibles.

If you're looking for health insurance in Delaware, you've got four metal plans to choose from: Bronze, Silver, Gold, and Platinum.

Each metal plan has a different balance of what your insurance company pays and what you pay out-of-pocket. The metal plans are based on the average amount of healthcare costs the plan will cover.

Here's a breakdown of the metal plans:

All insurers participating in the federal or a state healthcare exchange must offer, at minimum, Silver and Gold plans.

Marketplace insurance premiums are on the rise in Delaware, with a weighted average overall rate change of about 8.4% for 2025 individual/family health plans.

Aetna Health is proposing a 11.7% increase, while AmeriHealth Caritas is proposing a 6.05% increase, and Highmark BCBSD is proposing a 9% increase. Celtic, on the other hand, is proposing a -14% decrease.

Here's a breakdown of the market share for each carrier:

This variation in rate changes is due to the different market shares of each carrier. Highmark, with its large market share, had its rates approved as filed, contributing to the overall 8.4% increase.

It's worth noting that average rate changes are calculated based on full-price premiums, which most enrollees don't pay due to premium subsidies. As of 2024, over nine out of ten Delaware Marketplace enrollees received subsidies that reduced their monthly payments.

Here's a look at how average full-price premiums have changed in Delaware over time:

Finding affordable health insurance in Delaware can be a challenge, but there are several options available. As of early 2024, more than nine out of ten Marketplace enrollees in Delaware were receiving premium subsidies that reduced their average health insurance premiums by $588/month.

You may be eligible for these subsidies if you meet the eligibility requirements and enroll in Marketplace coverage. The subsidies can significantly lower your premium payments each month, making health insurance more affordable.

Delaware's reinsurance program has also helped keep full-price premiums lower than they would otherwise have been over the last few years. This means that even if you're not eligible for a subsidy, your premium payments may be lower than they would be without the program.

If your household income is no more than 250% of the federal poverty level, you may also be eligible for cost-sharing reductions (CSR). These subsidies can result in lower out-of-pocket costs, including deductibles, and more than a quarter of Delaware's Marketplace enrollees were receiving CSR benefits as of 2024.

You can also check if you're eligible for Medicaid or CHIP (Delaware Healthy Children), which can provide free or low-cost health coverage depending on your income and circumstances.

Here are some key facts about Delaware's health insurance market:

You can buy Marketplace health insurance in Delaware if you live in the state and are lawfully present in the United States. To qualify for subsidies, you must not be eligible for affordable health coverage offered by an employer, Medicaid, or CHIP.

To enroll in a Delaware Marketplace plan, you can visit HealthCare.gov, use the state-run Choose Health Delaware website, or purchase coverage with the help of an insurance agent or broker.

The Affordable Care Act created income-based subsidies that can help lower your premium payments each month. As of early 2024, more than nine out of ten Marketplace enrollees in Delaware were receiving premium subsidies.

Four insurers offer individual/family coverage through the Delaware Marketplace for 2024, including one newcomer, Celtic. All four have filed rates and plans for 2025.

During the open enrollment period for 2024 coverage, 44,842 people enrolled in private health plans through the Delaware Marketplace, a record high. This growth is partially due to the "unwinding" of the pandemic-era continuous coverage rule for Medicaid.

To find affordable health insurance in Delaware, consider the following options:

You can reach HealthCare.gov's call center by dialing 1-800-318-2596 (TTY: 1-855-889-4325) for assistance with enrolling in a Marketplace plan or learning more about your options.