Delaware Health Insurance: 2021 Coverage Guide
Delaware residents can soon begin buying health insurance! It’s important to get a grasp of how to properly compare your choices before you begin. We have created a guide to make it all easier. Do remember though: to avoid having to wait another year to get insured, make sure to buy during Open Enrollment. Otherwise, you will only be able to buy health insurance outside of this period if you have a qualifying event.
When Is Open Enrollment in Delaware?
November 1, 2020 - December 15, 2020. The coverage begins in January 2021.
How to Get Health Insurance in Delaware
It’s easy to just pick a health insurance plan because it’s priced right, but your monthly premiums aren’t the only cost to consider. How often you see a doctor matters and how much those copays cost matters too. And your deductible -- is it low enough for you to begin getting coverage? Or would you prefer a more affordable HMO? You have options, so make sure you make decisions based on your needs. One way to do this is to go over the number of times you visited doctors, specialists and other care providers. Consider the copays and coinsurance. See if another option may save you money, even if it costs more monthly.
Below, we give you more information on the tier system. Once you decide which tier is right for you, you can begin to compare health insurance companies and health insurance quotes. After you submit a form with us, you’ll see options based on your location. And we’ll connect you with an agent iso you can buy the coverage or ask questions about the plans you’re considering.
What Types of Health Insurance Are Available in Delaware?
HMOs, EPOs, PPOs and POS plans are available in Delaware. Most people choose between an HMO and a PPO. Short-term insurance options and catastrophic plans are available as well. For seniors and the disabled, keep scrolling to learn more about Medicare.
If you’re buying an individual or family plan, you’ll have tier system from which to choose the level of coverage that suits your needs. Bronze covers 60% of costs and costs the least each month; silver covers 70% and is what most people buy; gold covers 80% and is more affordable for people who have regular-to-frequent doctor visits.
Does Health Insurance Cover Pre-existing Conditions?
Marketplace health plans cannot deny anyone health insurance coverage due to pre-existing conditions.
Do I Qualify for a Special Enrollment Period?
Common reasons people qualify for a special enrollment period:
- If you lose a job, quit a job or switch jobs but aren’t given health insurance, you are eligible to buy health insurance. The same goes for new business owners.
- When you turn 26 and can no longer be on your parent’s health plan, you can buy a new plan.
- If a move makes you ineligible for your current coverage, you can buy a new plan.
- When your Cobra extension ends, you may buy a new health plan.
- If you divorce a spouse and lose health insurance coverage, you can buy a new plan.
- When you marry, you can add your spouse to your place or vice versa or you can buy a new plan, together or separately.
- When you have a baby or adopt a child, you can buy health insurance for the child.
- When a spouse or partner passes away and you lose health insurance coverage, you can buy a new plan.
- If a spouse or partner loses health care coverage due to a qualifying reason and you lose your coverage too, you can buy a new plan separately or together.
Is Health Insurance Required in Delaware?
No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.
How Much Is Health Insurance in Delaware?
The average cost of health insurance in Delaware for a 40 year old is about $521 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.
How to Save on Health Insurance in Delaware
The best way to save on health insurance in Delaware is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs
Medicare in Delaware
Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.
How Many People Are on Medicare in Delaware?
21% of Delaware residents are on Medicare.
How Much Is Medicare in Delaware?
If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income. .
Original Medicare vs Medicare Advantage: What’s the Difference?
Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.
How to Get Medicare Coverage in Delaware
If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.
Types of Medicare Plans Available
Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).
How Do I Qualify for Medicare?
To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.
How Can I Save on Medicare in Delaware?
You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.
Delaware State Health System Ranking
Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Delaware Health System are listed below:
- Delaware: Overall Ranking: 24 of 51
- Delaware: Overall Performance: Below U.S. Average
- Delaware: Access and Affordability: 19
- Delaware: Prevention and Treatment: 14
- Delaware: Avoidable Hospital Use and Cost: 34
- Delaware: Healthy Lives: 31
- Delaware: Health Care Disparities: 18
Delaware Health Insurance Coverage
The people of Delaware have different kinds of health insurance while some Delaware residents are not insured at all. See the breakdown below:
- Private coverage: 54%
- Medicaid: 18%
- Medicare: 21%
- Uninsured: 7%
Report: America's Health Insurance Plans
Delaware Health Insurance Companies
- Highmark BCBSD Inc.
- Aetna Health Inc. (Pennsylvania) - Delaware
- Optimum Choice, Inc.
- United Healthcare Services, Inc (Delaware)
- UnitedHealthcare Insurance Company (Delaware)
- Aetna Life Insurance Company (Delaware)
- Cigna Health and Life Insurance Company - Delaware
- Connecticut General Life Insurance Company - Delaware
- Compass Rose Health Plan
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Choosing a higher deductible plan will help to lower your health insurance premium. So this is a smart financial move. As is keeping a small emergency fund to pay for medical expenses until you reach that deductible.
Behavioral health refers to mental health, psychiatric health, marriage and family counseling and addiction treatments. Is it covered by health insurance?
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It’s always a good idea to get acquainted with the way plans are set up and what you’re responsible to pay before open enrollment which takes place in late fall. If you have a qualifying event, like a new job or if you’ve moved, had a baby, gotten divorced or had any life change that affect your coverage, you may be able to buy a new health insurance plan today.
Like auto and homeowners insurance healthcare insurance also has a deductible which needs to be paid before insurance begins to cover expenses. However, healthcare deductibles work a little differently. For instance, your healthcare insurance will pay for some services even before you meet your deductible.
You may be shopping for health insurance because you got a new job, which doesn’t offer health insurance. Some people even prefer to have a health plan separate from their jobs. It’s usually a more expensive option to buy an individual health insurance policy when an employer offers to pay a portion of your premiums each month. However, some people prefer to choose their own insurance company and a plan that fits their needs.