NEW CASTLE (Dec. 14, 2020) – Delawareans have until Tuesday, Dec. 15, to sign up for or change their health coverage for 2021 through Delaware’s Health Insurance Marketplace. For those who enroll by the deadline and pay their first premium, coverage will begin Jan. 1, 2021. State residents can sign up for coverage at www.HealthCare.gov or by calling 1-800-318-2596 (TTY: 1-855-889-4325). Free assistance is available through Westside Family Healthcare at 302-472-8655 in New Castle County and 302-678-2205 in Kent and Sussex counties or email@example.com. State-licensed insurance agents and brokers also can help individuals enroll or re-enroll and help employers update their coverage, at no extra charge. For contact information and other details about Delaware’s Health Insurance Marketplace, go to www.ChooseHealthDE.com.
Individuals who don’t act by Dec. 15 cannot get 2021 coverage unless they qualify for a Special Enrollment Period based on circumstances such as a loss of qualifying health coverage, change of income, birth or adoption of a child, a permanent move, marriage or divorce, or other qualifying factors.
To speed up the enrollment process, Delawareans should have the following documents or information ready:
- Birth dates of those applying for coverage.
- Social Security numbers of those applying for coverage.
- Pay stubs, W-2 forms or other information detailing your family’s income.
- Policy or member numbers for any current health insurance plans.
- Information about any health insurance that is available to you or your family through a job.
- Your log-in and account information if you have previously enrolled on the Health Insurance Marketplace.
All plans on the marketplace offer essential health benefits such as coverage of pre-existing medical conditions, outpatient care (including telehealth services), emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, and pediatric services.
Marketplace plans can’t terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19. Check with your health insurance company for their specific benefits and coverage policy. If you already have coverage through the Health Insurance Marketplace,
the rules in your marketplace plan for treatment of COVID-19 remain the same as for any other viral infection, but your health insurance company may have added benefits. Log in to HealthCare.gov to update your marketplace application if COVID-19 impacts your income or household. You may be able to change your plan if certain situations apply.
Rates on Delaware’s Health Insurance Marketplace have decreased more than 19 percent on average over the past two years. Monthly premiums for 2021 plans in Delaware are 1 percent lower on average than the 2020 plans. Highmark Blue Cross Blue Shield Delaware is the sole health insurer offering plans on Delaware’s Health Insurance Marketplace. Enrollees can choose from among 12 Highmark plans for 2021 or they will be re-enrolled automatically in a plan similar to their current one.
About 86 percent of last year’s enrollees in Delaware qualified for federal tax credits, which help reduce the cost of the monthly premium. Tax credits are available for those whose household income is between 138 percent and 400 percent of the Federal Poverty Level. For 2021 coverage, that’s between $17,609 and $51,040 for an individual, or between $36,156 and $104,800 for a family of four.
Plans on the marketplace are spread among metal-level categories – bronze, silver, gold and platinum – and are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums but high costs when you need care; gold plans have high premiums but lower costs when you need care. In a silver plan, the insurer pays about 70 percent of medical costs and the consumer pays about 30 percent. 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.
“Catastrophic” plans are also available to some people. Catastrophic plans have low monthly premiums and very high deductibles. They may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured. But you pay most routine medical expenses yourself.
For 2021, Highmark offers 12 plans for individuals and families – three gold plans, three silver, three bronze, two platinum, and one catastrophic. Two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – offer a collective 11 stand-alone dental plans on the marketplace, six with a low actuarial level (70 percent) and five with a high actuarial level (85 percent).
Consumers who pick silver health care plans might qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 29 percent of current enrollees qualify for cost-sharing reductions.
Through Nov. 28, 7,748 Delawareans had signed up for 2021 coverage through the marketplace, an increase of 5.7% from a similar period last year.
Last year, nearly 24,000 people signed up or renewed their coverage during open enrollment, including about 70 percent during the final three weeks. Open enrollment began Nov. 1.
“I urge Delawareans who need coverage through the Health Insurance Marketplace to take action now to enroll,” said Department of Health and Social Services (DHSS) Secretary Molly Magarik. “Go to HealthCare.gov or take advantage of our local resources to see the 2021 plans and find out if you qualify for financial assistance.”
In addition to the Health Insurance Marketplace, some Delawareans might be eligible for coverage through Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans have received coverage under the Medicaid expansion. To be screened for eligibility or to apply for Medicaid benefits, go to Delaware ASSIST.