Free one-on-one counseling saved Delawareans $3.2M in 2025

DOVER, DE (October 15, 2026) – As Medicare Open Enrollment approaches, the Delaware Department of Insurance and its Medicare Assistance Bureau (DMAB) are sharing their annual consumer information update. From October 15 to December 7, consumers can join, switch, or drop a Medicare Prescription Drug Plan (Part D) or Medicare Advantage Plan. DMAB’s free, confidential, unbiased one-on-one assistance can help residents determine if making a coverage change is the right choice.

“For the third consecutive year, the Medicare Assistance Bureau’s impressive results, saving Delawareans nearly $3.2 million in 2025, highlights the obvious and continuous need for unbiased, expert guidance during Open Enrollment. With a variety of options, annual plan changes, and federal cuts, it remains essential for beneficiaries to take advantage of free services like one-on-one counseling to ensure their coverage meets their health and financial needs” said Insurance Commissioner Trinidad Navarro.

Federal changes are important to keep in mind during enrollment, but the Department also urges consumers to be aware of local changes. Particular attention should be paid to the consumers’ access to their preferred health providers.

In addition to scheduled phone and virtual appointments, DMAB is offering appointments at all three Department of Insurance offices from October 20 to November 20:

New Castle Co.: 503 Carr Road

St. 303, Wilmington, DE 19809

Appointments available on:

October 21 & 29, November 4, 12, & 18.

Kent Co.: 1351 W North Street

St. 101, Dover, DE 19904

Appointments available on:

October 20 & 27, November 2, 9, & 17.

 Sussex Co.: 28 The Circle

St. 1, Georgetown, DE 19947

Appointments available on: October 22 & 29, November 2, 12, & 19.

Appointments for in-person services are required; walk-ins cannot be accommodated. For more information or to schedule your appointment, please call DMAB at 1(800) 336-9500 or (302) 674-7364.

Top Tips for a Successful Medicare Open Enrollment

• Know that enrolling in a Medicare Advantage plan means it becomes your primary coverage. Original Medicare will no longer pay for services. You will receive a new ID card from the new plan and should store your Original Medicare card in a safe place.
• When moving from Original Medicare to a Medicare Advantage plan, be prepared to pay both a monthly Medicare Advantage premium and a monthly Medicare Part B premium.
• Medicare Advantage plans do not automatically give you “more money in your Social Security check every month.” To qualify, you must be eligible for the Medicare Savings Program by having an income below Medicaid limits.
• Check that additional benefits, like dental, vision, hearing, fitness, or over-the-counter medications are actually accessible if offered. Some network providers of these services may be farther away than anticipated, including in neighboring states, so only factor them into your decision if you feel they are usable.
• Know that premium costs aren’t the only out-of-pocket costs you may face. Medicare Advantage plans may have co-pays or cost-sharing that differ from Original Medicare.
• Call your preferred healthcare providers and facilities to understand if your prospective plan contracts with them. You may experience additional out-of-pocket expenses, service denial, or referral requirements if providers are considered out of network.
• Check if a prospective plan is a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO). HMO plans require healthcare to be completed by a provider contracted with the plan’s network, otherwise the consumer will need a referral. PPO plans have both in-network and out of network providers and facilities, with consumer costs differing based on the network. HMO and PPO plans are not Medicare Supplement Plans and may have out-of-pocket costs each visit.
• Check if the plan provides Prescription Drug (Part D) coverage that meets your needs.
• Be aware that in most cases, enrollment locks a person into a plan for the full upcoming calendar year.
• Scrutinize any contact carefully during Medicare Open Enrollment to ensure it is from a known, credible source. Commercials, cold calls, and other contact may be scams or can provide deliberately misleading information about a plan.

Important Reminder- Federal Updates

When selecting 2027 coverage, the Medicare Prescription Payment Plan works with a beneficiary’s current drug coverage to help manage out of-pocket Medicare Part D drug costs by spreading them across the calendar year.

• Anyone with a Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage) can voluntarily use this payment option.
• If this payment option is selected, consumers will continue to pay their plan premium (if they have one) each month and will get a bill from the health or drug plan to pay for the prescription drugs instead of paying the pharmacy.
• There’s no cost to participate in the Medicare Prescription Payment Plan.
• In 2027 Part D enrollees’ out-of-pocket drug costs will be capped at $2,400. This amount will be indexed to rise each year at the rate of growth in per capita Part D costs.
• The 2027 negotiated prices for medications is available at Fact Sheet: Medicare Drug Price Negotiation Program June 2027

Replacement Medicare Beneficiary Cards

Approximately 1.3 million Medicare beneficiaries nationwide began receiving replacement Medicare cards in March 2026 after their personal information was potentially compromised in a recent data breach that led to fraudulent activity. The newly issued cards include updated Medicare Beneficiary Identifiers and have been mailed directly to affected individuals across the country. While this effort is unrelated to the 2018 CMS initiative that removed Social Security numbers from all Medicare cards, beneficiaries should remain vigilant against scams that often arise during periods of heightened outreach.

Medicare beneficiaries remember:

• You can call 1-800-Medicare or access your Medicare.gov account to confirm that you have been issued a new card
• Medicare cards are free
• Medicare cards are paper and never plastic
• Medicare will not contact beneficiaries by phone to issue a new card
• Medicare cards do not require activation

Examples of Medicare fraud (source Medicare.gov):

• A provider that bills Medicare for services or supplies they never gave you, like charging you for a visit you never had, or a back brace you never got.
• A provider that charges Medicare twice for a service or item that you only got once.
• A person who steals your Medicare Number or card and uses it to submit fraudulent claims in your name.
• A company that offers you a Medicare drug plan that Medicare hasn’t approved.
• A person comes to your house or calls you, offering to sign you up for hospice care if you give them your Medicare Number.

Individuals can confirm whether they have been issued a new card by calling 1‑800‑Medicare or checking their Medicare.gov account.

Medicare fraudsters are getting smarter. If you have suspicion of Medicare Fraud, please connect with the Senior Medicare Patrol at (800) 223-9074 ext. 2.

The “Birthday Rule” Special Enrollment Period

Beginning January 1, 2026, existing Medicare Supplement (Medigap) policyholders in Delaware have the right to a Special Enrollment Period (SEP) annually.

• For existing Medicare Supplement Policyholders, the law requires a new Special Enrollment Period where policyholders can change to a different Medicare Supplement (Medigap) plan with equal or lesser benefits, and carriers are required to approve the coverage without consideration of medical history. This period is specific to the individual, beginning 30 days before the individual’s birthday, and remaining open for 30 days after their birthday. Carriers must notify policyholders of their right to utilize this opportunity.
• For existing Medicare Advantage Policyholders, the new law, better ensures that those enrolled in a Medicare Advantage (Part C) can cancel their coverage and return to Original Medicare with a Medigap plan during federally designated enrollment windows, currently October 15-December 7, and January 1-March 31. Because this coverage is very different from Medicare Advantage offerings, Medigap carriers can consider medical history and may apply waiting periods for pre-existing conditions.

About the Delaware Medicare Assistance Bureau

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1(800) 336-9500 or (302) 674-7364 to set up a free, confidential session or visit the DMAB website for important educational resources. Counselors can assist with Medicare, Medicare Advantage, Medigap (Medicare Supplement Insurance), long-term care insurance, billing issues, prescription savings, and much more.

Medicare Advantage plans are regulated at the federal level, though the Insurance Commissioner and his peers are advocating for increased state regulatory authority.

Be aware of non-compliant alternative health plans

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