NEW CASTLE – Delawareans seeking coverage for 2024 will find more choice in insurers and plans than ever before on the Health Insurance Marketplace in the 11th year of open enrollment.

The marketplace’s open enrollment period started today, Nov. 1, and ends Jan. 15, 2024. Consumers can renew existing coverage or sign up for a new plan at www.HealthCare.gov. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will be effective Jan. 1.

Individuals who don’t act by Jan. 15, 2024, cannot get coverage for 2024 unless they qualify for a Special Enrollment Period based on circumstances such as a loss of qualifying health coverage, change of income, becoming a parent, or other qualifying factors.

Delawareans have four insurers to choose from this year, one more than the year prior, and a total of 55 plans compared to 30 plans last year. Insurance Commissioner Trinidad Navarro announced in June that a new insurer – Celtic Insurance Company Ambetter Health of Delaware – would join Highmark Blue Cross Blue Shield Delaware, AmeriHealth Caritas, and Aetna CVS Health in offering coverage on the marketplace for 2024.

“All Delaware families need access to affordable, quality health care,” said Governor John Carney. “This year, individuals have the most options available since the marketplace began 11 years ago. With four insurers and 55 plans, I encourage all Delawareans to closely consider those selections, especially small-business owners, independent contractors, and individuals who don’t have access to health insurance through an employer. Please make your health a priority.”

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – 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% of medical costs and the consumer pays about 30%. Consumers who pick silver health care plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance.

For 2024:

• Aetna CVS Health will offer six plans – two gold and four silver.
• AmeriHealth Caritas will offer seven plans – one gold, three silver, one bronze and two expanded bronze.
• Celtic/Ambetter Health of Delaware will offer 24 plans – eight gold, eight silver, and eight expanded bronze.
• Highmark will offer 18 plans – three platinum, six gold, three silver, five bronze, and one catastrophic.
• Two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a collective 12 stand-alone dental plans on the marketplace seven with a low actuarial level (pay less monthly, but more when you get dental services) and five with a high actuarial level (pay more monthly, but less when you get dental care). Delta Dental will offer two plans, one high and one low, while Dominion Dental will offer 10 plans, four high and six low.

“As recently as the 2022 plan year, Delawareans had just one insurer and 12 plan options to choose from. This Open Enrollment, you’ll find four carriers and more than 50 plan options. Improving health care accessibility and affordability across our state is one of my top priorities, and I’m proud that our work has led both options and enrollments to an all-time high,” said Insurance Commissioner Trinidad Navarro. “I encourage you to contact your trusted navigators so you can find the right plan for the coming year.”

All plans on the marketplace offer essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, pediatric services, birth control, and breastfeeding coverage. In addition, coverage cannot be terminated due to a change in health status.

“Providing access to high-quality, affordable health care is one of the ways that we can improve the overall health and well-being of Delawareans,” said Department of Health and Social Services Secretary Josette Manning. “We are grateful that this open enrollment period offers the highest number of plan options in the marketplace’s 11-year history and appreciate the stability the Biden administration, our congressional delegation, the Insurance Commissioner, and our own reinsurance program have all brought to the marketplace. I encourage everyone to visit HealthCare.gov for a look at the affordability of the available plans and how the coverage can fit into your family’s budget.”

“Health care is a right, not just a privilege for the few,’ said U.S. Department of Health and Human Services Acting Region 3 Director Melissa Herd. “The health insurance marketplace offers high quality, affordable health coverage options for Delawareans.”

Assistance for Delaware enrollees

Consumers can go to HealthCare.gov or CuidadodeSalud.gov now to explore their options for 2024 coverage, and they can enroll anytime between Nov. 1 and Jan. 15, 2024.

Delawareans who need help enrolling in coverage will have access to free in-person assistance from federally funded and trained specialists at Westside Family Healthcare (statewide) and Quality Insights, Inc., (New Castle and Sussex counties) and by certified application counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown. Westside and Quality Insights each received increased federal funding for navigators to help people enroll for coverage.

State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage, at no extra charge.

For more information, go to www.ChooseHealthDE.com. Delawareans can enroll in marketplace coverage at HealthCare.gov or by calling 1-800-318-2596 (TTY: 1-855-889-4325).

Support from Congressional Delegation

Delaware’s U.S. senators and representative urged uninsured Delawareans to find out what’s available for them on the marketplace.

“Open enrollment begins today, and quality, affordable health care coverage is available to everyone on the health insurance marketplace,” said U.S. Senator Tom Carper. “Health insurance navigators are available at no cost to help Delawareans review plans and pick the best one for themselves and their families, and I encourage Delawareans to get covered without delay.”

“For 11 years, the Affordable Care Act has provided quality, affordable health care coverage for Delawareans,” said U.S. Senator Chris Coons. “I urge Delawareans to explore open enrollment, find the plan that works best for them, and gain the peace of mind that comes with ensuring that they and their families are covered.”

“The pandemic showed us just how critical access to quality, affordable health care is, and I am committed to ensuring that Delawareans can get the care they deserve,” said Rep. Lisa Blunt Rochester, member of the House Health Subcommittee. “As we mark the beginning of the open enrollment period, I want to encourage Delawareans to utilize HealthCare.gov to find an affordable health care plan that works for them and their families. Don’t wait to get covered – open enrollment ends on January 15th!”

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage though Delaware’s expanded Medicaid program, which is open year-round. To be screened for or to apply for Medicaid benefits, visit Delaware ASSIST.

Congress sets April 1, 2023, as Medicaid renewal start date; Members should verify contact information with DHSS 

The Delaware Department of Health and Social Services (DHSS) will resume the standard eligibility renewal process for Medicaid and CHIP recipients starting April 1, 2023, as required by federal law. Annual renewals have not been required since March 2020 during the federal Public Health Emergency designation. Federal legislation, signed into law on December 29, 2022, set a specific date to resume renewals, regardless of when the Public Health Emergency ends.  

As of January 2023, approximately 310,000 Delawareans were enrolled in Medicaid. Once annual renewals begin, there will be Delawareans who were receiving continuous coverage due to the Public Health Emergency that will no longer be eligible for Medicaid. DHSS estimates 40,000 to 50,000 Delaware residents may no longer qualify for Medicaid or CHIP, also known as the Delaware Healthy Children Program, and may be disenrolled.  

“Over the past three years, the state’s public assistance programs have been a crucial safety net for so many Delawareans,” said Molly Magarik, Secretary of the Delaware Department of Health and Social Services (DHSS). “As we prepare for the monumental task of restarting eligibility renewals again, our goal is to ensure Medicaid members who continue to be eligible stay enrolled and that those who are determined to no longer be eligible get connected to affordable coverage.”  

The most important thing Medicaid and CHIP members can do right now is to update their mailing address, email and phone numbers with DMMA and sign up for electronic notifications. Contact the Change Report Center at (302) 571-4900, Option 2 or send changes via fax to (302) 571-4901. Changes and notification preferences can also be made at ASSIST Self Service, https://assist.dhss.delaware.gov/. 

“There are many Delaware residents who qualified for Medicaid coverage for the first time during the Public Health Emergency who have never had to complete an annual renewal before,” said Steven Costantino, Director of Health Care Reform for DHSS. “This is why it is critical that we have the most accurate information available for each member, and that individuals on Medicaid watch out for communication to avoid a potential disruption in coverage.”   

Between April 2023 and April 2024, DHSS will review every member’s eligibility and, where approved by state or federal rules, use available data sources to automatically renew members. If DHSS cannot auto-renew a person’s coverage using available and approved data sources, the member will receive a renewal packet by mail or a notification by email, depending on the selected preference.  

Delaware Medicaid and its Managed Care Organization partners will also use texts, email, and social media when available to enhance outreach efforts. A member will be able to complete the renewal packet through a variety of ways: Online, by phone, by mail, by fax, or at any Division of Social Services (DSS) office located within the Delaware State Service Centers. 

Health care providers and others who provide services to members can help by reminding their Medicaid members to look for and complete their Medicaid renewals this year and to encourage them to start exploring other coverage options if they believe they will no longer qualify for their current coverage. 

To help individuals who are no longer eligible for Medicaid coverage, the federal government has authorized a Special Enrollment Period for the Health Insurance Marketplace. Individuals who lose their coverage through Medicaid and CHIP any time between March 31, 2023, and July 31, 2024, will be eligible for a marketplace special enrollment period. After a person is determined eligible for the marketplace, they will have 60 days to choose a plan, and their coverage will start the first day of the month after the plan is selected.  

Many enrollees can find plans on the Health Insurance Marketplace that cost less than $10 a month. Plans cover services like prescription drugs, doctor visits, urgent care, hospital visits, and more. 

Assistance enrolling in the Delaware Health Insurance Marketplace is available from certified Health Insurance Marketplace Navigator teams at Westside Family Healthcare and Quality Insights. To be connected to a trained Navigator, call:  

• Westside Family Healthcare: New Castle County: 302-472-8655, Kent or Sussex counties: 302-678-2205 
• Quality Insights: 1-844-238-1189 

For more information, visit de.gov/medicaidrenewals. 

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Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

NEW CASTLE (Jan. 27, 2023) – With more choice in plans than ever before, enhanced federal subsidies, and Delaware’s reinsurance program keeping the cost of monthly premiums relatively steady, enrollment on Delaware’s Health Insurance Marketplace for 2023 again set an all-time high, increasing 8% over the open enrollment total for 2022.

During Delaware’s 10th open enrollment period, which began on Nov. 1, 2022, and ended Jan. 15, 2023, a total of 34,742 Delawareans enrolled for health insurance on HealthCare.gov. During the previous year, sign-ups during the open enrollment period totaled 32,113. For those who enrolled by Dec. 15, 2022, and paid their first premium, coverage began Jan. 1, 2023. For those who enrolled by Jan. 15, 2023, and paid their first premium, coverage will begin Feb. 1, 2023.

“All Delaware families need access to affordable, quality health care,” said Governor John Carney. “This year, we celebrated the 10th year of open enrollment on Delaware’s Health Insurance Marketplace with more plans to choose from, helping to make coverage even more affordable. With record-breaking enrollment numbers, we know Delawareans are prioritizing their health. Thank you to all the community navigators and health advocates who helped us reach this milestone.”

“Marketplace plans play a crucial role in improving access to high-quality and affordable health care,” said Department of Health and Social Services Secretary Molly Magarik. “I am thrilled to see a record number of Delawareans taking advantage of the many affordable options offered through Delaware’s Health Insurance Marketplace, and we are grateful to the community navigators and application counselors who worked hard during open enrollment to help individuals and families find the plan that was right for them.”

This year, Delawareans were able to choose from three insurers, compared to only one last year, and a total of 30 plans, the highest total in the 10 years of the marketplace. Insurance Commissioner Trinidad Navarro announced in June 2022 that two new insurers – AmeriHealth Caritas (four plans) and Aetna CVS Health (nine plans) – would join Highmark Blue Cross Blue Shield Delaware (17 plan options) in offering coverage on the marketplace for 2023.

All plans offer essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, pediatric services, birth control and breastfeeding coverage, and COVID-19 vaccines, including the updated bivalent booster. In addition, coverage cannot be terminated due to a change in health status, including diagnosis or treatment of COVID-19.

“Judging from the final enrollment numbers, it is clear that Delaware consumers appreciate being able to choose from a variety of plans at prices that are affordable,” said Insurance Commissioner Trinidad Navarro. “Affordable, high quality health care is critical to Delaware consumers, and market stability and increased competition are key to helping provide consumer-friendly health insurance options in Delaware.”

The overall stability of Delaware’s Health Insurance Marketplace reflects continued federal approval of Delaware’s reinsurance program. The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers’ claims costs are lower, the insurers can reduce the cost of premiums or limit increases.

In 2021, the Biden administration made expanding access to health insurance and affordability a priority through the American Rescue Plan Act, which increased tax credits and expanded subsidies into the middle class. This year, the passage of the Inflation Reduction Act continued those enhanced benefits through 2025. For instance, a family of four (both parents in their 40s) making $50,000 are eligible for a credit of roughly $16,000, compared with $14,300 previously.

“Over a decade ago, when crafting the Affordable Care Act, we had one goal in mind: to make affordable, quality health care available to all Americans – and the marketplaces were vital to reaching that goal,” said U.S. Senator Tom Carper. “Now, we are seeing enrollment numbers go up year after year, and more Delawareans are able to get preventative screenings at no cost and get access to health care services previously not afforded to them. I thank the hard-working navigators for their work enrolling uninsured Delawareans in plans that work best for their families, and I look forward to continuing our work to drive down health care costs for all Americans.”

“Over the past decade, the Affordable Care Act has made affordable, quality health care coverage a reality for millions of Americans,” said U.S. Senator Chris Coons. “I’m proud to have worked with President Biden and my colleagues to strengthen the ACA in the American Rescue Plan and Inflation Reduction Act, further driving down costs for families, and am excited to see record numbers of Delawareans benefitting from this landmark legislation this year.”

“Ensuring that Delawareans have accessible, affordable, high-quality health care is critical to the health and well-being of communities across the First State,” said U.S. Rep. Lisa Blunt Rochester. “I am encouraged to see that this year a record number of Delawareans signed up for health care coverage through Delaware’s marketplace. This would not have been possible without the hard work of DHSS, Insurance Commissioner Navarro, and Community Navigators such as Westside Family Healthcare and Quality Insights that were on the ground guiding Delawareans and providing the resources they needed to find plans that fit them and their families best. I am grateful to be a partner in keeping Delaware healthy and remain as committed as ever in advocating for more affordable, accessible, high-quality health care for Delawareans in the 118th Congress.”

Delawareans who need help enrolling in coverage have access to free in-person assistance from federally funded and trained specialists at Westside Family Healthcare (statewide) and Quality

Insights, Inc., (New Castle and Sussex counties) and by certified application counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown. Westside and Quality Insights each received increased federal funding for navigators to help people enroll for coverage.

“As a Federally Qualified Health Center, Westside understands how health insurance coverage reduces barriers to routine care and can save lives” said Lolita Lopez, President & CEO of Westside Family Healthcare. “Westside has provided enrollment assistance in the Health Insurance Marketplace since 2013, and we are thrilled with the record-breaking results during this open enrollment period. We commend the work of our state partners to reduce premium costs making coverage on the Delaware Health Insurance Marketplace more affordable than ever before.”

“We are very pleased to see a continued increase in those taking advantage of the affordable coverage offered through the Marketplace,” said Shanen Wright, Program Director of Quality Insights’ Navigator program. “And although 2023 open enrollment has concluded, we are available year-around to help Delaware residents learn more about their coverage options for 2024, or to enroll this year for those who become newly eligible through a qualifying event. We encourage anyone in need of information or assistance to reach out at qualityinsights.org/navigator or 1-844-238-1189.”

With the end of open enrollment on the health insurance marketplace, Delawareans can enroll for coverage if they experience a life event that qualifies them for a special enrollment period. Among the many qualifying life events are birth or adoption of a child, a permanent move, loss of other coverage through a job, and marriage or divorce. Visit HealthCare.gov/screener to see if you qualify.

In addition to the health insurance marketplace, some Delawareans might be eligible for coverage through Delaware’s Medicaid program, which is open year-round. To be screened for eligibility or to apply for Medicaid benefits, go to Delaware ASSIST.

NEW CASTLE (Feb. 3, 2022) – With strong public demand for coverage during the COVID-19 pandemic, enhanced federal subsidies, and Delaware’s reinsurance program keeping the cost of monthly premiums relatively steady, enrollment on Delaware’s Health Insurance Marketplace for 2022 set an all-time high, increasing 26.8% over the open enrollment total for 2021.

During Delaware’s ninth open enrollment period, which began on Nov. 1, 2021, and ended Jan. 15, 2022, a total of 32,113 Delawareans enrolled for health insurance on HealthCare.gov. During the previous year, sign-ups during the open enrollment period totaled 25,320.

For those who enrolled by Dec. 15, 2021, and paid their first premium, coverage began Jan. 1, 2022. For those who enrolled by Jan. 15, 2022, and paid their first premium, coverage began Feb. 1, 2022.

“We are pleased that an increasing number of Delawareans decided to buy coverage through Delaware’s Health Insurance Marketplace,” Governor John Carney said. “Being able to provide access to high-quality, affordable health care is one of the cornerstones of the Affordable Care Act. We are grateful to the Biden administration and the Congressional Delegation for providing enhanced federal subsidies on the marketplace plans to help improve access to health insurance for Delawareans.”

The Biden administration used American Rescue Plan Act funds to increase tax credits and expand subsidies further into the middle class. For instance, a family of four (both parents in their 40s) making $50,000 were eligible for a tax credit of roughly $16,500, compared with $14,300 previously. The vast majority of enrollees on Delaware’s marketplace were eligible for financial assistance, which helps to reduce the cost of monthly premiums and/or deductibles, and also lowers out-of-pocket health care costs.

“As we begin the recovery from COVID-19, providing this crucial access to high-quality, affordable health care is another way we will improve the overall health and well-being of Delawareans,” said Department of Health and Social Services (DHSS) Secretary Molly Magarik. “We urge everyone to use their coverage to get caught up on necessary screenings, vaccines and annual check-ups, and to work with health care providers to manage chronic health conditions, address emerging health care needs, and to improve their overall physical and behavioral health.”

Delawareans were able to choose from 13 health plans on the health insurance marketplace through Highmark Blue Cross Blue Shield Delaware. Two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – offer stand-alone dental plans on the marketplace. Monthly premiums for the 2022 health plans were about 3% higher on average than the 2021 plans due in part to increases in prescription costs and an anticipation of elective procedures resuming after being postponed due to the pandemic. This year’s single-digit increase in premiums follows decreases the previous two enrollment years, totaling more than 19%. Federal subsidies cut consumer costs across the country by an average of 40%, negating the small increase in base rates.

“Delaware’s Health Insurance Marketplace has seen great success in reducing our uninsured population – but the fact is that the pandemic increased it due to loss of employer-provided coverage. With the federal subsidies expanding, the 2021 Special Enrollment Period, and an extended enrollment period for 2022 plans, we were able to reach many of those in need of comprehensive coverage at an affordable price,” said Insurance Commissioner Trinidad Navarro. “It is my hope that Congress will not let the enhanced assistance expire at the end of the year so we can continue to serve those economically disadvantaged and middle-income families who have been hit hardest by the financial impacts of the pandemic.”

In June 2019, Governor Carney signed enabling legislation to create a reinsurance program in Delaware, and in August 2019, the Centers for Medicare and Medicaid Services (CMS) authorized the program. The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers’ claims costs are lower, the insurers can reduce the cost of premiums or limit increases. Delaware’s reinsurance program, which began Jan. 1, 2020, is administered by the Delaware Health Care Commission.

In September 2021, the Biden administration awarded Delaware $10.8 million through CMS to improve access to affordable, comprehensive health insurance coverage through its section 1332 state-based reinsurance waiver.

With the end of open enrollment on the health insurance marketplace, Delawareans can enroll for coverage only if they experience a life event that qualifies them for a special enrollment period. Among the many qualifying life events are birth or adoption of a child, a permanent move, loss of other coverage through a job, and marriage or divorce. Visit HealthCare.gov/screener/ to see if you qualify.

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.

NEW CASTLE (Nov. 1, 2021) – As the COVID-19 pandemic continues, Delawareans seeking health insurance, especially those who have lost coverage, can shop for 2022 coverage through the Health Insurance Marketplace. Enhanced federal subsidies, which began earlier this year under the Biden administration, will continue for 2022. The subsidies have helped to reduce consumer costs by as much as 40%.

The marketplace’s ninth open enrollment period started today, Nov. 1, and ends Saturday, Jan 15, 2022, at www.HealthCare.gov, where consumers can renew existing coverage or sign up for a new plan. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will take effect Jan. 1, 2022.

Individuals who don’t act by Jan. 15, 2022, cannot get coverage for 2022 unless they qualify for a Special Enrollment Period based on circumstances such as a loss of qualifying health coverage, change of income, becoming a parent, or other qualifying factors.

Monthly premiums for 2022 plans in Delaware will be 3% higher on average than the 2021 plans, Insurance Commissioner Trinidad Navarro announced in August. Highmark Blue Cross Blue Shield Delaware is the sole health insurer offering plans on Delaware’s Health Insurance Marketplace. Enrollees will choose one of 13 Highmark plans or they will be re-enrolled automatically in a plan similar to their current one.

This year’s single-digit increase in premiums follows decreases the last two enrollment years, totaling more than 19%. Those base premium reductions and the overall stability of Delaware’s Health Insurance Marketplace reflect continued federal approval of Delaware’s reinsurance program. The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers’ claims costs are lower, the insurers can reduce the cost of premiums or limit increases.

In addition, the Biden administration has made increased access to health insurance and affordability a priority by using American Rescue Plan Act funds to increase tax credits and expand subsidies further into the middle class. For instance, a family of four (both parents in their 40s) making $50,000 are eligible for a credit of roughly $16,500, compared with $14,300 previously. A majority of Delaware marketplace enrollees will be eligible for financial assistance, which can help reduce the cost of monthly premiums and/or deductibles, and lower out-of-pocket health care costs.

Through last year’s Open Enrollment and a Special Enrollment Period held earlier this year for people who lost coverage because of the pandemic, about 30,000 Delawareans now have coverage through Delaware’s Health Insurance Marketplace.

Federal tax credits are available for those whose household income is between 138% and 400% of the Federal Poverty Level. For 2022 coverage, that’s between $17,775 and $51,520 for an individual, or between $36,570 and $106,000 for a family of four. For coverage in 2021, about 81% of enrollees in Delaware were eligible for tax credits, which help reduce the cost of the monthly premium.

“All Delaware families need access to affordable, quality health care,” said Governor John Carney. “Delaware’s reinsurance program has stabilized premiums on the marketplace and the Biden administration has enhanced federal subsidies to make coverage even more affordable, even reaching into the middle class. As we continue to battle COVID-19, having access to affordable coverage is especially critical. I particularly encourage small-business owners, independent contractors and individuals who don’t have access to health insurance through an employer to check out the plans available on Delaware’s marketplace.”

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – 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% of medical costs and the consumer pays about 30%. Consumers who pick silver health care plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 25% of current enrollees qualify for cost-sharing reductions. For any marketplace plan in 2022, individual consumers can’t pay more than $8,700 in out-of-pocket medical costs and families can’t pay more than $17,400.

For 2022, Highmark will offer 13 plans for individuals – four gold plans, three silver, three bronze, two platinum and one catastrophic. Two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a collective 12 stand-alone dental plans on the marketplace, seven with a low actuarial level (71.6%) and five with a high actuarial level (84.2%).

All plans offer essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, pediatric services, birth control and breastfeeding coverage, and COVID-19 vaccines, including any necessary boosters. In addition, coverage cannot be terminated due to a change in health status, including diagnosis or treatment of COVID-19.

“Providing access to high-quality, affordable health care is one of the ways that we can improve the overall health and well-being of Delawareans,” said Department of Health and Social Services Secretary Molly Magarik. “We are grateful to President Biden and our Congressional Delegation for enhancing federal subsidies to help people pay their monthly premiums. I urge everyone to take another look at the affordability of the plans on Delaware’s Health Insurance Marketplace and look at how the coverage can fit into your family’s budget. Finally, with community transmission of COVID-19, we know how important having coverage is for Delawareans, especially those with chronic conditions or in other vulnerable circumstances.”

This year’s slight increase in premiums comes as the market has stabilized after a significant reduction over 19% over the past two years, said Insurance Commissioner Trinidad Navarro. “Now, more than ever, it is vital that every resident can afford the insurance they need for their families. With our work towards lower rates in recent years and the assistance of the American Rescue Plan, plans are more accessible than ever before. More than 20 percent of Delaware Marketplace participants were enrolled in a plan costing $10 or less a month in the past year.”

Assistance for Delaware enrollees

Consumers can go to HealthCare.gov or CuidadodeSalud.gov now to explore their options for 2022 coverage, and they can enroll anytime between Nov. 1 and Jan. 15, 2022.

Delawareans who need help enrolling in coverage will have access to free in-person assistance from federally funded and trained specialists at Westside Family Healthcare (statewide) and Quality Insights, Inc., (New Castle and Sussex counties) and by certified application counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown. Westside and Quality Insights each received federal funding for navigators to help people enroll for coverage.

State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage, at no extra charge.

For more information, go to www.ChooseHealthDE.com. You can enroll in marketplace coverage at HealthCare.gov or by calling 1 (800) 318-2596 (TTY: 1-855-889-4325).

According to the U.S. Department of Health and Human Services (HHS):

• Delaware’s total open enrollment for 2021 (25,320) increased about 5.6% over the previous year.
• About 81% of Delaware’s marketplace enrollees receive financial assistance to help pay their monthly premiums and/or deductibles and co-pays.
• The overall average monthly premium in Delaware is $675, with the average premium reduced to $211 per month after tax credit. For the 81% of
• Delawareans who receive financial assistance, the average premium after tax credit is $119 per month.
• Among the 25,320 people who signed up during last year’s open enrollment, about 80% were re-enrollees and 20% were new enrollees.
• Financial help is available for individuals with annual incomes up to $51,520; for a family of four the income limit is $106,000.
• About 74% of Delaware’s enrollees signed up during the final three weeks of open enrollment in 2020.

The 11-year-old Affordable Care Act (ACA), which created the Health Insurance Marketplace, allows states to waive certain ACA requirements in order to customize their health insurance systems while retaining the basic protections of the ACA. In August 2019, Governor Carney signed legislation codifying various ACA consumer protections into state law and ensuring that if the ACA is ever repealed or changed, its consumer protections will remain in effect in Delaware. This includes provisions such as guaranteed-issue coverage (regardless of medical history), coverage for essential health benefits, a ban on lifetime and annual benefit maximums, limits on out-of-pocket costs, and rules regarding the factors that insurers can use to set premiums.

Support from Congressional Delegation

Delaware’s U.S. senators and representative urged uninsured Delawareans to find out what’s available for them on the marketplace.

“No one should be without affordable, quality health insurance and starting Nov. 1, Delawareans are eligible to sign up for a plan that meets their needs and budget,” said U.S. Sen. Tom Carper. “Especially during a pandemic, I encourage everyone to visit HealthCare.Gov or seek free help from our many health insurance navigators and get covered without delay!”

“Affordable and comprehensive health insurance is critical, especially during a pandemic and nearing the height of flu season,” said U.S. Sen. Chris Coons. “Open enrollment is an opportunity for Delawareans to review and update existing health care plans or look for new coverage that best meets your needs. I’m encouraging everyone, whether you’ve got health coverage or not, to visit Delaware’s Health Insurance Marketplace to review coverage options and explore financial assistance that may be available before January 15.”

“In the midst of a pandemic, we’ve been starkly reminded of the importance of health insurance. That’s why I join with my colleagues and partners in telling Delawareans that November 1st marks the beginning of the open enrollment period for the Affordable Care Act,” said U.S. Rep. Lisa Blunt Rochester. “Experts and navigators will be on hand to help Delawareans select the plan that works best for them and their families and I encourage everyone to visit HealthCare.Gov to find out more and enroll.”

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage through Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans receive coverage under the Medicaid expansion each year. To be screened for or to apply for Medicaid benefits, go to Delaware ASSIST. Note: As of Oct. 1, 2020, dental care is included in coverage for adult Medicaid enrollees in Delaware.

Both the Health Insurance Marketplace and the Medicaid expansion have helped to reduce Delaware’s uninsured rate, decreasing from 10% in 2008 to 6.6% in 2019, according to the Census Bureau. That decline includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions.