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The Health Insurance Marketplace®

DE Marketplace Health Insurance Helpline

 

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The Health Insurance Marketplace®


The Health Insurance Marketplace® is where people who don't have health insurance through a job, Medicare, Medicaid, the Children's Health Insurance Program (CHIP), or another source can apply for qualifying health coverage. 

 

Tips about the Health Insurance Marketplace®



1. Open Enrollment for 2023 health insurance has passed

But you may still be able to get Marketplace health coverage for 2023 if you qualify for a Special Enrollment Period.


2. How to find out if you qualify for a 2023 Special Enrollment Period

Answer a few fast questions to find out or contact us.


3. You can enroll in Medicaid/CHIP any time of year

There's no limited enrollment period for Medicaid or the Children’s Health Insurance Program (CHIP). If you qualify, coverage can begin immediately. Learn more.


4. Don’t forget to pay your monthly premium

When you have Marketplace insurance, you'll pay your premiums directly to the insurance company — not to the Health Insurance Marketplace®. Your coverage won't start until you pay your first premium. Get more information on completing your enrollment.


5. Stay healthy & get the care you need

Read "From Coverage to Care: A Roadmap to Better Care and a Healthier You" for tips on using your new health insurance.

Healthcare
 

Benefits of Health Insurance

 

Although health insurance is no longer mandatory you may experience financial hardship if you get injured or develop a serious illness and don’t have coverage. The cost of health insurance is a fraction of what you would pay out of your pocket if you were uninsured. The Biden-Harris Administration is offering health care plans at record-low costs again in 2023.  Last year, 9 out of 10 people in Delaware received tax credits, which reduced their monthly premium.

Preventive Care

Marketplace health insurance plans include free preventive care.

Pre-Existing Conditions

You can't be turned down for coverage for having a pre-existing condition.

Plans may offer additional benefits, including:

Vision Coverage

Medical Management Programs

(for specific needs like weight management, back pain, and diabetes)

Dental Coverage

 

COVERAGE


All plans must cover the following 10 essential health benefits plus 2 others:
  1. Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  2. Emergency services
  3. Hospitalization (like surgery and overnight stays)
  4. Pregnancy, maternity, and newborn care (both before and after birth)
  5. Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
  11. Birth control coverage
  12. Breastfeeding coverage
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Eligibility


To be eligible to enroll in health coverage through the Marketplace, you:
  • Must live in the United States.
  • Must be a U.S. citizen or national (or be lawfully present). Learn about eligible immigration statuses.
  • Can't be incarcerated (serving a term in prison or jail)

If you have Medicare coverage, you are not eligible to use the Marketplace to buy a health or dental plan.

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Quality Insights offers FREE assistance to Delaware residents.

 

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