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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. You must apply by December 15, 2022, during the Open Enrollment Period, to get coverage that will begin on January 1, 2023.  If you apply between December 16, 2022 and January 15, 2023, your coverage will begin on February 1, 2023.

Delaware residents seeking coverage for 2023 will have more options than ever before.  Thirty health care plans are being offered by 3 insurance carriers:

  • Highmark Blue Cross Blue Shield will offer 17 plans (4 bronze, 3 silver, 6 gold, 3 platinum, 1 catastrophic)
  • Aetna CVS Health will offer 9 plans (3 bronze, 4 silver, 2 gold)
  • Amerihealth Caritas will offer 4 plans (2 bronze, 1 silver, 1 gold)

Thirteen stand-alone dental plans will also be offered by two dental insurance carriers (Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc.). Quality Insights trained staff will help you review your options so you can select the plan that best meets your and/or your families’ needs.

Laws were passed again this year to continue federal subsidies and tax credits, which reduce the costs that you have to pay. Individuals making up to $54,360 will be eligible for a tax credit as well as families of four who make up to $111,000.

If your application determines that you or a family member are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) program, we will help you complete the Medicaid application too for free.

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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