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The Health Insurance Marketplace®

DE Marketplace Health Insurance Helpline for New Castle and Sussex Counties

 

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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. Each state has a marketplace where you can shop for a health insurance plan, just like you would shop for any other important item in your life.

 

There are a variety of health insurance plans you can pick from. This year 12 plans are available to Delaware residents on open enrollment day. Quality Insights certified Navigators will help you shop by comparing plan features and prices side-by-side so you can select the one that is most affordable and meets you or your family’s needs. 

If your application determines that you eligible for Medicaid or the CHIP program, Quality Insights Navigators will put you in direct contact with the applicable agency. Since Delaware expanded Medicaid eligibility to adults under the age of 65 with incomes up to 138% of the federal poverty level (FPL), Medicaid enrollment in Delaware has grown by nearly 25,000 people. Children ages 1-18 who aren’t eligible for Medicaid but whose household income doesn’t exceed 212% of the FPL will be referred to the Healthy Children program, which is Delaware’s CHIP program.

Healthcare
 

Benefits of Health Insurance Coverage

 

Although health insurance coverage is no longer mandatory at the federal level, you may experience financial hardship if you get injured or develop a serious illness and don’t have health insurance. This year, the Biden-Harris Administration is offering health care plans at record-low costs because “Health care should be a right and in reach for everyone.”

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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We're here to help!

Quality Insights offers FREE education and hands-on assistance to Delaware federal healthcare marketplace consumers in New Castle and Sussex counties.

 

Sign Up for Assistance