Medicaid in Delaware
Delaware expanded Medicaid effective January 1, 2014, as one of the early expansion states. The expansion covers adults aged 19 to 64 earning up to 138% FPL (about $22,025 for a single person under the guidelines used for 2027 coverage). Delaware already had relatively broad Medicaid eligibility before the ACA, so the expansion primarily filled gaps for childless adults.
The state's Medicaid program, called Diamond State Health Plan, covers over 280,000 residents total (including expansion and traditional Medicaid). Delaware's small population (about 1 million) means Medicaid covers roughly one in four residents.
Delaware's uninsured rate is about 5.5%, well below the national average. Roughly 55,000 residents remain uninsured, many of whom are eligible for either Medicaid or subsidized marketplace coverage but have not enrolled.
What plans cost in 2027
The Delaware Department of Insurance approved average rate increases of 17.2% for Highmark Blue Cross Blue Shield (which had asked for 20.2%) and 13.94% for AmeriHealth Caritas for 2027, before subsidies.
The benchmark Silver plan rose more than that, because Ambetter left and the cheaper plans it offered went with it. Based on HealthCare.gov plan data, the benchmark Silver plan for a 40-year-old costs about $876 per month before subsidies in 2027, up from about $691 in 2026, and it is the same in all three counties. There are also fewer plans to choose from: 28 for 2027, down from 39.
The enhanced premium tax credits expired after 2025 and were not extended for 2027. If your household income is between 100% and 400% FPL ($15,960 to $63,840 for a single person), you still get a premium tax credit, and a higher benchmark means a larger credit. Above 400% FPL there is no subsidy, so you pay the full premium. For 2025, Delaware had approximately 30,000 marketplace enrollees.
Carriers in Delaware (2027)
Two carriers offer individual marketplace plans in Delaware for 2027, and both are available statewide:
- Highmark Blue Cross Blue Shield of Delawareis the dominant insurer in the state, covering the majority of marketplace enrollees and offering the most plans. Highmark's network includes ChristianaCare (the state's largest health system), Bayhealth, and most other Delaware providers. For most Delawareans, Highmark offers the broadest network and the simplest path to accessing local care.
- AmeriHealth Caritas Next offers HMO plans with lower premiums and a narrower network. AmeriHealth Caritas also runs a Delaware Medicaid plan, so some providers will be familiar to people moving from Medicaid to marketplace coverage. Check the provider directory before enrolling.
If you had an Ambetter plan in 2026, it ends December 31, 2026. You need to pick a new plan during Open Enrollment to avoid a gap in coverage.
Key regions
Wilmington and New Castle County
New Castle County in northern Delaware contains about 60% of the state's population. ChristianaCare, headquartered in Wilmington, is the largest health system in the state and one of the largest in the Mid-Atlantic. Nemours Children's Hospital is a major pediatric facility. Residents in this area also have reasonable access to Philadelphia-area hospitals (Penn Medicine, Jefferson Health) for specialized care, though those facilities may or may not be in-network depending on your plan.
Dover and Kent County
Bayhealth Kent General Hospital in Dover is the primary facility for central Delaware. Kent County has fewer provider options than New Castle but both marketplace carriers serve the area. State employees and military families (Dover Air Force Base is here) often have employer-sponsored coverage, keeping the individual marketplace enrollment relatively small.
Sussex County (southern Delaware)
TidalHealth Nanticoke in Seaford and Beebe Healthcare in Lewes are the main hospitals in Sussex County. The southern Delaware beach communities have a significant retiree population, many of whom are on Medicare rather than marketplace plans. Sussex County has fewer specialists than northern Delaware, and some residents travel north or to Maryland for complex care.
Estimate your subsidy
Subsidy Estimator
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Delaware-specific things to know
Proximity to Philadelphia is an asset and a complication.Many northern Delaware residents work in Philadelphia and may have doctors there. If you are shopping for a marketplace plan, check whether your Philadelphia-area providers are in-network. Highmark's broader network is more likely to include cross-state providers, but verify before enrolling.
Delaware's small market means fewer plan options. With two carriers and three counties, you will not see the breadth of plan choices available in larger states. Both carriers still offer several metal levels, so you can choose between lower-premium Bronze plans and higher-coverage Gold plans, and Highmark also offers Platinum.
Open Enrollment dates. Open Enrollment for 2027 runs from November 1, 2026, through January 15, 2027, on HealthCare.gov. Enroll by December 15 for coverage that starts January 1, or between December 16 and January 15 for coverage that starts February 1.
Free enrollment help is available.Delaware has a network of certified application counselors and navigators who provide free assistance. The state's small geography means in-person help is accessible to most residents. Contact the Delaware Health Insurance Marketplace or call the HealthCare.gov helpline.
Resources
- HealthCare.gov for marketplace enrollment (Delaware uses the federal marketplace)
- Delaware Division of Medicaid and Medical Assistance for Medicaid eligibility and enrollment
- Delaware Department of Insurance for consumer assistance and plan information