Health Insurance in Delaware

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 $20,783 for a single person in 2026). 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 2026

Delaware marketplace premiums are moderate for the Mid-Atlantic region. A 40-year-old in Wilmington can expect a benchmark Silver plan around $450 to $550 per month before subsidies. Delaware's small market and limited carrier competition contribute to premiums that are somewhat higher than neighboring states like Pennsylvania or Maryland.

For 2025, Delaware had approximately 30,000 marketplace enrollees. With enhanced subsidies expiring for 2026, those earning above 400% FPL ($63,440 for an individual) will face the full premium without any tax credit assistance. Lower-income enrollees will still receive subsidies but at reduced levels compared to 2025.

Carriers in Delaware (2026)

Two carriers offer individual marketplace plans in Delaware for 2026:

• Highmark Blue Cross Blue Shield of Delaware is the dominant insurer in the state, covering the majority of marketplace enrollees. 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.
• Ambetter from Home State Health (a Centene subsidiary) offers plans with lower premiums and narrower networks. Ambetter has expanded its Delaware presence in recent years and provides a price-competitive alternative to Highmark, particularly for younger and healthier enrollees willing to accept a more limited provider directory.

With only two carriers, Delaware's marketplace competition is limited. Both carriers are available statewide (Delaware has only three counties: New Castle, Kent, and Sussex).

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

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. On the positive side, both carriers offer multiple metal tier options, so you can still choose between lower-premium Bronze plans and higher-coverage Gold or Platinum plans.

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