Rates in Delaware have dropped by 19%

The deadline to sign up for health insurance or renew plans under the Affordable Care Act is Sunday, Dec. 15, but a positive surprise awaits.

Rates have dropped in Delaware because the state Department of Insurance worked with the Department of Health and Social Services, the governor and state legislature to apply for a federal waiver.

“I’m pleased that with the waiver, we were able to reduce rates by 19 percent,” said Insurance Commissioner Trinidad Navarro. “I urge all Delawareans to log on to ChooseHealthDE.com and check the plan that best works for their situation.”

Residents can choose one of eight Highmark Blue Cross Blue Shield of Delaware plans or they will be automatically re-enrolled in a plan that is similar to one they have.

Federal tax credits are available for those whose income is up to $49,960 for an individual or up to $103,000 for a family of four. For coverage in 2019, about 85 percent of enrollees in Delaware were eligible for tax credits, which reduce the monthly costs.

Gov. John Carney said the reduction in rates and the tax credit are helping to connect more people to quality health care.

“The reduction in rates for 2020 offers an important incentive to compare and shop for plans on our marketplace, especially for Delawareans who own small businesses, are independent contractors or who don’t have access to health insurance through an employer,” said Carney.

Plans available

Plans include bronze, silver, gold and platinum, based on how enrollees choose to split the costs of care with their insurance company. For example, bronze plans have low monthly premiums, but high costs when you need care. Gold plans have high premiums but lower costs when you need care. For any plan, the maximum annual out-of-pocket cap for 2020 is $8,200 for an individual and $16,400 for a family.

All plans cover pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services and pediatric services.

For dental insurance, Delta Dental of Delaware and Dominion Dental Services offer a total of 11 stand-alone dental plans.

Help in choosing and paying for plans

Delawareans who need help enrolling in coverage have access to free in-person assistance from federally funded and trained specialists at Westside Family Healthcare in Dover, and by certified applications counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown. Visit choosehealthde.com or call 302-674-7300.

State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage, at no extra charge.

The overall average monthly premium in Delaware is $842, with the average premium reduced to $202 per month after tax credit. For the 85% of Delawareans who currently receive financial assistance, the average premium after tax credit is $110 per month.

Medicaid option

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage though Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans have received coverage under the Medicaid expansion. To be screened for or to apply for Medicaid benefits, see the website assist.dhss.delaware.gov.

Delaware Health and Social Services Secretary Dr. Kara Odom Walker said both the Health Insurance Marketplace and the Medicaid expansion have helped to reduce the percentage of uninsured Delawareans from 10 percent in 2008 to 5.7 percent in 2018, according to a recent Census Bureau report.