Medicare is government-managed health insurance that you can get when you turn age 65. Medicare in Delaware is also available to people under age 65 who meet certain criteria.
Let’s explore more about your Medicare options and how to enroll in Delaware.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Delaware for the 2021 plan year:
- A total of 214,191 residents of Delaware are enrolled in Medicare.
- The average Medicare Advantage monthly premium slightly increased in Delaware compared to last year — from $19.22 in 2020 to $19.53 in 2021.
- There are 23 Medicare Advantage plans available in Delaware for 2021, compared to 19 plans in 2020.
- All Delaware residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 12 different Medigap plans offered in Delaware for 2021.
Medicare includes a few different parts, each designated by a letter of the alphabet. These parts of Medicare covers different things.
Original Medicare is offered by the government and includes parts A and B:
- Part A covers care you receive as an inpatient at a hospital and also includes hospice care, limited coverage for short-term skilled nursing facility care, and some part-time home healthcare services.
- Part B covers outpatient care, such as doctor’s visits, preventive care, and some durable medical equipment.
Medicare Advantage in Delaware
Medicare Advantage (Part C) bundles your coverage for Part A and Part B into a single plan that may include other benefits, such as dental or vision coverage. These plans often include prescription drug coverage as well.
Medicare Advantage plans are approved by the Centers for Medicare and Medicaid Services (CMS) and are available through private insurance companies. These companies offer plans in many counties in Delaware:
Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
Medicare supplement plans in Delaware
In addition to the four main parts, there are also Medicare supplement insurance plans. Often called Medigap, these plans covers out-of-pocket costs like copays and coinsurance that original Medicare plans don’t and are available through private insurance carriers.
You may not purchase both Part C and Medigap. You must choose type one or the other.
Many companies offer Medigap plans in Delaware. In 2021, some of the companies offering Medigap plans throughout the state include:
To be eligible for Medicare, you must be:
- 65 years or older
- a U.S. citizen or a legal resident for 5 years or more
If you are younger than age 65, you can get Medicare plans in Delaware if you:
- have a kidney transplant or end stage renal disease (ESRD)
- have amyotrophic lateral sclerosis (ALS)
- have been receiving Social Security or Railroad Retirement Board benefits for 24 months
When can I enroll in Medicare Delaware plans?
- Initial enrollment period (IEP) is a 7-month window around your 65th birthday, starting 3 months before and continuing for 3 months after your birthday. If you sign up before you turn 65 years old, your coverage begins in your birthday month. Signing up after this period will mean a delay in coverage.
- Special enrollment periods (SEPs)are designated times when you can sign up outside of open enrollment if you lose coverage for various reasons, including losing an employer-sponsored plan or moving outside of your plan’s coverage area.
- General enrollment (January 1 to March 31): If you did not sign up for Medicare during your IEP, you can enroll in Part A, Part B, Part C, and Part D plans. You may pay a penalty for signing up late.
- Medicare Advantage open enrollment (January 1 to March 31): You may switch to a new plan if you are already on Medicare Advantage or you can continue with original Medicare.
- Open enrollment (October 15 to December 7): You may switch between original Medicare and Medicare Advantage, or sign up for Part D if you didn’t sign up during your IEP.
Tips for enrolling in Medicare in Delaware
Choosing the right plan for depends on the following factors:
- your healthcare needs
- projected expenses
- which doctors (or hospitals) you want to see for care
You can find answers to your Medicare Delaware questions from these organizations:
Delaware Medicare Assistance Bureau(800-336-9500)
- the State Health Insurance Assistance Program (SHIP), formerly known as ELDERinfo
- free counseling for people with Medicare
- local counseling sites throughout Delaware (call 302-674-7364 to find yours)
- financial assistance to help pay for Medicare
- serves as the official Medicare site
- has trained staff on calls to help answer your Medicare questions
- has a plan finder tool to help you find available Medicare Advantage, Part D, and Medigap plans in your area
- More than 200,000 Delaware residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have slightly increased for 2021 Medicare Advantage plans in Delaware.
- There are also several Medigap plan options if you live in Delaware and are looking for additional coverage.