A special enrollment period is open through May 15 to get possibly subsidized health insurance through the federal marketplace, via HealthCare.gov.
The marketplace – created by the Affordable Care Act, also known as Obamacare – is normally open only at the end of the year and when you have a life-changing event, like getting married.
The new enrollment period was called for by President Biden to help people affected by the pandemic. Delaware posts details on ChooseHealthDE. (It can be complicated: the release announcing the period ran almost 1,750 words.)
A huge incentive is the possibility of federal tax credits, and about 86% of the 25,000 Delawareans who get their health insurance through marketplace get these credits.
The average monthly premium in Delaware in 2020 was $668, reduced to $192 after tax credit, according to the U.S. Department of Health and Human Services. For those Delawareans who qualify, the average premium after tax credit was $110.
These tax credits are available for those whose household income is between 138% and 400% of the federal poverty level. For 2021 coverage, that’s between $17,609 and $51,040 for an individual, or between $36,156 and $104,800 for a family of four.
Choices in the marketplace are limited. There’s only one insurer: Highmark Blue Cross Blue Shield Delaware, with 12 plans. The plans fit into four categories: bronze, silver, gold and platinum, based on how you split the costs of care with Highmark. In Delaware, about 29% of enrollees qualify for other cost-sharing reductions on silver plans.
Delta Dental of Delaware and Dominion Dental Services together offer 11 stand-alone dental plans.
Marketplace plans have to follow some rules that benefit consumers. For instance, you can’t lose coverage due to a change in health status, including diagnosis or treatment of COVID-19. And there’s a maximum annual cap on your costs.
Delawareans can get free help in enrolling from Westside Family Healthcare. Request an appointment at 302-472-8655 in New Castle County and 302-678-2205 downstate or firstname.lastname@example.org.
State-licensed insurance agents and brokers also help at no extra charge. There’s a list at ChooseHealthDE.com.
Biden’s executive order also called for states to re-examine some policies related to Medicaid, but that doesn’t affect Delaware, which under the ACA expanded access to Medicaid starting in 2014. The year-round portal for Medicaid benefits is Delaware ASSIST.
About 6.6% of Delawareans don’t have health insurance, according to the 2020 America’s Health Rankings. That’s down from the nearly 10% who lacked insurance in 2010 before the marketplace began.