Health insurance premiums and out-of-pocket expenses differ by metal tier. In Delaware, AmeriHealth offers the lowest rates for Bronze, Gold, and Silver, while Highmark (BCBS) has the most affordable plans for Catastrophic, Expanded Bronze and Platinum options.
If you are looking to balance monthly premiums with quality claims and coverage, MoneyGeek analyzed the best health insurance in Delaware.
Most Affordable Health Insurance in Delaware
Cheapest Health Insurance in Delaware by Metal Tier
The most cost-effective Silver plan available in Delaware is the AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals offered by AmeriHealth, boasting a monthly cost of $528. Silver plans are widely elected due to their monthly premiums and coverage balance. For individuals willing to accept higher out-of-pocket expenses in exchange for lower monthly premiums, Bronze plans can be an alternative option.
Health insurance costs are contingent upon the metal tier, each representing a balance between monthly premiums and out-of-pocket costs such as deductibles and copays.
Here are the most affordable health insurance plans from each metal tier:
- Catastrophic: my Blue Access Major Events PPO Catastrophic 9450 - 3 Free PCP Visits (Highmark (BCBS)) ($345 per month)
- Bronze: AmeriHealth Caritas Next Bronze Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals (AmeriHealth) ($384 per month)
- Expanded Bronze: my Blue Access PPO Bronze 8900 (Highmark (BCBS)) ($420 per month)
- Gold: AmeriHealth Caritas Next Gold Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals (AmeriHealth) ($526 per month)
- Silver: AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals (AmeriHealth) ($528 per month)
- Platinum: my Blue Access PPO Platinum 0 (Highmark (BCBS)) ($783 per month)
For more information on cheap health insurance options, one can explore various plans and their corresponding costs to find coverage that suits their needs and budget.
In the Delaware health insurance marketplace, consumers can choose from a range of metal tiers: Bronze, Silver, Gold and Platinum, as well as a Catastrophic plan designed for those under 30 or with a hardship exemption. Each metal tier represents a different balance between monthly premiums and out-of-pocket expenses.
Bronze plans typically have the lowest monthly premiums but the highest out-of-pocket costs. Conversely, valuable metal plans, like Platinum, feature the highest premiums but significantly lower out-of-pocket expenses. Lastly, Catastrophic plans, while offering low premiums, come with high deductibles and are intended to protect the policyholder from worst-case scenarios.
For individuals earning below 250% of the Federal Poverty Line, Silver plans can include cost-sharing reductions (CSRs). CSRs lower the amount one pays for deductibles, copayments and co-insurance. This makes it easier to access care by reducing the direct costs at the time of service without first meeting high deductibles. The choice of metal tier should align with one’s health care needs and financial situation, as premiums and out-of-pocket expenses are inversely related.
Cheapest Silver Plans in Delaware
Delaware's most cost-effective Silver-tier health plan is the AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals offered by AmeriHealth, with a monthly premium of $528.
Here are the three most affordable health Silver plans in Delaware:
- AmeriHealth Caritas Next Silver Classic from AmeriHealth ($528 per month)
- AmeriHealth Caritas Next Silver Premier from AmeriHealth ($533 per month)
- Silver S: Aetna network of doctors & hospitals from Aetna ($554 per month)
Silver plans offer a middle ground for those seeking a balance between monthly premium and out-of-pocket expenses when receiving care. They are particularly suitable for individuals or families that expect moderate health care usage. For those with lower incomes, cost-sharing reductions can significantly lower the amount you have to pay for deductibles, copayments and co-insurance, making Silver plans even more affordable and providing better access to health services.
Cheapest Gold Plans in Delaware
The AmeriHealth Caritas Next Gold Classic offered by AmeriHealth stands as the most cost-effective Gold tier plan in Delaware, with a monthly cost of $526.
Among the Gold health plans available in Delaware, these three rank as the most affordable:
- AmeriHealth Caritas Next Gold Classic from AmeriHealth ($526 per month)
- Gold 3 from Aetna ($529 per month)
- Gold S from Aetna ($535 per month)
Gold plans are ideal for customers who anticipate needing a fair amount of medical care. They tend to offer lower out-of-pocket costs when accessing health care services, making them an economical choice for individuals with regular prescription needs or who often visit health care providers. Customers willing to pay higher premiums for peace of mind with reduced copays and deductibles benefit the most from Gold plans.
Cheapest Bronze Plans in Delaware
The most affordable Bronze plan in Delaware is the AmeriHealth Caritas Next Bronze Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals from AmeriHealth, with a monthly cost of $384.
Bronze plans are designed for individuals who want to have essential health coverage while keeping their monthly premiums low. These plans are a good fit for those who are generally healthy and do not expect to need frequent medical care. They provide basic health services and are suitable for customers prioritizing lower monthly costs over lower out-of-pocket expenses when accessing health care services.
Cheapest Expanded Bronze Plans in Delaware
The most affordable plan in the Expanded Bronze tier in Delaware is my Blue Access PPO Bronze 8900 offered by Highmark (BCBS), with a monthly cost of $420.
The top three most economical Expanded Bronze plans in Delaware include:
- my Blue Access PPO Bronze 8900 from Highmark (BCBS) ($420 per month)
- AmeriHealth Caritas Next Expanded Bronze Classic from AmeriHealth ($433 per month)
- my Blue Access PPO Standard Bronze 7500 from Highmark (BCBS) ($437per month)
Expanded Bronze plans are ideal for customers looking for a balance between monthly premiums and out-of-pocket expenses. They generally offer lower premiums than Gold or Silver plans but have higher out-of-pocket costs. These plans are often suitable for those who do not expect to need frequent medical services or those seeking an affordable option while still having protection from very high health care costs.
Cheapest Catastrophic Plans in Delaware
The most affordable Catastrophic plan in Delaware is my Blue Access Major Events PPO Catastrophic 9450 - 3 Free PCP Visits from Highmark (BCBS), with a monthly cost of $277. As it is the only Catastrophic plan available in the state, Delaware residents looking for the lowest-priced option in this tier need look no further.
Expanded Bronze plans cater to individuals who desire a balance between affordable premiums and out-of-pocket costs. They are typically a good fit for those who expect to use moderate health care services and want some coverage for unexpected medical events. These plans generally offer lower premiums compared to higher-tier plans, making them suitable for consumers seeking value without compromising too much on coverage.
Cheapest Platinum Plans in Delaware
In Delaware, the most affordable Platinum tier health insurance plan is my Blue Access PPO Platinum 0 offered by Highmark (BCBS), with a monthly cost of $783.
Platinum plans are tailored for customers willing to pay higher monthly premiums in exchange for lower out-of-pocket costs when accessing health care services. This type of plan is ideal for individuals who frequently require medical care or anticipate significant health care needs. The lower copayments and deductibles found in Platinum plans can provide substantial savings for those with recurring prescriptions or ongoing medical treatments.
Cheapest Health Insurance in Delaware for Those With Low Income
Individuals in Delaware earning 250% below the Federal Poverty Level are eligible for cost-sharing reductions on Silver plans, which help to reduce health care costs by lowering deductibles and out-of-pocket expenses.
The most affordable Silver plan for individuals with an annual income between $14,580 and $21,870 is the AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals with a Maximum Out-of-Pocket cost of $1,900. The following list details the maximum out-of-pocket costs for the two cheapest plans:
- AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals from AmeriHealth ($528 per month; $1,900 MOOP)
- AmeriHealth Caritas Next Silver Premier + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals Plan from AmeriHealth ($533 per month; $1,800 MOOP)
Cost-sharing reductions in Delaware are available only with the purchase of a Silver plan. The income figures mentioned are for single individuals and vary with household size.
Cost-sharing reductions (CSRs) are discounts that lower the amount you pay for healthcare on Silver plans for people earning between 100% and 250% of the Federal Poverty Level (FPL). Qualifying for a CSR could adjust the maximum out-of-pocket (MOOP) cost for the AmeriHealth Silver plan from $7,200 to $1,900, a substantial decrease in potential health care expenses. The plan name remains the same, but the financial responsibility shifts dramatically based on CSR eligibility.
Cheapest Health Insurance in Delaware by Plan Type
In Delaware, the Health Maintenance Organization (HMO) plan type is the most sought-after among available health plan options. While HMO might be the most popular, individuals have access to Preferred Provider Organizations (PPO) and Exclusive Provider Organizations (EPO) as well.
The most affordable health plan in Delaware for the HMO plan type is the AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals from AmeriHealth at $528.
- HMO: AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals from AmeriHealth ($528 per month)
- EPO: Clear Silver from Ambetter ($563 per month)
- PPO: my Blue Access PPO Silver 7000 from Highmark (BCBS) ($568 per month)
PPO plans offer flexibility to see providers out of network without a referral, which could be vital for those who need to see specialists not covered by other plan types. Meanwhile, EPO plans often balance cost and flexibility by allowing direct specialist visits within a network, potentially saving on premiums and out-of-pocket costs for those who prefer staying in the network for their health care needs.
The most common plan type in Delaware is the Health Maintenance Organization (HMO) plan.
Other plan types available in Delaware include the Exclusive Provider Organization (EPO) and Preferred Provider Organization (PPO) plans.
Here are the differences between the plan types available in Delaware:
Health Maintenance Organization (HMO): HMOs typically have lower premiums and out-of-pocket costs. They also emphasize preventive care and usually require members to choose a primary care physician (PCP) to coordinate their health care and provide specialist referrals. HMOs also require members to use health care providers within their network. Going to a health care provider outside the network may result in no coverage, leading to higher out-of-pocket costs. Specialist visits typically require referrals from the PCP.
Exclusive Provider Organization (EPO): EPOs offer a blend of HMO and PPO features, providing some flexibility in choosing healthcare providers. EPO plans do not require referrals for specialists, allowing direct access as long as the provider is in-network. On the other hand, while more flexible than HMOs, EPOs still require members to use in-network providers. Seeking care outside the network usually means paying the full cost of services, except in cases of emergency.
Preferred Provider Organization (PPO): PPOs provide the greatest flexibility in choosing health care providers as they allow members to see both in-network and out-of-network providers without a referral. PPO plans may also cover a higher percentage of costs for out-of-network care compared to other plan types. However, PPO plans tend to have higher premiums and out-of-pocket costs compared to HMOs and EPOs. Since members can see any provider, costs for the insurance carrier are higher, resulting in more expensive plan options for consumers.
Cheapest Health Insurance in Delaware by County
Health insurance rates and availability of specific plans vary by county in Delaware.
Comparing the most affordable plans in the largest and smallest counties by population shows this variation:
- New Castle: "AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals" from AmeriHealth ($528 per month)
- Kent: "AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals" from AmeriHealth ($528 per month)
The following table displays all available plans in each county in Delaware.
Health Insurance Costs in Delaware by Age and Metal Tier
Age is a big deal for health insurance prices in Delaware. For a Silver plan, an 18-year-old pays about $409 each month. A 60-year-old pays much more for the same plan, about $1,215 monthly. That's a difference of $806 — way higher for the older person.
Metal tiers show how insurance plans are different. A Bronze plan for a 40-year-old costs around $384 each month. But a Gold plan, which offers more coverage, is more expensive, about $586 each month. So, the Gold plan costs $202 more monthly than the Bronze plan.
What to Know About Health Insurance in Delaware
MoneyGeek broke down all the health insurance options in Delaware. We explain private insurance that you can buy in the marketplace, including the different metal levels like Bronze, Silver, Gold and Platinum. We also cover Medicaid and Medicare. Our goal is to help you understand your choices so you can pick the best health care for yourself.
Private Health Insurance in the Delaware Marketplace
In Delaware, the open enrollment period for purchasing private health insurance coverage through the Health Insurance Marketplace typically runs from November 1 to December 15 of each year. During this time, residents can shop for, compare and enroll in health insurance plans. If you miss the deadline, you can sign up during a Special Enrollment Period if you experience certain life events like marriage, having a baby or losing other coverage. Otherwise, you must wait until the next open enrollment period to obtain coverage, barring any qualifying events that grant you a Special Enrollment Period.
Medicaid in Delaware
Medicaid is a joint federal and state program providing health care coverage to low-income individuals and families. In Delaware, eligibility for Medicaid is determined by income, age, pregnancy status, disability status and family size, with a focus on children, pregnant women, elderly adults and individuals with disabilities. The specific income thresholds are based on a percentage of the Federal Poverty Level and can vary annually. Applicants must also be U.S. citizens or qualified non-citizens and residents of Delaware. Individuals can apply through the Delaware Division of Social Services to determine if they meet the criteria for Medicaid benefits.
Medicare in Delaware
Medicare is a federal health insurance program primarily for individuals aged 65 and over, as well as for some younger people with disabilities and those with End-Stage Renal Disease. In Delaware, residents who meet these criteria are eligible. Medicare Part A covers hospital insurance, including inpatient care and skilled nursing facilities. Part B covers medical insurance for doctor visits, outpatient care and other medical services. Part C, known as Medicare Advantage, offers an alternative way to get Parts A and B coverage through private insurance companies and often includes Part D, which is prescription drug coverage. Lastly, Medicare Supplement (Medigap) plans are designed to help pay for out-of-pocket costs not covered by Original Medicare (Parts A and B).
Expert Tips on Finding the Cheapest Delaware Health Insurance
- What factors should individuals and families in Delaware consider when selecting a plan with the lowest out-of-pocket maxes?
- Are Health Savings Accounts (HSA) a viable option for those looking for the cheapest coverage in Delaware?
- Are there any special considerations that should be taken into account when selecting a plan in Delaware for people with pre-existing conditions?
- In your view, what can be done to make health insurance more affordable in the state of Delaware?
President of Diversified LLC
Delaware Health Insurance FAQ
You may have questions about cost and availability when looking for health insurance. MoneyGeek responded to frequently asked questions about cheap private health insurance in Delaware to help you learn more.
About Mark Fitzpatrick