With so many options, shopping for a Medicare plan in Delaware can be challenging. Understanding each type—Medicare Advantage, Part D prescription plans, or Medigap—is key to choosing the right plan for your healthcare needs.
Discover different plan types, gain insights into costs and enrollment, and identify top providers to get coverage that fits your health needs and budget.
Key Takeaways
- Medicare in Delaware offers a range of options, including Original Medicare, Medicare Advantage, Part D prescription drug plans, and Medigap policies to cover varying healthcare needs.
- Costs, coverage options, and provider networks vary widely across plan types, making plan comparisons essential for finding the most suitable coverage.
- Helpful resources like the Delaware Medicare Assistance Bureau (DMAB) and Area Agencies on Aging offer guidance to help residents make informed Medicare choices.
Medicare Plans Available in Delaware
Each Medicare plan type offers varying levels of coverage, benefits, and costs tailored to specific healthcare needs.
Original Medicare (Part A and Part B)
Original Medicare consists of two parts:
- Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
- Part B (Medical Insurance): Covers outpatient care, doctor visits, preventive services, and medically necessary services.
Part A and B costs include monthly premiums, deductibles, and coinsurance, varying amounts based on income and work history.
Medicare Advantage (Part C)
Medicare Advantage plans offer an all-in-one alternative to Original Medicare. These plans include Part A, Part B, and often Part D (prescription drug coverage). Many Medicare Advantage plans in Delaware also offer extra benefits, such as vision, dental, and hearing coverage.
- Delaware residents have access to several Medicare Advantage plans, each with its range of coverage and costs.
- Private insurers provide these plans, with premiums dependent on the plan and region.
| Plan Name | Monthly Premium | Coverage Highlights | Provider Network | Star Rating |
|---|---|---|---|---|
| Aetna Medicare | $0 | Dental, vision, prescription | Nationwide | 4.5 |
| Humana | $15 | Hearing aids, wellness programs | Regional network | 4.0 |
| Highmark | $20 | Dental, fitness benefits | Statewide | 4.5 |
Note: Data is based on publicly available resources, with variations in star ratings and plan details expected annually.
Top private insurers offering Medicare Advantage plans in Delaware include:
- Aetna
- Humana
- Highmark
- UnitedHealthcare (AARP)
- Wellcare
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Medicare Prescription Drug Plans (Part D)
Medicare Part D helps cover prescription drug costs and is available as a stand-alone plan to pair with Original Medicare or as part of a Medicare Advantage plan.
Each Part D plan includes a formulary, or list of covered medications, divided into pricing tiers. It’s essential to compare these formularies to ensure the medicine you rely on are covered at an affordable rate.
- Delaware residents can choose from 20 stand-alone Part D plans in 2024, covering a wide range of medication needs.
- Monthly premiums start at $6.80, with specific costs varying based on the plan and coverage.
Medigap (Medicare Supplement) Plans
Medigap plans, or Medicare Supplement plans, help Delaware residents cover gaps in Original Medicare, such as copayments, coinsurance, and deductibles. Popular options like Plan G and Plan N provide flexible coverage levels suited to different healthcare needs and budgets.
Private insurers offer Medigap policies, with premiums influenced by factors such as the plan type, age, and location. Note that Medigap plans do not cover prescription drugs, so you may also need a Part D plan to cover medication costs.
Leading Medigap providers in Delaware include:
- Highmark Blue Cross Blue Shield
- UnitedHealthcare (AARP)
- Humana
- Mutual of Omaha
- Cigna
- Colonial Penn
These insurers offer a range of Medicare Supplement options that cover costs not included in Original Medicare, such as deductibles and copayments. Plan G and Plan N remain especially popular for those looking for a blend of coverage and affordability.
Learn more: How to Compare Medicare Supplement Plans
Average Costs of Medicare Plans in Delaware
Medicare plan costs in Delaware vary by plan type. While Original Medicare includes standard premiums and deductibles, Medicare Advantage often provides low or even $0 premium options. Medigap and Part D plans come with additional costs that help reduce beneficiaries’ out-of-pocket expenses.
| Plan Type | Average Monthly Premium | Deductible | Coverage Highlights |
|---|---|---|---|
| Original Medicare | $174.70 (Part B) | $1,632 (Part A) | Basic hospital and outpatient coverage |
| Medicare Advantage | $18.50 | Varies by plan | Often includes extra benefits like vision and dental |
| Part D (Prescription Drug) | $6.80 | $545 | Covers medications with tiered pricing |
| Medigap (Plan G, N) | $120 – $300 | None | Fills gaps in Original Medicare |
Note: Costs reflect 2024 averages and may vary by provider and location.
This table offers a quick comparison to help Delaware residents understand and select a plan that aligns with their healthcare needs and budget.
Top Medicare Advantage and Medigap Providers in Delaware
Delaware offers a variety of Medicare Advantage and Medigap providers, each with unique coverage options, costs, and network sizes. Here are some of the top providers and key features to consider when choosing a plan.
Best Medicare Advantage Providers
Medicare Advantage plans in Delaware often provide additional benefits, such as vision, dental, fitness programs, and Part D drug coverage. Choosing the right provider can depend on your healthcare needs and budget.
| Provider Name | Average Monthly Premium | Network Size | Customer Satisfaction Score | Complaint Index |
|---|---|---|---|---|
| Humana | $15 | 40,000+ | 4.5 | Low |
| UnitedHealthcare | $25 | Nationwide | 4.5 | Low |
| Highmark Blue Cross | $20 | Statewide | 4.0 | Low |
Note: Providers were selected based on available market data and customer reviews. Ratings and premiums may vary by region and provider network.
Best Medigap Providers
Medigap plans in Delaware help cover out-of-pocket expenses, and top providers excel in affordability and customer service. Highmark Blue Cross offers competitive premiums with reliable service, while AARP/UnitedHealthcare combines affordable rates with various plan options.
Plan G Medigap Providers in Delaware
| Carrier | Premium | Fee | AM Best Rating |
|---|---|---|---|
| Highmark Blue Cross | $168.70 | None | A+ |
| AARP | $168.39 | None | A |
| United American | $169.00 | None | A+ |
Plan N Medigap Providers in Delaware
| Carrier | Premium | Fee | AM Best Rating |
|---|---|---|---|
| Highmark Blue Cross | $154.00 | None | A+ |
| AARP | $131.06 | None | A |
| United American | $144.00 | None | A+ |
Evaluating these providers based on network, costs, and customer satisfaction will help you select a plan that meets your healthcare needs.
How to Enroll in a Medicare Plan in Delaware
To enroll in Medicare in Delaware, you must be at least 65 years old or qualify earlier due to a disability, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS).
1. Choose Your Plan Type: Decide whether Original Medicare, Medicare Advantage, Medigap, or a Part D prescription drug plan best meets your healthcare needs and budget.
2. Know Your Enrollment Windows: There are key enrollment periods to keep in mind:
- Initial Enrollment: Starts 3 months before your 65th birthday and ends 3 months after.
- Annual Enrollment: Runs from October 15 to December 7 each year.
- Special Enrollment: This is for qualifying life events like moving, losing employer coverage, or changing your plan’s service area.
3. Gather the Required Documents: To ensure a smooth enrollment, have your Medicare card (if already enrolled), photo ID, and any relevant personal information ready.
4. Submit Your Enrollment: You can enroll online at Medicare.gov by calling 1-800-MEDICARE or with the help of a licensed insurance agent, such as CoverRight.
5. Get Support if Needed: Delaware’s State Health Insurance Assistance Program (SHIP) and licensed agents can offer personalized guidance if you’re not sure about which plan is right for you.
How to Choose the Right Medicare Plan in Delaware
- Assess Your Healthcare Needs:
Evaluate your typical healthcare usage, including doctor visits, specialist consultations, and any regular prescriptions. This helps determine if a more comprehensive plan, like Medicare Advantage, or a supplemental option, like Medigap, might be beneficial. - Compare Plan Options:
Explore Delaware’s range of Medicare Advantage, Medigap, and Part D plans to see how each aligns with your healthcare needs and budget. - Check Provider Networks:
Ensure your preferred doctors, hospitals, and pharmacies are included in the plan’s network for easy care access when needed. - Evaluate Costs and Benefits:
Review premiums, deductibles, and out-of-pocket limits to understand each plan’s total costs. Look for added benefits, like dental, vision, or fitness programs, that may add value. - Get Personalized Help if Needed:
If you’re unsure which plan is best for you, use Medicare’s Plan Finder tool or reach out to a licensed insurance agent for expert guidance tailored to your situation.
Medicare Resources for Delaware Residents
Delaware offers valuable resources to assist residents with Medicare decisions. The Delaware Medicare Assistance Bureau (DMAB) provides free, personalized counseling to Medicare beneficiaries, helping them understand their options and make informed choices.
Local Area Agencies on Aging (AAA) also provide support, including assistance with in-home care and access to community resources for older adults. Medicare.gov offers tools to compare plans and find healthcare providers, ensuring beneficiaries choose the best coverage for their needs.
These resources offer essential guidance for Delaware residents beyond initial enrollment, aiding in ongoing plan selection and healthcare access.
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Sources
- Centers for Medicare & Medicaid Services (CMS)
- 2025 Medicare Advantage and Part D Star Ratings. Published October 2024. Available at: cms.gov. Last Accessed November 13, 2024
- Kaiser Family Foundation (KFF)
- Key Facts About Medigap Enrollment and Premiums for Medicare Beneficiaries. Published September 2024. Available at: kff.org. Last Accessed November 13, 2024
- Delaware Department of Health and Social Services
- The Medicare Supplement Insurance Shopper’s Guide. Published January 2023. Available at: dhss.delaware.gov. Last Accessed November 13, 2024
Sources
- Centers for Medicare & Medicaid Services (CMS)
- Medicare Open Enrollment Partner Resources. Published 2024. Available at: cms.gov. Last Accessed November 20, 2024
- Centers for Medicare & Medicaid Services (CMS)
- 2024 Medicare Advantage and Part D Ratings Fact Sheet. Published October 13, 2023. Available at: cms.gov. Last Accessed November 20, 2024
- Medicare.gov
- Medigap Coverage Information: When to Buy. Available at: medicare.gov. Last Accessed November 20, 2024
- Medicare.gov
- Medigap Overview. Available at: medicare.gov. Last Accessed November 25, 2024
- Medicare.gov
- What Does Medicare Cost? Available at: medicare.gov. Last Accessed November 26, 2024.
- Medicare.gov
- When Does Medicare Coverage Start? Available at: medicare.gov. Last Accessed November 26, 2024.
- Medicare.gov
- What Does Medicare Cost? Available at: medicare.gov. Last Accessed November 26, 2024.
- Kaiser Family Foundation (KFF)
- Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2024. Available at: kff.org. Last Accessed November 26, 2024.
