Delaware Health Insurance: Plans, Costs & Enrollment Guide for 2026
Whether you’re signing up for the first time, switching carriers after Aetna’s exit, or just checking whether a better deal exists, Delaware gives you three carriers to choose from — Highmark Blue Cross Blue Shield, AmeriHealth Caritas, and Ambetter — with 40 plans across every metal tier on the federal marketplace. More than nine out of ten marketplace enrollees qualify for subsidies that bring monthly costs down significantly, and the state’s reinsurance program helps keep premiums lower across the board. This guide breaks down what plans are available, what they actually cost at different ages and income levels, and how to get enrolled.
How Much Does Health Insurance Cost in Delaware?
Delaware health insurance costs an average of $791 per month before subsidies for a 40-year-old, according to approved rate filings with the Delaware Department of Insurance. After premium tax credits, subsidized enrollees paid approximately $217 per month on average in 2025. Premiums range from $468 for Catastrophic plans to over $1,800 for older adults selecting PPO coverage. For cost-reduction strategies, see the guide to affordable health insurance in Delaware.
For 2026, regulators approved a weighted average rate increase of 27.7% for individual marketplace plans. Highmark rates rose 25%, AmeriHealth Caritas increased 34.98%, and Ambetter entered at competitive pricing. These increases reflect rising prescription drug costs, higher healthcare utilization, and the projected impact of the expiration of enhanced federal premium tax credits at the end of 2025.
| Plan Tier | Avg. Monthly Premium (Age 40) | Avg. Deductible | Insurer Pays |
|---|---|---|---|
| Bronze | $542 – $607 | $7,000 – $7,950 | ~60% |
| Silver | $719 – $849 | $2,190 – $3,324 | ~70% |
| Gold | $752 – $849 | $1,106 – $1,163 | ~80% |
| Platinum | $1,018+ | $0 – $500 | ~90% |
| Catastrophic | $468+ | $9,450 | Minimal until deductible met |
Young Adults (Age 26)
~$576/moAverage $576/month before subsidies for Silver EPO coverage through Ambetter. Catastrophic plans available for those under 30 at lower premiums.
Adults (Age 40)
~$719/moAverage $719/month for Silver coverage. HMO options through AmeriHealth start around $542 at the Bronze tier.
Older Adults (Age 60)
~$1,623/moAverage $1,623/month for HMO coverage before subsidies. Premium tax credits rise proportionally with age, keeping costs manageable for many.
After Subsidies
~$217/moOver 90% of Delaware marketplace enrollees receive financial help. Average subsidized premium was approximately $217/month in 2025, with credits averaging $538/month.
Delaware Health Insurance Plans and Coverage Options
Delaware health insurance plans are available in five metal tiers: Bronze, Silver, Gold, Platinum, and Catastrophic. Each tier offers a different balance between monthly premiums and out-of-pocket costs. All plans sold on the Delaware marketplace must cover the ten essential health benefits required by the Affordable Care Act, including emergency care, hospitalization, prescription drugs, maternity and newborn care, mental health services, and preventive care at no additional cost.
Plan types in Delaware include PPO, HMO, and EPO networks. HMO plans (AmeriHealth) use a defined provider network but do not require referrals for specialists. PPO plans (Highmark) allow visits to any provider — in-network or out — with lower costs for in-network care and access to over 2 million providers nationwide through the BlueCard program. EPO plans (Ambetter) require in-network care but also skip the referral requirement. Learn more about how PPO, HMO, EPO, and POS plans compare.
Bronze Plans
~60%Lowest premiums, highest deductibles. Cover approximately 60% of costs. Best for healthy individuals who rarely need medical care and want protection against major events.
Silver Plans
~70%Moderate premiums and deductibles. Cover approximately 70% of costs. Only tier eligible for cost-sharing reductions (CSR) that lower deductibles (the amount paid before coverage begins) and copays for qualifying incomes.
Gold Plans
~80%Higher premiums, lowest deductibles. Cover approximately 80% of costs. The most popular tier in Delaware at 38% of enrollments — the $47/month gap between Silver and Gold makes Gold attractive for regular healthcare users.
Catastrophic Plans
<30Available to adults under 30 or those with a hardship exemption. Very low premiums with a $9,450 deductible. Cover three primary care visits per year before the deductible applies.
Delaware law caps insulin out-of-pocket costs at $35 per month and specialty drugs at $150 per month for state-regulated plans, which includes all marketplace coverage.
Delaware Health Insurance Companies and Carriers
Delaware’s individual marketplace features plans from three insurance carriers for the current plan year. Aetna, which participated in 2025, has exited the marketplace nationwide. Each remaining carrier serves all three Delaware counties — Kent, New Castle, and Sussex — and offers distinct plan types with different pricing. For carrier rankings, see the guide to the best health insurance in Delaware. A directory of all health insurance companies is also available.
Highmark BCBS Delaware
PPOHighmark Inc. • Blue Cross Blue Shield
The only carrier offering PPO plans in Delaware. Access to over 2 million providers nationwide through the BlueCard program with no referral requirement. Approximately 85% of Highmark BCBS Delaware ACA members qualify for tax credits. Highmark also operates Blue Cross Blue Shield plans in Pennsylvania and West Virginia. Rate change: +25%.
AmeriHealth Caritas
HMOAmeriHealth Caritas • Independence Health Group
Offers HMO plans across Bronze, Silver, Gold, and Platinum tiers without requiring specialist referrals. Typically the lowest Gold-tier premiums in Delaware — a 40-year-old pays roughly $752/month before subsidies. Rate change: +34.98%.
Ambetter (Celtic)
EPOCeltic Insurance Company • Centene Corporation
Offers EPO plans with no out-of-network coverage but no referrals needed. Entered the Delaware market in 2025 and generally offers the lowest overall premiums — a 40-year-old pays approximately $719/month for Silver before subsidies.
Aetna CVS Health
Exited 2026Aetna Life Insurance • CVS Health
Aetna withdrew from the Delaware marketplace effective January 1, 2026, as part of a nationwide exit from ACA individual plans. Former Aetna members needed to select a new carrier during Open Enrollment to maintain coverage.
How to Enroll in Delaware Health Insurance
Enrolling in Delaware health insurance starts at HealthCare.gov, the federal marketplace platform. Delaware does not operate its own state exchange. Approximately 42,000 residents enrolled through the marketplace for the current plan year, according to CMS enrollment data. Open Enrollment runs from November 1 through January 15 each year — enrolling by December 15 secures a January 1 coverage start date. For a complete walkthrough, see the Delaware marketplace enrollment guide.
Gather Information
Step 1Collect Social Security numbers, immigration documents (if applicable), employer and income information, and current policy numbers for everyone who needs coverage.
Compare Plans Side by Side
Step 2Review options from Highmark, AmeriHealth, and Ambetter across all metal tiers. Compare premiums, deductibles, provider networks, and prescription drug coverage.
Check Financial Assistance
Step 3Determine eligibility for premium tax credits, cost-sharing reductions, or Medicaid/CHIP based on household income and family size.
Enroll and Pay First Premium
Step 4Select a plan that fits the household budget and healthcare needs. Contact the carrier directly to make the first premium payment — coverage is not active until payment is received.
Free in-person enrollment assistance is available statewide through Westside Family Healthcare navigators and certified application counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown.
Compare Delaware Health Insurance Plans
See plans from Highmark BCBS, AmeriHealth, and Ambetter side by side — with real premium estimates based on your zip code, household size, and estimated income so you can compare costs after subsidies.
Compare All Carriers Call 888-215-4045Financial Help for Delaware Health Insurance
Multiple programs help make Delaware health insurance more affordable for qualifying residents. Over 90% of marketplace enrollees receive some form of financial assistance, with subsidies averaging $538 per month in 2025. Delaware’s state reinsurance program also helps stabilize premiums for the individual market by reimbursing carriers for high-cost claims, keeping full-price premiums lower for residents who do not qualify for subsidies.
Premium Tax Credits
Federal premium tax credits are available to individuals earning up to $62,600 per year (400% FPL) and families of four earning up to $128,600 who purchase marketplace coverage. These credits reduce monthly premiums and can be applied in advance or claimed at tax time.
Cost-Sharing Reductions
Residents earning up to 250% FPL (approximately $39,125 for an individual) may qualify for additional savings on deductibles, copays (fixed per-visit fees), and coinsurance (the percentage share of costs after the deductible). These reductions apply only to Silver-tier plans. Roughly 30% of Delaware enrollees received CSR benefits in 2025.
Medicaid & CHIP
Delaware expanded Medicaid under the ACA, covering adults earning up to 138% FPL (approximately $21,597 for an individual). The Delaware Healthy Children Program (CHIP) covers uninsured children under 19. Both programs are open year-round through Delaware DHSS or HealthCare.gov.
Choosing the Right Delaware Health Insurance Plan
Bronze plans starting around $542 per month suit healthy enrollees who rarely see a doctor, while Gold plans with lower deductibles typically save money for anyone managing an ongoing condition — and Silver paired with cost-sharing reductions often delivers the best overall value for subsidy-eligible households earning below 250% of the federal poverty level.
Healthy and Rarely Use Care
BronzeBronze plans offer the lowest premiums starting around $542/month for a 40-year-old HMO. Accept higher deductibles in exchange for lower monthly costs.
Moderate or Uncertain Needs
SilverSilver plans balance premiums and deductibles. The only tier eligible for cost-sharing reductions — a significant benefit for incomes between 100% and 250% of FPL.
Frequent Care or Ongoing Conditions
GoldGold plans carry higher premiums but deductibles as low as $1,106. Often the most cost-effective choice for residents with predictable, regular healthcare expenses.
Need Provider Flexibility
PPOHighmark’s PPO plans are the only option in Delaware for out-of-network coverage. Best for residents who travel, see out-of-state specialists, or want the widest provider access.
Frequently Asked Questions About Delaware Health Insurance
Three carriers sell Delaware health insurance on the marketplace for 2026, open enrollment runs from November 1 through January 15, and premium tax credits can reduce monthly costs to $0 for eligible residents. The questions below cover enrollment deadlines, carrier changes, subsidies, and the state’s insulin cost cap.
How many health insurance carriers are in Delaware?
Three carriers offer marketplace plans in Delaware: Highmark Blue Cross Blue Shield (PPO), AmeriHealth Caritas (HMO), and Ambetter by Celtic (EPO). Aetna exited the marketplace at the end of 2025.
When is Open Enrollment for Delaware health insurance?
Open Enrollment runs from November 1 through January 15 each year. Enrolling by December 15 ensures coverage begins January 1. After January 15, enrollment requires a qualifying life event such as job loss, marriage, birth of a child, or a move to a new coverage area.
Does Delaware have its own health insurance exchange?
No. Delaware uses the federally facilitated marketplace at HealthCare.gov. All individual and family marketplace enrollment, subsidy applications, and plan comparisons are handled through the federal platform.
How much does health insurance cost in Delaware after subsidies?
After premium tax credits, the average Delaware marketplace enrollee paid approximately $217 per month in 2025. Subsidy amounts vary by income — a single adult earning $35,000 could see a Silver plan drop to roughly $150–$180 per month after credits.
What is the income limit for health insurance subsidies in Delaware?
Individuals earning up to $62,600 per year and families of four earning up to $128,600 generally qualify for premium tax credits. Additional cost-sharing reductions are available for Silver plans if individual income is below approximately $39,125.
Does Delaware cap insulin costs?
Yes. Delaware law caps insulin out-of-pocket costs at $35 per month for residents enrolled in state-regulated health plans, including all marketplace coverage. Specialty drug costs are capped at $150 per month.
Delaware Health Insurance Resources
How to enroll, deadlines, and qualifying life events.
Affordable CoverageLow-cost plans, subsidies, and strategies to reduce premiums.
Best Plans & CarriersHighmark, AmeriHealth, and Ambetter ranked and compared.
PPO PlansFlexibility for specialists and out-of-network care nationwide.
Find the Right Delaware Health Insurance Plan
With plans across Bronze, Silver, Gold, and Platinum tiers from three carriers, the right coverage depends on zip code, income, and household size. See every option side by side in minutes.
Compare All Carriers Call 888-215-4045Broker Disclosure
ForHealthInsurance.com is an independent health insurance agency serving Delaware residents. We are not affiliated with any carrier or government agency. We help you compare plans and enroll in coverage that meets your needs at no extra cost to you.