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Medicare in Delaware


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In 2018, there were 196,363 Medicare beneficiaries in Delaware, according to the Centers for Medicare and Medicaid Services (CMS). Delaware offers numerous resources to help these Medicare beneficiaries understand and take advantage of their coverage.

Original Medicare is the government health insurance program for American citizens and qualified legal residents aged 65 and older and those who qualify by disability. Original Medicare in Delaware includes Part A (hospital insurance), and Part B (medical insurance). The same is true in every state.

You may have other Medicare plan options in Delaware, as described below.

Original Medicare doesn’t include prescription drug coverage in most situations. A stand-alone Medicare Part D Prescription Drug Plan can help pay for your prescription medication costs. Designed to work alongside your Original Medicare coverage, Medicare Prescription Drug Plans are available from private insurance companies approved by Medicare.

You can apply for a Medigap (Medicare Supplement) insurance plan to work alongside your Original Medicare coverage.

Instead of getting your Original Medicare coverage directly through the government, in most cases you can sign up for a Medicare Advantage plan in Delaware. Medicare Advantage plans are offered by private insurance companies that contract with Medicare, and include all your Medicare Part A and Part B benefits except hospice care, which Medicare Part A covers. Many Medicare Advantage plans also include extra benefits such as routine dental and vision care. Some plans also include prescription drug coverage; these are called Medicare Advantage Prescription Drug plans, and they deliver all your Medicare benefits come through a single plan.

With any type of Medicare Advantage plan, you have to keep paying your Medicare Part B premium, along with your plan premium if there is one.

Medicare resources in Delaware

Delaware Medicare Assistance Bureau (DMAB) – Formerly known as ELDER info, DMAB is the State Health Insurance Assistance Program (SHIP) of Delaware, which is part of the Delaware Department of Insurance. DMAB offers free health and insurance counseling to those with Medicare through volunteers who have completed extensive health insurance training. The DMAB team of trained counselors can answer questions, provide information, and empower Medicare beneficiaries in Delaware to better understand their options and make sound decisions regarding their health care. DMAB offers one-on-one confidential counseling, and there is no charge for their services.

Delaware Senior Medicare Patrol Program – This program was designed to provide public information to all Medicare beneficiaries in Delaware. This program encourages beneficiaries to read their Medicare summary notices for accuracy and to ask questions if they believe they have received incorrect information. The Senior Medicare Patrol offers training to retired citizens so that they may offer aid to other beneficiaries. This program is a key resource for anyone who suspects fraud or abuse of the Medicare program. This office also offers links and telephone contacts to federal and state agencies that specialize in fraud and abuse cases.

Quality Improvement Organization Program – This program, also called KEPRO, exists in many states, including Delaware. KEPRO is dedicated to promoting significant improvements to Medicare quality. This QIO protects Delaware Medicare beneficiaries by helping providers improve their delivery of health care, and providing safer and more effective care to beneficiaries. This organization also fights to remove socioeconomic, educational, and cultural barriers that limit access to health care. Delaware’s KEPRO offers not only valuable consumer resources, but also detailed information about the rights, health, and care of beneficiaries in the state.

Medicare statistics in Delaware

Here are some interesting statistics regarding Medicare in Delaware as of 2018, according to CMS:

  • There were 147,208 Medicare beneficiaries enrolled in Medicare Prescription Drug plans (including Medicare Advantage Prescription Drug plans).
  • Of these beneficiaries, CMS estimates 85% could enroll in a Medicare Prescription Drug Plan with a lower premium than they paid in 2017.
  • Everyone who has Medicare in Delaware is expected to have access to a Medicare Advantage plan in 2018.
  •  28,167 beneficiaries (14% of beneficiaries) in Delaware were enrolled in Medicare Advantage and other Health plans in 2018.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

The product and service descriptions, if any, provided on these eHealth Insurance Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply.

Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year.

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