Delaware Medicare beneficiaries have access to a range of coverage options, state-specific protections, and free counseling services. This comprehensive Delaware Medicare guide covers your SHIP office contacts, Medigap plan availability, birthday rule protections, Medicare Savings Program eligibility, Medicare Advantage options, and how to compare plans. Whether you are turning 65, helping a parent navigate Medicare, or re-evaluating your coverage, understanding Delaware Medicare rules is essential for making informed decisions.
All information in this guide has been verified against official state sources, CMS data, and NAIC reports as of April 2026.
In This Delaware Medicare Guide:
Delaware SHIP — Free Medicare Counseling
Every state has a State Health Insurance Assistance Program (SHIP) that provides free, unbiased Medicare counseling. Delaware’s SHIP program can help you understand your coverage options, compare plans, resolve billing issues, and navigate enrollment periods at no cost.
| SHIP Program | Delaware Medicare Assistance Bureau (DMAB) |
| Phone | 1-800-336-9500 |
| Website | https://insurance.delaware.gov/divisions/dmab/ |
SHIP counselors are trained volunteers and staff who are not affiliated with any insurance company. They do not sell plans. Contact your Delaware SHIP office before making any major Medicare decisions.
Delaware Medigap (Medicare Supplement) Plans
Medigap plans in Delaware help cover out-of-pocket costs not paid by Original Medicare, including the Part A deductible, Part B coinsurance, and skilled nursing facility copays. Medigap plans are standardized by federal law, meaning Plan G from one carrier covers the same benefits as Plan G from another carrier. The difference is premium cost.
Plans available in Delaware: A, B, C, D, F, G, K, L, M, N (Plans C and F available only to those Medicare-eligible before January 1 2020)
Most popular plan: Plan G (most popular among new enrollees; Plan F remains most popular overall at 40% but is closed to new beneficiaries since 2020) is the most popular Medigap plan in Delaware. Plan G covers all gaps in Original Medicare except the annual Part B deductible ($240 in 2026). Plan N is the most popular lower-premium alternative, with small copays for some doctor visits and ER visits.
Pricing method: Delaware uses community-rated Medigap pricing. This is the most favorable method for consumers because premiums are the same regardless of age. Your premium will not increase simply because you get older.
The average monthly Plan G premium for a 65-year-old in Delaware is approximately $161. Plan N averages approximately $125 per month. Actual premiums vary by carrier, age, gender, tobacco use, and zip code. Always compare quotes from at least three carriers.
Delaware Medigap Birthday Rule
Delaware is one of the few states with a Medigap birthday rule. Effective January 1, 2026, under Senate Bill 71, Delaware Medigap enrollees have a 60-day annual window (30 days before through 30 days after their birthday) to switch to any Medigap plan with the same or lesser benefits on a guaranteed-issue basis, without medical underwriting. Insurers must notify members at least 30 days before their birthday window.
This annual switching window gives Delaware Medicare beneficiaries an opportunity to change Medigap plans without medical underwriting, potentially finding lower premiums or better coverage. Not all states offer this protection.
Delaware guaranteed issue protections: Delaware follows all federal Medigap guaranteed issue rights plus the birthday rule (SB 71) providing an annual guaranteed-issue switching window. SB 71 also grants guaranteed issue rights when switching from Medicare Advantage back to Original Medicare. Under-65 Medicare beneficiaries with disabilities are also eligible for Medigap in Delaware.
Delaware Medicare Advantage (Part C)
Approximately 250000 people in Delaware are enrolled in Medicare. About 32% of Delaware Medicare beneficiaries choose Medicare Advantage plans, with the remainder on Original Medicare with or without Medigap supplement coverage.
Medicare Advantage plans in Delaware are offered by private insurers as an alternative to Original Medicare. Most MA plans include prescription drug coverage (Part D) and often add dental, vision, and hearing benefits. However, MA plans use provider networks, which can limit your choice of doctors and hospitals.
Key Medicare Advantage considerations in Delaware:
- Networks matter: HMO plans require you to use in-network providers except in emergencies. PPO plans allow out-of-network care at higher cost.
- $0 premium plans: Many Delaware MA plans have $0 monthly premiums (you still pay your Part B premium).
- Maximum Out-of-Pocket (MOOP): MA plans cap your annual spending, unlike Original Medicare which has no cap.
- Star ratings: CMS rates MA plans 1-5 stars. Higher-rated plans often have lower costs and better coverage.
Top Medicare Advantage carriers in Delaware by enrollment:
- UnitedHealthcare
- Humana
- Aetna
- Highmark Blue Cross Blue Shield
- Wellcare
Delaware Medicare Financial Help Programs
Delaware offers Medicare Savings Programs (MSPs) that help low-income Medicare beneficiaries pay for premiums, deductibles, and copays. The four programs are:
- QMB (Qualified Medicare Beneficiary): Pays Part A and Part B premiums, deductibles, coinsurance, and copays.
- SLMB (Specified Low-Income Medicare Beneficiary): Pays Part B premiums only.
- QI (Qualifying Individual): Pays Part B premiums (limited funding, first-come first-served).
- QDWI (Qualified Disabled Working Individual): Pays Part A premiums for disabled workers.
Delaware MSP eligibility: QMB: 1235/month single, 1663/month married; SLMB: 1478/month single, 1992/month married; QI: 1660/month single, 2239/month married. No asset limit in Delaware.
Apply through your local SHIP office or your state Medicaid agency for free help determining eligibility.
Top Medicare Insurance Companies in Delaware
Top Medigap carriers in Delaware:
- AARP/UnitedHealthcare
- Mutual of Omaha
- LifeShield National Insurance
- State Farm
- Wellabe
When comparing carriers, focus on premium cost (for identical standardized Medigap plans, benefits are the same — only price differs), financial strength ratings from AM Best (A or higher), customer satisfaction ratings, and claims processing speed.
Delaware Medicare Enrollment Periods
Understanding Medicare enrollment deadlines prevents costly late enrollment penalties:
- Initial Enrollment Period (IEP): 7-month window around your 65th birthday (3 months before, birthday month, 3 months after). Enroll in Parts A and B during this period.
- Medigap Open Enrollment: Standard federal 6-month Medigap Open Enrollment Period beginning the first day of the month the beneficiary is both age 65 or older and enrolled in Part B. Delaware does not extend this initial OEP beyond 6 months, but the birthday rule provides annual guaranteed-issue switching opportunities thereafter.. During this period, insurance companies cannot deny you Medigap coverage or charge higher premiums based on health conditions.
- Annual Enrollment Period (AEP): October 15 through December 7 each year. Switch between Original Medicare and Medicare Advantage, change MA plans, or add/change Part D drug plans.
- Medicare Advantage Open Enrollment Period (OEP): January 1 through March 31. Switch MA plans or return to Original Medicare (and add a Medigap plan, subject to underwriting).
- Special Enrollment Periods (SEP): Available when you lose employer coverage, move, or qualify for other life events.
Additional Delaware Medicare protections: Birthday rule (SB 71, effective January 2026) providing annual guaranteed-issue Medigap switching; mandatory carrier notification at least 30 days before birthday window; guaranteed issue rights when disenrolling from Medicare Advantage to Original Medicare; Medigap access for under-65 disabled Medicare beneficiaries; Delaware DOI compliance and enforcement standards for Medigap carriers under SB 71
Compare Delaware Medicare Plans
Ready to compare Medicare options in Delaware? Use the official Medicare Plan Finder or contact your local SHIP counselor for free, unbiased help.
Official Sources & Resources
- Medicare.gov: medicare.gov
- Delaware Department of Insurance: https://insurance.delaware.gov/
- Delaware Medicare Assistance Bureau (DMAB): https://insurance.delaware.gov/divisions/dmab/
- CMS.gov: cms.gov
- NAIC: naic.org
This Delaware Medicare guide was last verified against official sources in April 2026. If you notice outdated information, please contact us.