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Medicare in Delaware

October 6, 2016

Once you reach the retirement age of 65, you may want affordable health insurance coverage in case you get sick or your health suddenly deteriorates. This is where Medicare, the government-sponsored health insurance plan, comes in. Some people are eligible for Medicare before the age of 65.

As a Delaware Medicare beneficiary, you generally have access to hospital and medical insurance under Original Medicare, Part A and Part B, and might have Medicare plan options available to you under the Medicare Advantage (Medicare Part C) and Medicare Part D (prescription drug coverage) programs.

Original Medicare for Delaware beneficiaries

Original Medicare includes both Medical Part A (hospital insurance) and Medical Part B (medical insurance). In Delaware, as in the rest of the United States, you might be automatically enrolled in Original Medicare as soon as you become eligible. Otherwise, you may want to enroll in Original Medicare during the Medicare Initial Enrollment Period to avoid a possible late-enrollment penalty. Your Initial Enrollment Period begins three months before you turn 65 and ends four months after that date. If you miss your Initial Enrollment Period, you’re able to enroll in Medicare during the annual General Enrollment Period, which runs from January 1 to March 31, but you may have to pay higher monthly premiums.

Delaware Medicare beneficiaries (like those in other states) often receive Medicare Part A (hospital insurance) without a monthly premium. The Part A premium is generally waived if you’ve worked at least 10 years (40 quarters) while paying Medicare taxes. Those Medicare beneficiaries without the qualifying work history may have to pay a Part A monthly premium. Medicare beneficiaries may receive health benefits under Medicare Part A such as (but not limited to):

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Limited home health services

Medicare Part B (medical insurance) comes with a monthly premium in most cases. Delaware Medicare beneficiaries whose annual income is above a certain amount may have higher Part B premiums. Under Medicare Part B, Delaware residents may be eligible for health benefits such as (but not limited to):

  • Clinical research
  • Ambulance services
  • Durable medical equipment
  • Mental health (inpatient, outpatient, and partial hospitalization)
  • Getting a second opinion before surgery
  • Limited outpatient prescription drugs 

Medicare plan options in Delaware

The Medicare Advantage program (Medicare Part C) offers Delaware residents an alternative way to receive their Medicare benefits. In Delaware and the rest of the United States, Medicare Advantage plans are required to offer at least the same coverage as Original Medicare, Part A and Part B, with the exception of hospice care, which is still covered under Part A. Some Medicare Advantage plans in Delaware might include additional coverage, like routine dental, vision, and hearing benefits. In many cases, you can combine health and prescription drug coverage under a single Medicare Advantage Prescription Drug plan. But remember that whether you enroll in a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan, you have to stay enrolled in Original Medicare and continue paying the Medicare Part B premium in order to keep your health insurance coverage and avoid being dis-enrolled from Medicare. Learn more about Medicare Advantage plans in Delaware.

Medicare Supplement (Medigap) plans help pay for some of your out-of-pocket costs under Original Medicare, including cost-sharing expenses and emergency overseas travel coverage. Plan benefits are standardized across 10 plan types (labeled letters A through N), and each plan includes different benefits and level of coverage. In 47 states, including Delaware, Medigap plans offer the same standardized benefits for plans of the same letter type. Also, please note that some companies may offer additional innovative benefits.

These plans can only be used to help with Original Medicare costs, and you’ll need to stay enrolled in Part A and Part B for your hospital and medical coverage. In addition, keep in mind that prescription drug coverage isn’t included in these plans, so if you want help with your medication costs, you should enroll in a stand-alone Medicare Prescription Drug Plan.

Specific plan types and premium amounts may vary depending on where you live in the state. Find out about Medicare Supplement plans in Delaware.

The Medicare Part D program offers prescription drug coverage to Delaware Medicare beneficiaries. Costs of Delaware Medicare Part D Prescription Drug Plans may vary, and they generally depend on the type of coverage selected by each beneficiary. Medicare Part D Prescription Drug Plans in Delaware, as in the rest of the United States, may require payment of a monthly premium, annual deductible, and copayment or coinsurance. Get information about Medicare Prescription Drug Plans in Delaware.

As a Medicare beneficiary in Delaware, you might have access to various Medicare Advantage, Medigap, and Medicare Prescription Drug Plans, depending on the county in which they live. For example, a resident of Wilmington in New Castle County might have different Medicare plan options available than a resident of Dover in Kent County. To find a Medicare plan option that fits your needs, you can customize your search for plans based on your individual health needs. Just enter your zip code where indicated on this page to get started.

More information for Medicare beneficiaries in Delaware

Delaware Medicare beneficiaries with Medicare-related issues and concerns can contact the following resource for more information:

 

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.