Updated: November 21, 2024
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Best Health InsuranceDelawareBest Health Insurance in Delaware
Why Trust MoneyGeek? We downloaded plan data for Delaware directly from the Centers for Medicare & Medicaid Services (CMS). MoneyGeek’s scoring methodology balances costs, claims approval and plan types to find the best providers in the state.
Plan data was updated with the CMS exchange data released in October 2023 for the 2024 enrollment period.
Ambetter has a MoneyGeek rating of 72 out of 100 and is the overall best health insurance in Delaware. The provider has low costs and low out-of-pocket maximums. It also has a record of denying fewer claims than its competitors.
To learn which company offers the best health insurance, we looked at 17 plans in Delaware, including Silver EPO, HMO and PPO plans.
Very few claims denied
Low out-of-pocket costs
Diverse range of plan types
Higher premium rates
MoneyGeek's top pick for the best health insurance in Delaware is Ambetter. The provider offers eight Silver EPO plans at an average plan rate of $563 per month. The average maximum out-of-pocket cost for these plans is $5,400.
Ambetter's Silver EPO plans are known for their simple structure where you don't need to get a referral to see a specialist. They offer an average plan rate of $581 with an average maximum out-of-pocket cost of $7,725. Ambetter has a denial rate of 15%, which means customers are more likely to get covered.
MoneyGeek recommends the following Silver plans:
With a score of 80 out of 100, Highmark Blue Cross Blue Shield has the highest MoneyGeek ranking for health insurance in Delaware. This provider offers plans with low out-of-pocket costs and has a good record of not denying claims as often as other providers in the competition.
Looking at the Gold and Platinum plans, we evaluated eight EPOs, three HMOs and nine PPO plans in Delaware for this analysis.
Approves the majority of claims
Low out-of-pocket maximum costs
Offers a diverse range of plan types
MoneyGeek's top pick for the best health insurance in Delaware for low out-of-pocket costs is Highmark (BCBS). They offer six Gold PPO plans and three Platinum PPO plans, known for lower out-of-pocket costs. PPO plans also have more options for out-of-network coverage.
They offer an average plan rate of $654 and the average maximum out-of-pocket cost for these plans is $6,222. Highmark (BCBS) has a denial rate of 13%, which is lower than most of the competition.
MoneyGeek recommends the following Gold and Platinum plans:
AmeriHealth offers the best cheap health insurance in Delaware, with a MoneyGeek score of 54. The provider has the cheapest plan options, though it does not score well in its average out-of-pocket costs factor and has a tendency to deny claims more often than its competitors do.
For the analysis, 17 Silver plans in Delaware were evaluated, including eight Silver EPO, six Silver HMO and three Silver PPO plans. MoneyGeek gave more weight to plans with lower monthly premiums in determining the best provider. However, typically, plans with lower premiums will have higher out-of-pocket costs.
Offers affordable premium rates
Offers multiple plan options
Denies claims more frequently
Limited plan options
MoneyGeek's top pick for the best cheap health insurance in Delaware is AmeriHealth. This insurer offers two Silver plans, among them are HMOs. With an HMO, you usually need to stay within the network, but this can help keep costs down.
This insurer offers an average plan rate of $531 with an average maximum out-of-pocket cost of $9,250 for these plans. AmeriHealth has a denial rate of 38%, much higher than that of most providers in the competition.
MoneyGeek recommends the following cheap Silver plans:
With a MoneyGeek score of 55 out of 100, AmeriHealth offers low-income people the best health insurance in Delaware. It also provides the cheapest plan options in the state.
In Delaware, we analyzed 17 plans, which include eight Silver CSR EPO, six Silver CSR HMO and three Silver CSR PPO plans.
MoneyGeek focused more on plans with low monthly premiums that offer cost-sharing reductions (CSRs). CSRs help lower what you must pay out of your pocket if you make a certain amount each year. A typical Silver plan pays for about 70% of your health care, but CSR Silver plans can help pay even more.
Here's what you might expect with a CSR Silver plan:
Remember, how much you can earn to fall into these categories changes if you have more or fewer people living in your home.
Low premium rates
Diverse plan options available
Higher potential for out-of-pocket costs
Frequent claim denials
MoneyGeek's top pick for the best health insurance in Delaware for low-income people is AmeriHealth. This provider offers cost-effective plans for individuals earning below 250% of the federal poverty line (FPL). AmeriHealth provides two Silver CSR plans in Delaware at an average cost of $531 per month. The average MOOP for these plans is $7,375.
The provider offers no PPO or POS plans; however, EPO plans typically have lower monthly premiums. The company's denial rate is 38%, much higher than most other competitors. That means there is a high likelihood of your claim not being accepted.
Plan Recommendations
AmeriHealth's top-rated plan offers lower out-of-pocket expenses for the same premium for people in different income brackets. Here are some of the lower overall out-of-pocket costs based on income levels:
Highmark (BCBS), with a MoneyGeek score of 98 out of 100, offers the best health insurance in Delaware for young adults. The provider has good rates, low out-of-pocket costs and better-than-average claims approval. On the other hand, only young adults under the age of 30 may purchase Catastrophic plans.
In Delaware, we evaluated one Bronze HMO plan, 15 Expanded Bronze plans and one Catastrophic PPO plan for this category.
Affordable premium rates
Low out-of-pocket costs
Very few claims denied
Varieties of plan types offered
Highmark Blue Cross Blue Shield is the best issuer for young adults seeking health insurance in Delaware. The provider offers one Catastrophic plan and five Expanded Bronze plans for those who might not need medical services more often. Each plan is a PPO, which usually has more coverage for services outside your network.
The insurer offers an average plan rate of $308, with an average maximum out-of-pocket cost of $8,875 for these plans. Highmark Blue Cross Blue Shield's 13% denial rate is lower than that of most competitors.
MoneyGeek recommends the following plans for young adults:
Health insurance companies have different plan types to offer. The best providers for all plan categories available in the state are:
MoneyGeek's recommendations focus on Silver plans. Silver plans offer a good balance between monthly costs and what you pay when you go to the doctor. Silver plans work well for people who do not go to the doctor very often.
In Delaware, eight Silver EPO plans, six Silver HMO plans and three Silver PPO plans are available.
MoneyGeek's top pick for the best health insurance in Delaware for Silver PPO plans is Highmark Blue Cross Blue Shield. It offers three Silver PPO plans with an average plan rate of $585 and an average maximum out-of-pocket cost of $9,217 for these plans. The provider has a denial rate of 13%, which means it denies fewer customer claims than average.
PPO plans give you the freedom to choose your doctors and you don't need a referral to see a specialist. This can be really nice if you want more choices. But, they can cost more than other health insurance types like HMO plans, so it's important to think about your budget.
We suggest the following Silver PPO plans from Highmark (BCBS):
MoneyGeek's top pick for the best health insurance for Silver EPO plans in Delaware is Ambetter. This provider offers eight different Silver EPO plans. It has an average plan rate of $581 with an average maximum out-of-pocket cost of $7,725 for these plans. The provider has a denial rate of 15%. This means customers are more likely to have their claims covered.
Silver EPO plans have both benefits and drawbacks. They're notable because they are quite common, being the third most common plan type. One positive aspect is that you might not need a referral to see a specialist, which gives you some flexibility in your health care. However, like HMOs, you are required to use the doctors and hospitals within the plan's network except in emergencies, limiting your options.
We suggest the following Silver EPO plans from Ambetter:
MoneyGeek's top pick for the best health insurance in Delaware for Silver HMO plans is Aetna Medicare. They offer four HMO plans. These plans have an average rate of $561, and the average maximum out-of-pocket cost is $9,075. The provider has a denial rate of about 21%, a rate that is a bit higher than average.
HMO plans are often chosen because they can be less expensive. But you have to see doctors in the network for your care to be covered, except in an emergency. If you want to see a specialist, you need to get a referral from your regular doctor. These plans can be good if you're looking to pay less every month, and you're okay with the choice of in-network doctors.
We suggest the following Silver HMO plans from Aetna:
With a total MoneyGeek score of 85 out of 100, UnitedHealthcare ranks as the best short-term health insurance provider in Delaware.
Short-term health insurance isn’t a permanent replacement for standard health insurance. These plans aren’t required to comply with the Affordable Care Act, so most of them fail to cover essential health benefits.
National General Accident & Health stands out because it offers a wide range of plan options to accommodate various health care demands. For high-risk patients, the company offers plans with modest co-insurance and out-of-pocket expenses. Plans can have durations of three months to three years and offer several options for cost-sharing and prescription drug coverage.
Choosing the best health insurance is a balancing act. You must weigh your health care needs against how much you can afford to pay in terms of monthly premiums and out-of-pocket costs. Here’s MoneyGeek’s advice when shopping for health insurance.
In health insurance, in-network means doctors and hospitals that have a deal with the insurance company. This deal means lower prices when you go see them. Out-of-network means no special deal, so it costs more to get care from these health care providers. Different plans, such as PPO and EPO, have different ruling regarding the use of in-network or out-of-network services.
Delaware has three PPO and eight EPO plans. PPO plans allow you to visit out-of-network doctors and hospitals. EPO plans cost less. However, you have to stay in-network or you pay the maximum care cost out of your own pocket.
When looking for health insurance, you want a good balance of how much you pay each month and how high your maximum out-of-pocket costs are. The best plan for you will fit your health needs and your budget.
Choosing a plan with a lower monthly cost might mean spending more on medical services before your insurance pays. But, if you pick a plan with a higher monthly payment, it could have a lower MOOP.
The Silver plan called "Clear Silver" from Ambetter has the lowest MOOP at $5,400. Its monthly premium is $563. It is lower than what you might pay on average for other Silver plans from Ambetter.
Having low monthly payments and a low MOOP are excellent, especially if you can still see good doctors and visit excellent hospitals.
Medicare is a federal health insurance program for adults who are 65 years of age or older. Younger individuals who have a qualifying disability or illness may also be eligible.
This program subsidizes health care services and has three components:
We’ve also outlined the best Medicare Advantage and best Medicare Supplement plans in Delaware to help you find the right plan that matches your needs.
Medicaid is another federal program that provides health coverage for eligible individuals with income below the state-specified threshold. In Delaware, you may qualify for Medicaid if your household income is at or below 100% of the current Federal Poverty Level (FPL) for your household size. Elderly adults, pregnant women, children and those with disabilities may also qualify for Medicaid.
Finding an ideal health insurance plan can be complicated due to concerns about price and availability. MoneyGeek answers some frequently asked questions to help you find the best options.
The best health insurance in Delaware for 2024 is provided by Ambetter. However, the best choice for you will depend on your unique circumstances and needs.
A plan with reasonable prices and sufficient coverage is what you should be looking for. Despite offering reduced prices, some plans and companies might only offer a few services that may not suit all your medical needs. Your unique needs will determine what the best health insurance plan for you is.
About Mark Fitzpatrick
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.
Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
