Delaware Medicaid: Overview and Eligibility Requirements

In this article...
  • Delaware Medicaid provides health coverage to low-income and disabled residents. Read on to learn more about this program and its application requirements.

What Is Delaware Medicaid?

Delaware Medicaid is a cooperative effort between Delaware's state government and the United States federal government. The program provides health coverage for low-income residents of Delaware as well as elderly or disabled residents who don't have enough income to pay for necessary medical services.

Covered Services

In Delaware, Medicaid pays for a wide variety of medical and behavioral health services. Under this program, coverage is available for blood and urine tests, X-rays, hospital care, routine vaccinations, prescription drugs, substance abuse treatment and doctor visits.

As of October 2020, Delaware's Medicaid program covers up to $1,000 per year in dental care for adults between the ages of 21 and 65. An additional $1,500 worth of care per year may be available if the beneficiary needs emergency dental care or has a severe dental issue requiring supplementary care.

Plan Types

Most Delaware Medicaid participants are enrolled in a managed care plan. Residents have two options for managed care: High Mark Health Options and AmeriHealth Caritas. Participants who also have Medicare coverage or receive Medicaid for long-term care are enrolled in the fee-for-service Medicaid plan. Under this type of plan, Medicaid reimburses health care providers directly for any services they provide.

Who Is Eligible for Medicaid in Delaware?

Eligibility Overview

Unlike some states, Delaware doesn't consider an individual's assets when determining eligibility for Medicaid. This means applicants may still qualify for Medicaid even if they own their own homes or personal vehicles. Delaware Medicaid is also available to working individuals, provided their income doesn't exceed the annual limit. Delaware even has a program to provide Medicaid coverage to families who previously received a welfare check and have now returned to work.

Residency and Citizenship

Applicants must provide proof of Delaware residency to qualify for Medicaid coverage. An applicant must also be a U.S. citizen or qualifying immigrant to receive services through Medicaid. U.S. nationals, permanent residents and legal aliens are all considered qualifying immigrants for the purpose of determining Medicaid eligibility.

Income Limits

To qualify for Medicaid in Delaware, adult applicants must meet one of the following requirements:

  • Responsible for a child under the age of 19
  • Pregnant
  • Age 65 or older
  • Blind
  • Have a disability or live with a family member who has a disability

Applicants must also meet certain income requirements to qualify for Medicaid. The annual income limit depends on an applicant's household size, with larger households allowed to earn higher incomes. The table below shows the income limits for households of one to eight people.

Household Size Maximum Annual Income
1 $16,971
2 $22,930
3 $28,888
4 $34,846
5 $40,805
6 $46,763
7 $52,722
8 $58,680

How Do I Enroll in Medicaid in Delaware?

Individuals in need of Medicaid coverage should visit the Delaware ASSIST website to fill out an application. Click the Apply for Benefits button, confirm that you've turned off your pop-up blocker, and create an account to fill out the application for assistance. This application is used to determine eligibility for several assistance programs, including Medicaid and food stamps.

Contact Information for Delaware Medicaid

Email: medicaidinfo@delaware.gov

Customer Relations Hotline: (866) 843-7212