Medicare in Delaware
- Medicare can be confusing. Find out what options are available for Delaware residents and get some guidance on how and when you might apply.
What Delaware Medicare Plans Are Available?
Medicare is a federally funded insurance program for retired adults as well as those who have certain types of disabilities. If you're approaching retirement age, you may realize that Medicare coverage is coming. But what does that mean, and do you have any options? Find out more about the Medicare Plans available to Delaware residents below.
- Medicare Part A
This is one half of what most people think about when they consider Medicare, which is Original Medicare. Part A coverage doesn't cost most people who qualify anything and covers inpatient medical stays, such as staying overnight in a hospital for a surgery or spending time in a skilled nursing facility.
- Medicare Part B
This is the other half of Original Medicare. It offers coverage for outpatient medical needs, such as doctor's appointments, lab work and physical therapy. Medicare Part B also pays for some medically necessary equipment and supplies. That can include things such as hospital bed rentals, wheelchairs, mobility devices like walkers or canes and maintenance supplies such as diabetic test trips. Medicare Part B does come with a monthly premium for most people as well as a small annual deductible and a copay on most services. How much you pay in premiums depends on your income, but the amount is usually taken out of your Social Security benefit so you don't have to worry about making a payment.
- Medicare Part C
Part C plans are also called Medicare Advantage plans. These are administered by private health insurance companies and are designed to take the place of Parts A and B. They have to offer at least the same benefits that are offered by Parts A and B, but many Part C options offer additional coverage. You do pay a premium monthly and may have a deductible and copay, so it's important to compare your coverage options and what you might pay out of pocket with each type of Medicare coverage before you make a selection. Choose the option that seems to cover the benefits you might need most.
- Medicare Part D
Part D is the Medicare prescription drug benefit. It helps reduce the cost of your prescription medications. You can choose to purchase such a plan to add on to Part A/B or Part C. However, some Medicare Advantage Plans already have prescription drug coverage, so double check before you decide on a plan.
- Medicare Supplement Insurance
This is sometimes called Medigap. It's an insurance plan that covers costs Medicare doesn't, including deductibles and copays. These plans can be a good idea for older adults who are managing chronic diseases or for anyone who thinks they may deal with large medical bills. If you can't afford supplemental insurance coverage, consider applying for Delaware Medicaid. Medicaid can act as an insurance secondary to Medicare.
In Delaware in 2020, a total of 213,678 people where covered by Medicare. Of those, 174,919 had opted for Original Medicare coverage and 38,759 had opted for Medicare Advantage plans.
Who Is Eligible for Delaware Medicare?
Most people age 65 and older are eligible for Medicare in Delaware. Individuals with certain disabilities may also be eligible for Medicare earlier if their disability impairs their ability to work and earn a certain level of income.
If you or your spouse worked and paid into the Medicare and Social Security system, meeting minimum requirements over your lifetime, you'll be automatically enrolled in Medicare as long as you're getting Social Security benefits within 4 months of your 65th birthday. You'll typically receive your Medicare card along with additional enrollment information around 3-4 months prior to your 65th birthday. The coverage starts on the first day of the month you turn 65.
However, if you want to change your enrollment elections or you're not automatically enrolled in Part A, you can enroll during your Initial Enrollment Period. That's a time period that begins 4 months before your 65th birthday and goes to 3 months after.
You're not locked into the coverage you select for life, though. And if you miss or don't enroll during that 7 month period, you can also enroll during other periods, including:
- Special enrollment periods, which occur right after you lose coverage through an employer or a spouse's employer
- Open enrollment periods, which occur from October 15 to December 7 each year
- Medicare Advantage open enrollment, which occurs from January 1 through March 31 each year and lets you switch from a Medicare Advantage plan to another one or to Original Medicare
How Do I Enroll in Medicare in Delaware?
If you're not automatically enrolled or don't receive a benefits package from Medicare, you can enroll online. The online application offered by the Social Security Administration takes only around 10 minutes to complete. You can also call the Social Security Administration or go to a local office to get help applying for Original Medicare.
Contact Information for Delaware Medicare, Medicaid and Insurance Help
- Read more about Delaware Medicaid to find out if you might be eligible for this coverage too.
- Visit the Delaware Medicare Assistance Bureau online or call them at 800-336-9500 to learn more about Medicare coverage or get assistance applying for benefits.
- Continue your research on the Delaware Department of Insurance
Find out about the Delaware Prescription Assistance Program, which can help eligible individuals cover the cost of prescription drugs.