Medicare in Delaware
This article was updated on: 09/16/2018
As a Medicare beneficiary in Delaware, you may have many choices when it comes to your Medicare coverage. You may want to consider all available options, whether you keep Original Medicare, or get a Medicare plan such as Medicare Advantage offered through a private insurance company approved by Medicare. Here’s an overview of your Medicare options in Delaware.
If you’re a Medicare beneficiary in Delaware, Original Medicare works the same way as it does throughout the country. Original Medicare provides health coverage for beneficiaries aged 65 and older, as well people under 65 with certain disabilities and illnesses.
Original Medicare comes in two parts, Medicare Part A and Part B. Medicare Part A covers inpatient hospital services, skilled nursing facility care, and limited home health care. Medicare Part B covers medical services, such as doctors’ visits, preventive services, medically necessary durable medical equipment, and other items and services. Original Medicare doesn’t include prescription drug coverage, which is optional and can be obtained separately through Medicare-approved private insurance companies.
Types of Medicare coverage in Delaware
Delaware beneficiaries may have Medicare insurance plan options as well. Private insurance companies contract with Medicare to provide certain types of coverage, such as prescription drug coverage and supplemental coverage. Prices and availability may vary among companies and locations.
Types of Medicare insurance plan options include:
- Medicare Advantage (Part C): This is a type of Medicare health plan that provides at least the same level of benefits as Original Medicare, but can also include additional benefits, such as prescription drug coverage, or routine vision and dental services. Costs and coverage might differ among plans, and not every Medicare Advantage plan will be available in each county. You must still continue paying your Part B premium when you have a Part C plan.
- Medicare prescription drug coverage (Part D): Medicare prescription drug benefits are available through stand-alone Medicare Part D Prescription Drug Plans or Medicare Advantage Prescription Drug plans. Stand-alone Part D plans work alongside your Original Medicare (Part A and Part B) coverage, while Medicare Advantage Prescription Drug plans provide all your Medicare coverage through a single plan. Medicare prescription drug coverage is only available through private insurance companies approved by Medicare.
- Medicare Supplement (Medigap): Medigap insurance may help with out-of-pocket costs not covered in Original Medicare, such as copayments, coinsurance, or foreign travel emergency health coverage. Medicare Supplement insurance only works with Original Medicare costs and can’t be used with Medicare Advantage.
Medicare resources in Delaware
- Medicare Savings Programs: These programs help with Original Medicare costs for people with limited income. To find out if you qualify, contact your state’s Medicaid department.
- Delaware State Health Insurance and Assistance Programs (SHIP): Delaware Medicare Assistance Bureau is Delaware’s Medicare counseling organization that helps people with Medicare understand their options and answers any questions they may have.
How to apply for Medicare in Delaware
To apply for Medicare in Delaware, you must be a United States citizen or legal permanent resident of at least five continuous years. You’re generally eligible when you are 65 or older, but you may qualify under 65 through disability or having certain conditions. You’ll get Medicare Part A for free if you’ve worked at least 10 years (40 quarters) while paying Medicare taxes, but you pay a premium for Medicare Part B.
There are some circumstances where you don’t need to take any action to enroll in Medicare. You may be automatically enrolled in Medicare if:
- You’re receiving Social Security or Railroad Retirement Board benefits. You’ll be automatically enrolled the first day of the month that you turn 65.
- You’re under 65 with a disability and have received disability benefits from Social Security or certain disability benefits from the Railroad Retirement Board for 24 months. You’ll be automatically enrolled in the 25th month of disability benefits.
- You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig’s disease). You’ll be automatically enrolled the same month that you start receiving disability benefits.
If you have End-Stage Renal Disease, you may qualify for Medicare before you’re 65, but you need to apply manually.
If you have to apply for Medicare manually, then you can enroll in Medicare through Social Security by:
- Visiting the Social Security website.
- Calling Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
- Visiting a Social Security office in person.
If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, from 9AM to 3:30PM.
If you’re interested in learning about your Medicare plan options, I can help you there. To take a look at my background and view my profile, click the View profile link by my photo. If you prefer to have me contact you directly, I can help you over the phone or email you some tailored Medicare plan information; just use the links below. Or, if you’d like to browse plans on your own, just use the Compare Plans button on the side of this page.