Delaware residents have several options if they want to buy health insurance. The average cost of premiums for Delaware health insurance is $541 per month, and that’s an expense that may be beyond the budget of some residents of the state. However, Delaware Medicare insurance offers health insurance coverage for certain individuals. Those qualified can include people who are older than 65 years of age, along with workers with disabilities.
Original Medicare refers to the combined coverage of Medicare Part A and Part B. Part A often does not require payment of monthly premiums, though a few others may have to. The Part A coverage includes inpatient care and other hospital services.
Medicare Part B covers the cost of medical treatments and supplies. There is a premium, which is determined by the amount of the beneficiary’s income. Both Parts A and B also come with deductibles and coinsurance payments.
Private health insurance carriers in Delaware which have been approved by Medicare can offer Medicare Advantage Plans. These are also known as Medicare Part C. These plans cover all the hospital and medical services that are covered by Medicare A and B. However, these plans may also include additional coverage not found in Original Medicare. These will require a premium as well.
Another option is Medicare Part D, which is also known as the Medicare Plan for Prescription Drugs. As its other name indicates, its purpose is to cover the cost of prescription drugs which many Medicare beneficiaries may be unable to afford at full price.
Other supplemental plans can also cover the various deductibles and coinsurance costs that come with Medicare. These plans may also provide coverage for medical services that are not covered in Medicare Parts A and B.
For those who receive Medicare Part A benefits and have low income, assistance for Medicare payments and other expenses may come from the Delaware Medicaid and Medical Assistance program. The level of assistance depends on the particular type of assistance program.
The Qualified Medicare Beneficiary (QMB) Program pays for the premiums for both Medicare Part A and Part B. It also covers the deductible for Parts A and B, along with the 20% coinsurance for lab work and doctor visits. To qualify, the monthly income of the QMB must be no more than $1,012. A married couple can be eligible with a combined monthly income of less than $1,372.
The program for Specified Low-Income Medicare Beneficiaries (SLMB) pays for the Medicare Part B premium. To qualify, the individual must have a monthly income that does not exceed $1,214. Married couples are eligible if their combined income is not higher than $1,646.
There is also a program for Qualified Individuals (QI) to help cover the cost of the Medicare Part B premium. This is for QIs with a monthly income of no more than $1,366. The combined monthly income limit for married couples is $1,852.
A program for Medicare assistance is also available for Qualified Disabled and Working Individuals. The income limit is 200% the federal poverty level, which for an individual is a monthly income of no more than $2,023. The income ceiling for a married couple is $2,743 per month.
There is another program that offers low-income subsidy that can help cover the cost of prescription drugs. The individuals who are eligible for this program must have an annual income of no more $18,090 along with resources (such as savings and stocks) that total no higher than $13,820. Married couples can also qualify if their combined annual income does not exceed $24,360 a year and if their combined resources do not total more than $27,600.
The federal Medicare law requires all states to create a program that offers unbiased advice and counseling for Medicare beneficiaries. This is the State Health Insurance Assistance Program or SHIP. However, in Delaware, it is called the Delaware Medicare Assistance Bureau or DMAB.
DMAB offers information, explanations, and counseling for various aspects of Medicare. These include more explicit explanations for Medicare Prescription Drug Plans and supplemental plans as well. The program also offers help for disabled Medicare beneficiaries and can provide advice regarding Advantage Plans, and long-term care and payment options.
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