Medicaid Unwinding in Delaware: What You Need to Know If You Lose Coverage

The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. The PHE was renewed a dozen times between January 2020 and February 2023.

People who were eligible for Medicaid coverage during the COVID PHE were able to keep their insurance, even if they were no longer eligible. This is because all the states — including Delaware — were mandated to provide continuous coverage during the PHE.

But the PHE ended on May 11, 2023, and automatic Medicaid renewals stopped on March 31, 2023. Over the next year, 8 million to 24 million enrollees nationwide could lose Medicaid coverage.

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Delaware has resumed eligibility reviews for more than 300,000 people enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) — known in the state as the Delaware Healthy Children Program. This is called the redetermination process. Anyone who no longer qualifies could be disenrolled as early as July 1, 2023. In fact, state officials estimate that 40,000 to 50,000 enrollees in Delaware could lose Medicaid or CHIP coverage.

Here’s what you need to know about Medicaid changes in Delaware, and information on what to do if you lose your insurance coverage.

Why is Medicaid changing nationwide?

After the PHE ends, COVID-19 will remain a public health priority — just not an emergency. As part of this change, Medicaid renewals will no longer be automatic. This is being referred to as the unwinding of Medicaid.

The unwinding will affect Medicaid in every state, Washington, D.C., and five U.S. territories.

What’s happening with Medicaid renewal in Delaware?

Delaware Health and Social Services  (DHSS) is responsible for overseeing the state’s Medicaid program. The agency has an unwinding plan that outlines how the state intends to resume renewals for current Delaware Medicaid and Delaware Healthy Children Program enrollees. Over the next year, the Division of Medicaid and Medical Assistance (DMMA) and the Division of Social Services (DSS) will be handling the eligibility reviews. Cases will be worked through from oldest to newest. Some people could lose coverage as early as July 1, 2023.

It’s important for DHSS to have your current contact information. You can confirm or update your information by: 

• Logging in to your account on DHSS’s ASSIST self-service portal

• Calling the Change Report Center at 302-571-4900 and selecting Option 2

• Sending changes via fax to 302-571-4901

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DHSS is also warning Medicaid enrollees about renewal scams. Be wary of health insurance offers that seem too good to be true, such as “health sharing” plans and discounts that are not insurance. No one from Delaware Medicaid should ever call and ask you for money, your bank information, or your credit card number.

What to expect during the renewal process

Enrollees will receive information about Medicaid renewal in several ways from DHSS, DMMA, and DSS. You can expect to receive renewal reminders via:

• Mail, including postcards

• Text

• Email

• Phone

• Your account on the ASSIST self-service portal

• Social media

For some people, the state already has enough eligibility information from other programs to renew coverage automatically. If more information is needed for your case, however, you will receive a renewal form in the mail. It will come in an envelope with a DHSS logo on it.

You will have 30 days to submit your information. You can submit your renewal in these ways:

• The ASSIST self-service portal

• Mail

• Fax

• In person

Once your completed renewal is reviewed, you will receive one of three decisions:

• Notice to continue your benefits: This means you are still eligible for Delaware Medicaid. Check to make sure the information on your letter is correct. If not, follow the instructions on the letter to make changes.

• Notice about changes to your coverage: You are still eligible for Medicaid, but you qualify for a different type of coverage than what you’ve had before. Your letter will explain the new coverage and tell you if you need to take further action.

• Notice to deny your medical assistance: You are no longer eligible for Delaware Medicaid. The letter will explain the next steps you can take to access alternative health insurance, such as through the state’s Affordable Care Act (ACA) marketplace platform, Choose Health Delaware. You can also appeal the decision or reapply.

People who have intellectual or developmental disabilities, live in a nursing home, or are eligible for long-term care will not have their coverage automatically stopped if they are no longer eligible for Medicare.

If you need to reach Delaware Medicaid by phone, call 302-571-4900.

What should I do if I lose my Medicaid coverage in Delaware?

In order to receive Medicaid in Delaware, you must meet all of the following criteria:

• You must be a Delaware resident.

• You must be a U.S. citizen, permanent resident, or legal resident.

• You must need assistance with access to healthcare or insurance coverage.

• Your annual household income before taxes are withheld must be below the limit for your household size.

In Delaware, you may also qualify for reasons other than income, including if you are:

• Pregnant

• A child or teenager

• Responsible for the care of a child who is 18 years old or younger

• Blind

• 65 years old or older (and meet certain criteria)

• A person with a disability, or you have a person in your household who has a qualifying disability

• A former foster child

• In need of nursing home care 

• Are of any age and have family planning needs

• In need of treatment for breast or cervical cancer (and have been screened or are still undergoing treatment)

If you no longer qualify or Delaware Medicaid can’t reach you to get information for your renewal, you will no longer be able to use your benefits, which could leave you temporarily uninsured. If you lose your coverage but believe you still qualify, you can reapply for Medicaid. You may be uninsured for a while until you’re approved for coverage again.

If you choose not to reapply for Medicaid coverage, or if you’re no longer eligible, you may qualify for other low-cost or free healthcare options. You can also use GoodRx coupons to save on your prescription medications. In addition, you may be able to enroll in an alternative health insurance plan, such as:

• Affordable Care Act (ACA) marketplace plan: You may be able to find an ACA health plan for $10 or less per month if you qualify for a premium subsidy on the Choose Health Delaware platform. If you lose Medicaid, you can purchase a plan in the ACA marketplace during the unwinding special enrollment period from March 31, 2023 to July 31, 2024.

• Employer plan: Your company may offer employer-sponsored health insurance.

• Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.

• Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.

• Special plans: Short-term insurance can be a great choice if you anticipate that a better option, like job-based health insurance, will be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance plans.

• Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.

• U.S. Department of Veterans Affairs (VA) benefits: If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.

Delaware Medicaid resources

Here are some resources with more information about Medicaid in Delaware and upcoming changes related to the end of the public health emergency:

• Delaware Medicaid office: Delaware Health and Social Services oversees and administers the state’s Medicaid program.

• Delaware Medicaid self-service portal: You can visit the ASSIST self-service portal and access your account online 24/7 to confirm or update your contact information.

• Delaware Medicaid redetermination: Read more about Delaware’s Medicaid unwinding plan.

• Delaware Medicaid office phone assistance: You can call Delaware Medicaid at 302-571-4900.

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Written by:

Lorraine Roberte

Lorraine has been writing in-depth insurance and personal finance content for 3 years. She has written hundreds of articles on these topics, with her work appearing on such sites as the Balance, the Simple Dollar, ConsumerAffairs, and I Will Teach You To Be Rich.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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