Private Health Insurance in Delaware
Private health insurance in Delaware is coverage you buy directly, outside the ACA Marketplace, priced on your age, zip code and health instead of your income. With Delaware Marketplace premiums rising 16.4% to 16.5% on average for 2027, more people who earn too much for a tax credit are pricing a private plan first. It is not the right fit for everyone, and the sections below explain how it works in Delaware and when the Marketplace is the better call.
Who buys their own coverage in Delaware
Delaware, which enrolls through HealthCare.gov, had 44,663 plan selections in the 2026 open enrollment period, CMS figures show, about 16 percent below the 52,931 recorded for 2025. Roughly 81 percent of this year's enrollees got an advance premium tax credit, against about 91 percent a year earlier, leaving close to one buyer in five, about 19 percent, paying full price. Agents and brokers assisted with about 48 percent of selections. In Census estimates for 2024, about 43 percent of Delaware households earned $100,000 or more, a bracket that sits mostly beyond the reach of the credits.
How Delaware regulates private plans
Delaware sorts individual health policies into eight categories under 18 Del. C. § 3604, among them hospital confinement indemnity and limited benefit coverage, and § 3605 requires an outline of coverage with each policy. Regulation 1304 requires hospital indemnity policies to pay daily benefits for at least 31 days per stay and limited benefit outlines to call the coverage limited or supplemental. Title 18 has no exemption for health care sharing ministries, which the Department calls unregulated, and no provision for agricultural organization plans. Association group policies under § 3506 need a bona fide association at least five years old.
Protecting yourself when you buy in Delaware
Delaware's insurance code sets no general free-look period for individual health policies; its 30-day return rights cover Medicare supplement and long-term care policies. Under Regulation 1304, when a policy sold directly, without an agent, replaces existing coverage, the required notice gives you 10 days to decide without cost. The Department's Licensee Lookup, run with the NAIC, confirms an agent's license, and its Consumer Services Division takes complaints at 1-800-282-8611 or online. Its limited benefit plan page tells shoppers to ask about enrollment or membership fees and to check whether a plan appears on an official Marketplace site.
The Delaware Marketplace you would be comparing against
Delaware buyers enroll through HealthCare.gov, while the state certifies plans and runs a reinsurance program approved through 2029 that lowers premiums. Even so, final 2027 individual rates rise about 16.5 percent, and one of the state's three individual-market insurers is leaving, so affected enrollees must choose new plans. Delaware's own continuation law covers employers with 1 to 19 workers for up to nine months, filling the gap below federal COBRA. Short-term plans are limited to three nonrenewable months, among the strictest rules in these states. Small-group plans face an even larger increase than individual plans, about 18 percent, which gives small Delaware employers a reason to compare individual coverage reimbursement against their renewal.
Other Delaware rules to know
- Leaving a small employer: Delaware requires insured group plans of employers with 1 to 19 employees to offer up to nine months of continuation after three months of coverage, at no more than 102 percent of the group rate.
- Short-term plans: Delaware limits short-term plans to three months, with no back-to-back renewals, under its insurance regulation.
- Where to enroll: Delaware uses HealthCare.gov through a state partnership. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027. Private, medically underwritten plans can start the first of any month if approved.
- 2027 rates: individual plans 16.4% to 16.5% on average, small-group plans about 18%. See the Delaware 2027 rate page.
Why people leave the Marketplace for a private plan
Marketplace premiums are rising again for 2027, and above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) there is no tax credit at all. Underestimate your income and you repay the credit in April. Many Marketplace plans are local HMOs or EPOs, out-of-pocket maximums reach $12,000 per person in 2027, and you can only enroll once a year without a qualifying event.
What a private plan does differently
A private, medically underwritten plan is priced on health, not income, so a strong year never raises the premium and there is nothing to pay back at tax time. If approved, it can start the first of any month, and many plans use national PPO networks that work when you travel.
The honest trade-offs
You apply and answer health questions, and approval is not guaranteed. Underwritten plans can decline an application or exclude a pre-existing condition, and benefits and limits differ from plan to plan. Private plans are not ACA Marketplace plans. If you have a significant health condition, the Marketplace is the guaranteed option, and I will tell you so.
For 2027 the Marketplace credit stops at 400 percent of the poverty level: $63,840 for one person, $86,560 for two and $132,000 for a family of four. The out-of-pocket maximum for 2027 Marketplace plans is $12,000 for one person and $24,000 for a family. The full guide covers the rest.
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Delaware questions
Where do Delaware residents enroll in 2027 coverage?
Delaware uses HealthCare.gov through a state partnership. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027.
What continuation rights does Delaware give after leaving a small employer?
Delaware requires insured group plans of employers with 1 to 19 employees to offer up to nine months of continuation after three months of coverage, at no more than 102 percent of the group rate.
How much are Delaware premiums rising for 2027?
Individual-market premiums are set to rise 16.4% to 16.5% on average, and small-group plans about 18%.
What is private health insurance?
Coverage you buy directly from an insurer outside the ACA Marketplace. Medically underwritten private plans are priced on age, zip code and health rather than income, and they can start the first of any month if you are approved.
Is private health insurance cheaper than the Marketplace?
Often for healthy people above the subsidy line, who pay full price on the Marketplace. Below the line, a Marketplace plan with a tax credit may be cheaper. The only way to know is to price both.
Can a private plan turn me down?
Yes. Underwritten plans can decline an application or exclude a pre-existing condition. The Marketplace has to accept everyone during open enrollment or a special enrollment period.
Sources: www.cms.gov, delcode.delaware.gov, regulations.delaware.gov, delcode.delaware.gov, insurance.delaware.gov. Facts checked October 2026. See all Delaware health insurance rules.
Private plans in other states
Written by Frank Caballero, licensed health insurance agent in Delaware and 30 other states, NPN 21032307.