DELAWARE - Time is running out for Delawareans seeking health insurance coverage through the Affordable Care Act Marketplace for 2026 as Jan. 15, 2026, is the final deadline to enroll or make changes to a Marketplace plan, according to Insurance Commissioner Trinidad Navarro and the Delaware Department of Insurance.
Individuals who miss the deadline generally will not be able to obtain coverage for 2026 unless they qualify for a Special Enrollment Period triggered by certain life events, such as losing other health coverage, a change in income, or becoming a parent.
State officials are urging residents, particularly small business owners, self-employed individuals and older adults, to review their options as Congress has not yet extended enhanced premium tax credits that currently help more than 24 million Americans, including about 42,000 Delawareans, afford coverage. They say without congressional action, those credits will continue in 2026 but at significantly reduced levels.
Under current rules, individuals earning less than $62,600 annually, families of two earning less than $84,600, and families of four earning less than $128,600 may still qualify for tax credits to help offset monthly premiums.
DelDOT says the Marketplace plans are organized into metal tiers, bronze, silver, gold, platinum and catastrophic, based on how costs are shared between consumers and insurers. Bronze plans typically feature lower monthly premiums but higher out-of-pocket costs, while gold plans have higher premiums and lower costs when care is needed. Silver plans generally cover about 70 percent of medical expenses, with consumers responsible for the remaining 30 percent.
Depending on income, some enrollees may also qualify for cost-sharing reductions through silver plans, which lower deductibles and copayments. Navigators and enrollment assisters can help consumers determine eligibility.
DelDOT says all Marketplace plans include essential health benefits, such as coverage for pre-existing conditions, outpatient and emergency care, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, pediatric care and reproductive health coverage. Coverage cannot be terminated due to changes in health status.
State officials emphasized that the Marketplace remains the most reliable option for comprehensive individual coverage, cautioning consumers against short-term limited-duration plans and health care sharing ministries, which may offer lower premiums but lack full protections.
People already enrolled in Marketplace coverage are encouraged to log in to Healthcare website or CuidadodeSalud.gov to review and update their plans. Those who do not wish to continue coverage in 2026 should notify their insurer to avoid automatic re-enrollment and billing. Enrollees whose plans begin Jan. 1, 2026, still have until Jan. 15 to switch plans if needed.
Insurance Commissioner Trinidad Navarro urged Delawareans to seek help from state-certified navigators or verified insurance brokers.
"Buying health insurance can already feel overwhelming," Navarro said. "We’ve developed a Smart Buyer’s Guide to Individual Health Insurance to help simplify the process and spot deceptive tactics or misleading language."
The Department of Insurance has reported an increase in predatory and deceptive practices during open enrollment, including scams involving unauthorized enrollment and aggressive marketing of non-comprehensive plans. The state’s guide helps consumers verify legitimate coverage and identify warning signs.
In-person enrollment assistance is available for free at Westside Family Healthcare locations across the state. Delawareans can enroll online on the Healtchcare website or by phone at 1-800-318-2596 (TTY: 1-855-889-4325).