WILMINGTON, DE — Time is running out for Delaware residents who need health insurance coverage for 2026, with January 15 marking the final deadline to enroll in an Affordable Care Act Marketplace plan without qualifying for a special enrollment period.
State insurance officials are urging consumers to act now, warning that those who miss the January 15, 2026, cutoff may be locked out of coverage for the year unless they experience a qualifying life event such as job-based coverage loss, a change in income, or the birth of a child.
The urgency is heightened by uncertainty in Washington. Congress has not yet extended enhanced premium tax credits that currently help more than 24 million Americans, including about 42,000 Delawareans, afford coverage. While most Marketplace enrollees will still qualify for some tax assistance in 2026, the Delaware Department of Insurance cautions that subsidies could be significantly smaller if lawmakers fail to act.
Consumers with annual incomes below $62,600 for an individual, $84,600 for a family of two, or $128,600 for a family of four may still qualify for premium tax credits to help offset monthly costs.
Marketplace plans are offered across metal tiers — bronze, silver, gold, platinum, and catastrophic — reflecting how costs are shared between consumers and insurers. Bronze plans typically carry lower premiums but higher out-of-pocket costs, while gold plans feature higher premiums and lower costs when care is needed. Silver plans generally split costs at roughly 70 percent paid by insurers and 30 percent by consumers.
For some households, silver plans may also unlock cost-sharing reductions that lower deductibles and copayments. State officials recommend speaking with a certified navigator or assister to determine eligibility for those additional savings.
All ACA Marketplace plans include essential health benefits, such as coverage for pre-existing conditions, emergency services, hospitalization, prescription drugs, mental health and substance use disorder treatment, laboratory services, pediatric care, and reproductive health. Coverage cannot be terminated due to changes in health status.
Insurance Commissioner Trinidad Navarro said the Marketplace remains the safest option for comprehensive coverage, particularly as misleading alternatives proliferate.
“Buying health insurance can already feel overwhelming, especially with the wide range of plans and companies out there,” Navarro said. “We’ve developed a Smart Buyer’s Guide to Individual Health Insurance to help you simplify the process and spot deceptive tactics or misleading language.”
The Department of Insurance has reported an increase in predatory activity during open enrollment, including unauthorized enrollments designed to generate commissions and aggressive marketing of non-comprehensive plans such as short-term policies and health care sharing ministries. Officials say these options often expose consumers to significant financial risk.
Current Marketplace enrollees who have not yet selected a plan for 2026 are encouraged to log in to HealthCare.gov or CuidadodeSalud.gov immediately to review options and confirm coverage. Those who are already enrolled in a plan effective January 1, 2026, still have until January 15 to change plans if needed.
Residents without employer-sponsored coverage or eligibility for Medicaid or Medicare are also urged to consider enrolling before the deadline. Free, in-person enrollment assistance is available statewide at Westside Family Healthcare locations.
Delawareans can enroll online at https://www.HealthCare.gov or by calling 1-800-318-2596 (TTY: 1-855-889-4325). State officials say acting before the deadline could make the difference between reliable coverage and facing unpredictable medical costs throughout the year.
For the latest news on everything happening in Chester County and the surrounding area, be sure to follow MyChesCo on Google News and MSN.