TSM Life & Health is an independent, licensed agency helping Delaware residents compare Medicare Advantage, ACA Marketplace, life insurance, final expense and annuity options in plain language. For 2026, CMS lists 18 Medicare Advantage (MA-PD) plans in New Castle County (Wilmington), 12 in Kent County (Dover) and 15 in Sussex County (Georgetown), many at a $0 monthly plan premium. On the ACA Marketplace, Delaware is a single statewide rating area, so all three counties share the same 39 plans and many shoppers qualify for a monthly premium tax credit. We help you compare, at no cost and no pressure.
County-level snapshots we pulled live from CMS and the HealthCare.gov Marketplace. Delaware has only three counties, so the figures below cover the entire state. Medicare Advantage availability is set county by county; the ACA Marketplace uses one statewide rating area.
Every figure below is for non-SNP Medicare Advantage plans with prescription drug coverage (MA-PD) in the named county for contract year 2026. Averages are computed across all MA-PD plans CMS lists in that county. New Castle County uses ZIP 19801 (Wilmington), Kent County ZIP 19901 (Dover) and Sussex County ZIP 19947 (Georgetown) as representative anchors.
| County (city) | MA-PD plans | $0-premium plans | Avg premium/mo | Avg in-network MOOP | Avg Part D deductible | Rated 4★+ (of rated) |
|---|---|---|---|---|---|---|
| New Castle (Wilmington) | 18 | 12 | $18.59 | $7,178 | $497 | 9 of 15 (60%) |
| Kent (Dover) | 12 | 6 | $30.31 | $6,912 | $562 | 7 of 11 (64%) |
| Sussex (Georgetown) | 15 | 9 | $24.25 | $7,100 | $490 | 8 of 14 (57%) |
A $0 plan premium does not mean $0 cost — you still pay your Medicare Part B premium and any plan copays or coinsurance. The in-network maximum out-of-pocket (MOOP) is the most you would pay for covered Part A and Part B services in a year; once you reach it, the plan pays 100% for the rest of the year. Star ratings are the CMS Overall Star Rating; a few newer plans are not yet rated, so the star column counts only plans that carry a rating.
Delaware runs on HealthCare.gov as a single statewide rating area, so the same set of Marketplace plans and the same example premium tax credit apply in New Castle, Kent and Sussex counties. For 2026, three issuers offer individual plans statewide: AmeriHealth Caritas Next, Ambetter Health of Delaware and Highmark Blue Cross Blue Shield Delaware. The example premium tax credit (APTC) below is modeled for a single 40-year-old non-tobacco applicant with a $30,000 modified adjusted gross income — your own amount depends on your income, household size and the plans you choose, and this is an estimate, not a quote or offer of coverage.
| County (city) | Marketplace plans (2026) | Example monthly tax credit* | Lowest net premium in sample* |
|---|---|---|---|
| New Castle (Wilmington) | 39 | $536 | $6.33 (Bronze) |
| Kent (Dover) | 39 | $536 | $6.33 (Bronze) |
| Sussex (Georgetown) | 39 | $536 | $6.33 (Bronze) |
*Example only, for a single 40-year-old at $30,000 income (2026); the estimated tax credit is about $536 per month ($6,432 for the year). A low net premium reflects the tax credit applied to a lower-cost Bronze plan and does not mean $0 out-of-pocket cost. Open Enrollment for 2026 coverage runs November 1, 2025 through January 15, 2026; a qualifying life event can open a Special Enrollment Period at other times.
TSM Life & Health is an independent, licensed insurance agency (founder Keith McLiverty, National Producer Number 3481853). We are licensed in Delaware and work with Delaware residents by phone and video, so you get the same plain-spoken, no-pressure guidance whether you are in Wilmington, Dover, Newark, Georgetown or anywhere else in the First State. Because we are independent, we help you compare options across carriers — we do not work for any one insurance company.
Yes. We are an independent, licensed insurance agency serving Delaware residents. We help you compare Medicare Advantage, ACA Marketplace, life insurance, final expense and annuity options by phone and video, at no cost to you.
Availability is set county by county. For 2026, CMS lists 18 MA-PD plans in New Castle County (Wilmington), 12 in Kent County (Dover) and 15 in Sussex County (Georgetown), with many offering a $0 monthly plan premium. Tell us your county and we will pull the current list for you.
Many Delaware households qualify for an advance premium tax credit that lowers the monthly premium. For example, a single 40-year-old with a $30,000 income could see an estimated credit around $536 per month for 2026. Because Delaware is one statewide rating area, plan availability and this example credit are the same in all three counties. Your actual amount depends on income, household size and available plans.
ACA Marketplace Open Enrollment for 2026 runs November 1, 2025 to January 15, 2026, with Special Enrollment Periods after qualifying life events. Medicare has an Annual Enrollment Period October 15 to December 7, plus Initial and Special Enrollment Periods. We can help you find the window that applies to you.
No. There is no cost to you to compare plans with us. We are compensated by the carriers when you enroll, and we present your options neutrally so you can choose what fits.
Sources. Medicare Advantage plan counts, premiums, in-network out-of-pocket maximums, Part D deductibles and CMS Overall Star Ratings come from the CMS Medicare Advantage / Part D Landscape for contract year 2026 (cms.gov), for New Castle, Kent and Sussex counties, DE, covering non-SNP MA-PD plans; averages are computed across the plans in each county. ACA Marketplace plan counts and the example premium tax credit come from the HealthCare.gov Marketplace API for plan year 2026 (healthcare.gov), modeled for a single 40-year-old at $30,000 income; Delaware is a single statewide rating area. Data accessed via The Brain (Ambrose) MCP on July 31, 2026. For all of your options, see medicare.gov or ssa.gov.
TSM Life & Health is an independent, licensed insurance agency. We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program (SHIP) to get information on all of your options. We are not connected with or endorsed by the U.S. government, the federal Medicare program, or CMS. Figures are estimates for education only, not quotes or guarantees of coverage or savings. Verify current plan details with a licensed agent before enrolling.
Medicare in Delaware works the same way it does everywhere in the country. Most people choose between Original Medicare and a Medicare Advantage plan, and then decide how they want prescription drug coverage. Here is a plain-language look at the three main paths.
| Path | What it is | Good to know |
|---|---|---|
| Original Medicare | Federal Part A (hospital) and Part B (medical) coverage. | Covers the essentials but not everything — there is no built-in drug coverage and no annual out-of-pocket cap. |
| Medicare Advantage (Part C) | A private plan that bundles Part A and Part B and usually Part D together. | Often adds extra benefits and includes a yearly out-of-pocket cap; uses a plan network of doctors and hospitals. |
| Medicare Part D | Prescription drug coverage sold by private plans. | Can pair with Original Medicare as a stand-alone plan, or come built into a Medicare Advantage plan. |
TSM Life & Health is an independent agency. We do not offer every plan available in your area, and we help you compare the options neutrally so you can choose what fits.
Timing matters with Medicare. These are the main windows set by the Centers for Medicare & Medicaid Services (CMS).
| Enrollment period | When it runs | What it is for |
|---|---|---|
| Initial Enrollment Period (IEP) | The 7 months around your 65th birthday — the 3 months before, your birthday month, and the 3 months after. | Your first chance to sign up for Medicare. |
| General Enrollment Period (GEP) | January 1 – March 31 each year. | For people who missed their IEP; coverage starts the month after you sign up. |
| Annual Enrollment Period (AEP) | October 15 – December 7 each year. | Join, switch or drop a Medicare Advantage or Part D plan for the next year. |
| Medicare Advantage Open Enrollment | January 1 – March 31 each year. | If you are already in a Medicare Advantage plan, make a one-time change. |
A Special Enrollment Period (SEP) can also open outside these windows after certain qualifying events — for example, losing employer coverage or moving.
You generally qualify for Medicare if you are a U.S. citizen or lawful permanent resident and one of the following applies:
Statewide figures for Delaware, pulled from federal data. Plan counts and premiums are for contract year 2026; the beneficiary counts are the latest annual figures published by CMS.
Sources: CMS Medicare Advantage / Part D Landscape, contract year 2026 (plan counts and premiums, computed across the MA-PD and stand-alone PDP plans CMS lists for Delaware); CMS Medicare Monthly Enrollment, 2024 annual (beneficiary totals). Retrieved via The Brain (Ambrose) MCP; accessed 2026-07-31.
There is no cost or pressure to talk with us. Here is how we help Delaware residents get to a confident decision.
These free, official resources can help you understand your options. Your State Health Insurance Assistance Program (SHIP) offers free, unbiased Medicare counseling — it does not sell insurance.
Medicare is usually the reason people call, but it’s rarely the only thing on the kitchen table. We’re an independent agency, so we compare across carriers rather than representing one — and a fair number of these conversations end with us telling someone that what they already have is the right fit.
Not sure which of these applies to you? That’s a normal place to start. Book a free consultation or call 203-951-0339 and ask one question — that is allowed.
You will probably recognize yourself in one of these. Each one starts in a different place, so each one gets a different first conversation.
There are three shopping bags of mail on the table, every plan claims to be free, and you’d like to keep your cardiologist. We start with your doctors and your prescriptions, then look at the plans — not the other way around.
Start with MedicareYou’re the one reading small print at 11pm, wondering whether the postcard that looks like a Medicare card is a scam. Bring us the mail. We’ll tell you what’s real, and you can put us on speakerphone with your mother.
See how we workCOBRA quoted more than the mortgage payment and you’ve got a few years to get to Medicare. We help you think through the income estimate the Marketplace runs on, and set the calendar so you land on Medicare at 65 without a gap or a penalty.
Read the ACA guideSize it before you shop it — debt, income to replace, mortgage, education, minus what you already have. Then match the tool: term for the years with a mortgage and children in the house, a smaller permanent policy for what never expires.
See life insuranceNone of these are dramatic enough to notice in the mail. All three show up later — at the pharmacy counter, at the front desk, or in a monthly check that can’t be changed.
Working past 65 does not always let you delay Medicare. Whether you can wait depends on the size of your employer and whether the coverage counts as creditable. Nothing that arrives in the mail tells you which case you’re in, and the penalties for guessing wrong are added to your premium for as long as you hold the coverage. Here is how the enrollment windows actually work.
The higher earner’s Social Security decision is really the survivor’s decision. When one spouse dies, the survivor keeps the larger of the two checks — not both. So the higher earner’s claiming age sets the income the widow or widower lives on, potentially for decades. It’s the single most expensive thing to get wrong, and the easiest to miss. We walk through 62 versus 67 versus 70 here.
“Keep what I have” is one of the options being compared, not the default. Plans change every year — premiums, formularies, networks, the out-of-pocket maximum — and so does your life. Once a year we re-run your drug list and your doctors against the plans we offer in your area. If the plan you have is still the right one, that’s what we tell you, and it costs nothing either way. That yearly review is the part of the relationship that matters most.
Happy to look at any of this with you, at your pace. Our office is at 479 New Haven Avenue in Milford, Connecticut, and a real person answers the phone Monday to Friday 9–6 and Saturday 10–2. Get in touch.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP), to get information on all of your options. TSM Life & Health is a licensed independent insurance agency and is not connected with, affiliated with, or endorsed by the U.S. government, the federal Medicare program, the Social Security Administration, or the Centers for Medicare & Medicaid Services (CMS). This is a solicitation for insurance; a licensed insurance agent may contact you. Product availability and benefits vary by state and carrier, and all guarantees are backed solely by the claims-paying ability of the issuing insurance company. This page is general educational information only and is not insurance, tax, legal, or investment advice.
Tell us your county, your doctors and your prescriptions, and we will help you match a plan — at no cost and no pressure.