Medicaid provides medical assistance to families with low income who are eligible and to individuals who are qualified, aged, blind, and/or disabled and whose income is insufficient to cover the costs of necessary medical services. Medicaid covers doctor visits, hospital care, laboratory tests, prescription drugs, transportation, routine vaccinations for children, mental health services, and substance abuse treatment.

Medicaid in Delaware covers a range of services for eligible individuals. These include:

1. Medical Assistance Programs: These core services are covered by Medicaid, including doctor visits, hospital care, lab tests, and prescription drugs.
2. Long-Term Care Services: Medicaid provides long-term care services, including nursing facility care, home and community-based services, 30-day acute care hospital services, children's community alternative disability program, and out-of-state rehabilitation hospital services.
3. Special Programs: Delaware's Medicaid includes specific programs like the Developmental Disabilities Home & Community Based Waiver Program, Chronic Renal Disease Program, and the Healthy Children Program (CHIP).
4. Transportation Services: Non-emergency medical transportation services are available for Medicaid members, which can be crucial for accessing healthcare facilities for routine and specialized care.
5. Mental Health and Substance Abuse Services: These are critical components of Medicaid coverage, addressing the needs of individuals requiring mental health care and substance abuse treatment.
6. Additional Benefits: Other benefits include adult dental benefits and assistance for children with medical complexities.

For detailed information and to understand the full scope of covered services under Delaware Medicaid, you can visit the Delaware Division of Medicaid & Medical Assistance website.

Eligibility for Medicaid in Delaware is based on several criteria:

1. Resource Assessment: Delaware Medicaid does not consider personal resources like a car, bank account, or home when determining eligibility. This means owning these assets does not automatically disqualify you from receiving Medicaid.
2. Employment Status: Being employed does not disqualify you from Medicaid. Individuals can work and still be eligible for Medicaid benefits.
3. Other Insurance: It is possible to have other health insurance and still receive Medical Assistance through Medicaid.
4. Age and Income Requirements: Low-income uninsured adults between 19 and 65 may qualify for Medicaid.
5. Family Situations: Children living with stepparents, grandparents, or siblings may be eligible for Medicaid depending on the family's income. Needy families with children who are part of Temporary Assistance for Needy Families (TANF) may also be eligible.
6. Post-Welfare Support: Families that start working and leave welfare may still be eligible for Medicaid.
7. Special Groups: Low-income pregnant women and children under 19 may qualify. Furthermore, most women of childbearing age could be eligible for birth control and family planning services for up to 24 months after their regular Medicaid coverage ends.
8. Retroactive Eligibility: There is a provision for retroactive eligibility under certain conditions.
9. Enrollment in Managed Care Plans: Most people receiving Medicaid in Delaware are enrolled in managed care plans under the Diamond State Health Plan.

For more detailed and personalized information regarding eligibility and enrollment, it's advisable to visit the Delaware Division of Medicaid & Medical Assistance website or contact their office directly.

Applying for Medicaid in Delaware can be done through several methods:

1. Online Application via ASSIST: The easiest way to apply for Medicaid is through ASSIST, an online service that allows you to learn about benefits, check eligibility, and apply or reapply. You can access ASSIST at https://assist.dhss.delaware.gov.
2. Email: For inquiries or assistance, you can email Medicaid at MedicaidInfo@delaware.gov.
3. Phone Numbers and Service Hotlines:
4. Medicaid Customer Relations: For general information, referrals, and assistance, call 302-571-4900 or toll-free at 866-843-7212.
5. Provider Relations: For provider-related inquiries, call 800-999-3371.
6. Health Benefits Manager: For help understanding your benefits and prescriptions, call 800-996-9969.

These contact options provide direct lines for support and assistance throughout the application process, ensuring that applicants receive the necessary guidance for their needs and situations.

Renewing Medicaid in Delaware involves a few key steps to ensure continuous coverage:

Update Contact Information

It's crucial to keep your contact information up to date with Delaware Medicaid. This includes any changes in name, mailing address, email address, and phone number. You can update your information by:

1. Logging into your Delaware ASSIST account.
2. Calling the Change Report Center at (302) 571-4900, Option 2.
3. Sending changes via fax to (302) 571-4901.
4. For TTY users, call 1-855-889-4325.
5. For assistance in languages like Español, Kreyól ayisy, ربية, Tiếng Việt, or others, call 1-866-843-7212.

Monitor Mail and Email

Keep an eye on your mail and email for letters from the Department of Health and Social Services (DHSS), the Division of Medicaid and Medical Assistance (DMMA), and the Division of Social Services (DSS). These communications will include important information about your Medicaid renewal.

Complete and Return the Renewal Form

If you receive a Delaware Medicaid renewal form, complete it and follow the instructions to return it. Look for the DHSS logo on the envelope for mailed renewal notices.

Renewal Process Timeline

Medicaid eligibility renewals in Delaware restarted on April 1, 2023. The renewal process will be spread over 12 months (14 months including notice period), based on each member's annual renewal date. Some members will be automatically renewed using the most recent information on file, while others will need to complete a renewal packet to determine ongoing eligibility.

Assistance and Alternative Coverage

‍If you no longer qualify for Medicaid after renewal, assistance is available, and you may be eligible for other health insurance options.

If you have any questions about your benefits or the renewal process, contact the Division of Social Service Customer Support Unit at 1-866-843-7212 for guidance and assistance.

For more detailed information, it's recommended to visit the Delaware Health and Social Services website or contact the relevant Medicaid offices directly.