Delaware Medicaid Office

Delaware Medicaid office (DMMA)

The Division of Medicaid and Medical Assistance (DMMA) runs Delaware Medicaid from a single headquarters in New Castle and uses a Service Directory with seven dedicated phone lines depending on what you need. The Office of the Director sits at the DHSS Herman Holloway Campus in the Lewis Building at 1901 N. DuPont Highway, New Castle, DE 19720, reachable at (302) 255-9500 or 1-800-372-2022. Long-term care intake and member transportation use separate channels from general member services.

DMMA Service Directory — pick the right line

Long-Term Care Medicaid offices by county

For all new LTC application inquiries, members can call the statewide Central Intake Unit at 866-940-8963 instead of routing through a specific county office.

Who qualifies for Delaware Medicaid?

Delaware's eligibility rules have two features that surprise first-time applicants. First, no resource test for MAGI Medicaid: DMMA states explicitly that "you can have a car, bank account, and a home and still qualify for Medicaid. DMMA does not look at any of your resources when determining your eligibility for Medicaid." Second, an unusually long Family Planning Extension: most women of childbearing age may be eligible for birth control and family planning services for 24 months after their regular Medicaid coverage stops. Most other states offer a 12-month extension or none at all.

Who may qualify for Delaware Medicaid

• Adults ages 19–65 who are low-income and uninsured — Delaware's Medicaid Expansion population.
• Low-income pregnant women — full coverage through pregnancy.
• Children under age 19 — through Medicaid or the Delaware Healthy Children Program (CHIP).
• Children living with stepparents, grandparents, or siblings with income — Delaware's eligibility rules treat these kinship arrangements like parent households.
• Families with children who are part of Temporary Assistance for Needy Families (TANF).
• Families leaving TANF for work — transitional Medicaid keeps them covered while the income change is processed.
• Adults 65+, blind, or disabled — non-MAGI track with both income and resource tests.

Distinctive program tracks

• Medicaid for Workers with Disabilities (MWD) — buy-in for working people with disabilities who would otherwise lose Medicaid because their earnings put them over the disability income limit.
• Delaware Healthy Children Program (DCHP) — CHIP for children up to age 19 whose family income is too high for Medicaid; 212% FPL.
• Delaware Prescription Assistance Program (DPAP) — helps disabled and elderly individuals pay for prescriptions they otherwise couldn't afford.
• Chronic Renal Disease Program (CRDP) — for Delaware residents with End Stage Renal Disease.
• Children's Community Alternative Disability Program (CCADP) — Delaware's Katie Beckett-style program for children with disabilities using only the child's income and resources, not the family's.
• Family Planning Extension — 24 months of birth control and family planning coverage for women of childbearing age after their regular Medicaid stops.

The DSHP 1115 framework

Delaware's Diamond State Health Plan (DSHP) 1115 Demonstration Waiver — initially approved in 1995 and implemented January 1, 1996 — is what makes Delaware Medicaid a managed-care program. Eligible Medicaid recipients are mandatorily enrolled in MCOs, with savings used to expand coverage. DMMA continues to renew and amend the waiver; the most recent extension was approved in 2024.

Delaware Medicaid income limits (2026)

DMMA publishes a single FPL income chart that supports every Delaware Medical Assistance program — Medicaid, CHIP, MSP tiers, MWD, DPAP, and CRDP all reference percentage bands on this table. The figures below are the 2026 Countable Income Limits effective for the year.

2026 Countable Monthly Income by family size — FPL-related Medicaid programs

Annual 100% FPL: Family 1 $15,960; Family 4 $33,000; Family 8 $55,720. The 212% column is the Delaware Healthy Children Program (CHIP) income limit.

Medicare Savings, MWD, CRDP, DPAP — monthly countable income

2026 Supplemental Security Income (SSI) standard

Which percentage applies to your category

Match your category to its FPL anchor: Adult Medicaid Expansion at 133–138% FPL (adults 19–65); pregnancy at 212% FPL or higher; children's Medicaid at varying ages (142% FPL for ages 1–5, 133% FPL for ages 6–18); CHIP/DCHP at 212% FPL up to age 19; MSP tiers at 100/120/135% FPL; MWD at 275% FPL; CRDP at 300% FPL.

How to apply for Delaware Medicaid

Most Delaware applicants apply through ASSIST, the state's self-service portal — one application covers Medicaid, Delaware Healthy Children (CHIP), and several non-Medicaid benefits like SNAP. Long-term care and the Prescription Assistance Program use separate intake channels because they involve more documentation and different financial tests.

Apply through ASSIST (Medicaid and DCHP)

• Online — assist.dhss.delaware.gov. The portal handles Medicaid, Delaware Healthy Children Program (CHIP), and related benefits; you submit one application and ASSIST routes it to the right program.
• By phone — call Medicaid Customer Relations at 302-571-4900 or 866-843-7212 for help starting an application or to ask which program is right for you.
• In person — visit a State Service Center (multiple locations across the three counties — Milford, Dover, Georgetown, Newark, Wilmington).

Long-Term Care Medicaid — separate intake

For nursing-home placement, HCBS waivers, or other long-term care coverage, applicants call the Medicaid Central Intake Unit (CIU) at 866-940-8963 instead of using ASSIST. The CIU handles both financial and medical screening to determine LTC eligibility. Once approved, members are referred to the county-specific LTC office for ongoing case management (see the office section for addresses).

Delaware Prescription Assistance Program (DPAP)

DPAP requires a separate paper application (PDF on the DMMA prescription assistance page) because it has its own income test (200% FPL) and is for disabled and elderly Delawareans who cannot afford their prescriptions. Mail the completed application to DMMA per the form instructions, or call 1-800-996-9969 for help.

Federal decision deadlines

Federal Medicaid rules give DMMA up to 45 days to decide a non-disability application and up to 90 days for applications based on disability. Coverage can be retroactive up to three months before the application month when the applicant had qualifying medical bills during that window. DMMA also offers a retro-eligibility flow for situations where members became eligible during a window where they weren't enrolled.

What Delaware Medicaid covers

Delaware Medicaid runs primarily through managed care under the Diamond State Health Plan (DSHP) — the 1115 demonstration waiver implemented January 1, 1996. Most members are enrolled with one of the contracted MCOs, choose a family doctor through that plan, and use the plan's network for almost all medical care. Seven specific populations are CARVED OUT of MCO enrollment and stay in fee-for-service Medicaid. Knowing which side you're on is the most important practical question after enrollment.

What Medicaid covers in Delaware

DMMA's summary: Medicaid pays for doctor visits, hospital care, labs, prescription drugs, transportation, routine shots for children, mental health services, and substance abuse services. The full benefits set is delivered through the member's MCO contract (or fee-for-service for carve-outs).

• Doctor visits and specialist care
• Hospital inpatient and outpatient care
• Laboratory services and diagnostic testing
• Prescription drugs
• Non-emergency medical transportation through Modivcare (866-412-3778 or 866-896-7211)
• Routine immunizations for children
• Mental health services
• Substance abuse services
• Adult dental benefits (separately covered)
• Pediatric services through EPSDT for members under 21

Who is NOT enrolled in DSHP managed care (FFS carve-outs)

• Individuals entitled to or eligible to enroll in Medicare (dual-eligibles)
• Individuals residing in a nursing facility or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)
• Individuals covered under the Medicaid home and community-based waiver programs (DDDS Lifespan waiver, etc.)
• Non-lawful and non-qualified non-citizens (Emergency Medicaid)
• Individuals with military health insurance — active duty, retired military, and their dependents
• Individuals eligible for the Medicaid Breast and Cervical Cancer program
• Presumptively eligible pregnant women

Members in any of those categories receive their care through fee-for-service Medicaid, with DMMA paying providers directly rather than through an MCO.

If you're in DSHP managed care

Choose a family doctor (PCP) inside your plan's network — the PCP arranges or authorizes most of your preventive care and medical services. The Medicaid Health Benefits Manager at 800-996-9969 helps you enroll in an MCO and walks you through plan choice and prescription benefit comparison. Plan changes typically take effect the first of the following month.

Other state Medicaid pages