Delaware Medicaid and Medicare Insurance | Highmark Health Options
- Highmark Health Options Delaware provides managed care services through Medicaid and Medicare Dual Eligible Special Needs Plans (D-SNP) to eligible residents of the state.
- The Highmark Health Options Duals (HMO SNP) plan is available for individuals who qualify for both Medicare and Medicaid.
- Medicaid is a public health insurance program available to millions of Americans, including people with disabilities, elderly adults, pregnant women, children, and eligible low-income adults.
Highmark Health Options Delaware provides managed care services through Medicaid and Medicare Dual Eligible Special Needs Plans (D-SNP) to eligible residents of the state. These programs are designed to coordinate healthcare services and provide additional benefits beyond basic coverage to help participants maintain their physical and mental well-being.
Medicare D-SNP Coverage
The Highmark Health Options Duals (HMO SNP) plan is available for individuals who qualify for both Medicare and Medicaid. This plan provides the same core benefits as Original Medicare but includes additional supplemental benefits. These extras include coverage for prescription drugs, vision care, and dental care.
Medicaid Benefits and Services
Medicaid is a public health insurance program available to millions of Americans, including people with disabilities, elderly adults, pregnant women, children, and eligible low-income adults. Highmark Health Options Delaware manages these benefits to provide comprehensive care for both mental and physical health.
Specific benefits provided under the Medicaid plan include:
- Prescription Drug Coverage: Comprehensive coverage for necessary medications through a network of pharmacies.
- Dental Care: Coverage for adults aged 21 and older to help prevent and correct dental issues.
- Mental Health and Substance Use: Benefits covering emotional well-being and the treatment of problems related to substance use.
Eligibility and Enrollment Requirements
To qualify for full Medicaid benefits through Highmark Health Options in Delaware, applicants must meet specific residency and legal criteria. Applicants must be residents of Delaware and must be either U.S. Citizens or legally residing noncitizens.
Financial eligibility is determined by household income levels, which are based on the size of the applicant’s family. Individuals who meet these income limits and residency requirements can apply for coverage via Delaware Assist.
Maintaining coverage requires participants to successfully complete the Delaware renewal process. Highmark Health Options notes that coverage may end if a member fails to complete this process or no longer meets the eligibility criteria for benefits.
Community Support and Resource Integration
Beyond clinical healthcare, Highmark Health Options Delaware operates a Community Support system. This service is designed to connect members with local resources at no cost through an anonymous search tool.
The support system provides connections for hardship relief in several categories, including:
- Food and care services.
- Housing and education.
- Financial and legal matters.
- Employment and work-related resources.
Provider Network and Resources
Highmark Health Options maintains a network of approved doctors, hospitals, and pharmacies to facilitate member care. To support these healthcare providers, the organization operates the Highmark Health Options Delaware Provider Resource Center.
The Resource Center serves as a central gateway for providers, offering essential tools such as provider manuals and training information to ensure the delivery of high-quality healthcare to Medicaid and D-SNP members.