DE MEDICAID MARKET
Delaware
monitoring
No current verified market signal.
Last verified: unavailable
Last verified: unavailable · no state-specific item
No current verified signal
Precapture is monitoring this market. No state-specific public intelligence item is currently published.
Plans in this market
Parent, plan, and program come from the plan graph. Enrollment and share use the latest CMS reported count. Operations counts are CMS MCPAR. A dollar amount is not on this page.
Plans in this market 16
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| Independence Blue Cross | AmeriHealth Caritas of Delaware | not reported | 70,089 (2024) | 32.0% calculated | 1 sanctions, 556 appeals resolved |
| AmeriHealth Caritas | AmeriHealth Caritas of Delaware | not reported | 63,276 (2019) | 31.7% calculated | not reported |
| not reported | Delaware First Health | not reported | 29,825 (2024) | 13.6% calculated | 60 appeals resolved |
| Highmark | Highmark Health Options of Delaware | not reported | 119,253 (2024) | 54.4% calculated | 1,891 appeals resolved |
| not reported | LogistiCare | not reported | 208,650 (2019) | 100.0% calculated | not reported |
show all 16
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| not reported | LogistiCare Non-Emergency Medical Transportation | not reported | 217,895 (2020) | 100.0% calculated | not reported |
| not reported | LogistiCare/Circulation Non-Emergency Medical Transportation | not reported | 208,802 (2018) | 100.0% calculated | not reported |
| not reported | PACE Your Life | not reported | 53 (2024) | 14.3% calculated | not reported |
| not reported | ModivCare Non- Emergency Medical Transportation | not reported | 268,117 (2022) | 100.0% calculated | not reported |
| not reported | ModivCare Non-Emergency Medical Transportation | not reported | 244,822 (2021) | 100.0% calculated | not reported |
| not reported | Modivcare Non-Emergency Medical Transportation | not reported | 236,213 (2024) | 100.0% calculated | not reported |
| not reported | Saint Francis Life | not reported | 317 (2024) | 85.7% calculated | not reported |
| UnitedHealth | UnitedHealthcare Community Plan | not reported | 90,843 (2017) | 43.7% calculated | not reported |
| not reported | Highmark Health Options | not reported | 106,499 (2016) | 54.4% calculated | not reported |
| not reported | Saint Francis Life | not reported | 191 (2016) | 100.0% calculated | not reported |
| not reported | UnitedHealthcare Community Plan | not reported | 89,412 (2016) | 45.6% calculated | not reported |
CMS reported enrollment
CMS reporting years in this file run from 2016 through 2024. Retrieved 2026-11-01. The latest reporting year is 2024, which is behind the retrieval date. Enrollment figures are the CMS cell for that reporting year. Share is calculated from CMS reported total enrollment for that state, program, and year. Precapture does not combine rows. A year missing from a trend was not reported. A plan and region with more than one CMS row in a year has no trend and no year-over-year change. The dataset says a reported 0 may not truly represent 0 when a state suppressed a small count. CMS reported.
Diamond State Health Plan & Diamond State Health Plan Plus (Comprehensive MCO + MLTSS)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| AmeriHealth Caritas of Delaware | AmeriHealth | AmeriHealth | Statewide | CMS reported 70,089 (2024) | 32.0% | -23,051 (-24.7%) | -1.7 pts | 2019: 63,276; 2020: 78,177; 2021: 94,461; 2022: 103,974; 2023: 93,140; 2024: 70,089 |
| Delaware First Health | Delaware First Health | Delaware First Health | Statewide | CMS reported 29,825 (2024) | 13.6% | -3,134 (-9.5%) | +1.7 pts | 2023: 32,959; 2024: 29,825 |
| Highmark Health Options of Delaware | Highmark | Highmark | Statewide | CMS reported 119,253 (2024) | 54.4% | -31,008 (-20.6%) | +0.0 pts | 2019: 136,448; 2020: 133,731; 2021: 146,199; 2022: 157,514; 2023: 150,261; 2024: 119,253 |
Diamond State Health Plan (Comprehensive MCO + MLTSS)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| AmeriHealth Caritas of Delaware | AmeriHealth | AmeriHealth | Statewide | not reported | not reported | not reported | not reported | 2018: 47,114 |
| Highmark Health Options of Delaware | Highmark | Highmark | Statewide | not reported | not reported | not reported | not reported | 2017: 117,154; 2018: 152,531 |
| Highmark Health Options | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 106,499 |
| UnitedHealthcare Community Plan | UnitedHealth Group | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2016: 89,412; 2017: 90,843 |
LogistiCare Non-Emergency Medical Transportation (Non-Emergency Medical Transportation)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| LogistiCare Non-Emergency Medical Transportation | LogistiCare | LogistiCare | Statewide | not reported | not reported | not reported | not reported | 2020: 217,895 |
LogistiCare/Circulation Non-Emergency Medical Transportation (Non-Emergency Medical Transportation)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| LogistiCare/Circulation Non-Emergency Medical Transportation | LogistiCare | LogistiCare | Statewide | not reported | not reported | not reported | not reported | 2018: 208,802 |
| LogistiCare | LogistiCare | LogistiCare | Statewide | not reported | not reported | not reported | not reported | 2019: 208,650 |
ModivCare Non-Emergency Medical Transportation (Non-Emergency Medical Transportation)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| ModivCare Non-Emergency Medical Transportation | ModivCare | Modivcare | Statewide | not reported | not reported | not reported | not reported | 2021: 244,822 |
Modivcare Non-Emergency Medical Transportation (NEMT)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Modivcare Non-Emergency Medical Transportation | Modivcare | Modivcare | Statewide | CMS reported 236,213 (2024) | 100.0% | -49,619 (-17.4%) | 0.0 pts | 2023: 285,832; 2024: 236,213 |
Non-Emergency Medical Transportation (NEMT)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| ModivCare Non- Emergency Medical Transportation | ModivCare | Modivcare | Statewide | not reported | not reported | not reported | not reported | 2022: 268,117 |
PACE (PACE)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| PACE Your Life | Milford Wellness Village | Milford Wellness Village | Sussex County | CMS reported 53 (2024) | 14.3% | +19 (+55.9%) | +4.0 pts | 2023: 34; 2024: 53 |
| Saint Francis Life | Saint Francis Healthcare | Saint Francis Healthcare | New Castle County | CMS reported 317 (2024) | 85.7% | +23 (+7.8%) | -4.0 pts | 2023: 294; 2024: 317 |
PACE (Program of All-inclusive Care for the Elderly (PACE))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Saint Francis Life | Saint Francis Healthcare | Saint Francis Healthcare | New Castle County | not reported | not reported | not reported | not reported | 2019: 261; 2020: 255 |
| Saint Francis Life | Saint Francis Healthcare | Saint Francis Healthcare | New Castle county | not reported | not reported | not reported | not reported | 2021: 253 |
Program of All-Inclusive Care for the Elderly (PACE)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| PACE Your Life | Milford Wellness Village | Milford Wellness Village | Sussex County | not reported | not reported | not reported | not reported | 2022: 6 |
| Saint Francis Life | Saint Francis Healthcare | Saint Francis Healthcare | New Castle County | not reported | not reported | not reported | not reported | 2022: 264 |
Saint Francis Life (Program of All-inclusive Care for the Elderly (PACE))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Saint Francis Life | Saint Francis Healthcare | Saint Francis Healthcare | New Castle County | not reported | not reported | not reported | not reported | 2016: 191; 2017: 224; 2018: 242 |
Plan operations (CMS MCPAR)
Counts, rates, dates, and status are the CMS MCPAR cells for that plan, program, and reporting year. The appeal rate is calculated from CMS reported appeals resolved in favor of the enrollee divided by CMS reported appeals resolved. It is not a CMS-published rate. A plan links when the name matches one enrollment plan in that same state and program. Unmatched is shown and is not guessed. A sanction amount is not on this page. Retrieved 2026-11-02. CMS MCPAR.
National plan operations · Federal compliance deadlines
Appeals, grievances, and enrollment share (2024)
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| AmeriHealth Caritas Delaware | AmeriHealth | Diamond State Health Plan | 211 | 110 | 52.1% calculated | 1,682 | 27.7% | 35.4% |
| Delaware First Health | Delaware First Health | Diamond State Health Plan | 37 | 15 | 40.5% calculated | 242 | 11.9% | 15.2% |
| Highmark Health Options | Highmark | Diamond State Health Plan | 992 | 397 | 40.0% calculated | 4,369 | 47.1% | 60.1% |
Sanctions (2024)
not reported.
Award history
- Delaware Medicaid Managed Care Organizations (Diamond State Health Plan / Plus) HSS-22-008: awarded. Delaware Medicaid Managed Care Organizations (Diamond State Health Plan / Plus) (HSS-22-008). Status recorded from the retrieved documents: awarded. Named awardees in confirmed excerpts: Highmark BCBSD Health Options Inc. dba Highmark Health Options, AmeriHealth Caritas Delaware, Inc., Granite State Health Plan, Inc. dba Delaware First Health. Award date 2022-07-13. Contract start 2023-01-01. Contract end 2027-12-31.
Retrieved 2026-11-03. Sources and scores
Early procurement signals
No official early-procurement document has been retrieved for this state. This is not a finding that no signal exists. Early signals
Contract amendments
No official Medicaid managed-care contract amendment has been retrieved for this state. This is not a finding that no amendment exists. Contract amendments
Medicaid policy
Indiana rows are official policy instruments. Other states show only Federal Register notices of hearings on SPA disapprovals, which are a narrow slice and not waiver or SPA coverage.
Federal Register notices of hearings on SPA disapprovals are read from the Federal Register JSON API. That covers no approved SPAs, waivers, or section 1115 demonstrations.
Coverage not_collected.
No official Medicaid managed-care policy instrument has been retrieved for this state. This is not a finding that no waiver, state plan amendment, or rule exists. Medicaid policy
Federal Register SPA disapproval hearing notices (2015 or later): 0
Plan financials
No official Medicaid plan financial filing has been retrieved for this state. This is not a finding that no filing exists, and it is not a zero. Plan financials. Coverage: not_collected.
Federal compliance deadlines
Cited federal Medicaid managed care deadlines, with the Federal Register citation, the effective date, the compliance date, and the plan obligation.