Delaware Medicaid Income Limits (2026)

Delaware Medicaid is the state's joint federal-state health coverage program for low-income individuals, administered by the Delaware Division of Medicaid and Medical Assistance (DMMA) within the Department of Health and Social Services (DHSS). Delaware adopted the Affordable Care Act Medicaid expansion in January 2014 and remains one of the 40 states plus the District of Columbia that covers adults up to 138% of the Federal Poverty Level (FPL). For 2026, the 2026 FPL base is $15,960 for a household of one in the 48 contiguous states, making the Delaware Medicaid adult threshold $22,025 per year or $1,835 per month for a single adult. The threshold rises with each additional household member at roughly $5,680 per year per person, so a household of four qualifies if annual income stays below $45,540.

Delaware Medicaid covers four main population groups. First, expansion adults ages 19-64 qualify at 138% FPL with no asset test applied. Second, pregnant women receive a notably more generous threshold of 217% FPL, with 12 months of guaranteed postpartum coverage after delivery. Third, children face a tiered eligibility structure: infants under 1 year qualify at 217% FPL (the same rate as pregnant women), children ages 1-5 qualify at 147% FPL, and children ages 6-18 qualify at 138% FPL. Children who exceed the Medicaid income limit but fall under 217% FPL may qualify for the Delaware Healthy Children Program (DHCP), the state's CHIP program. Fourth, aged (65+), blind, and disabled individuals (ABD) face SSI-linked income and asset tests; long-term care Medicaid applies a separate $2,485 per month income limit and a $2,000 individual asset limit. The 2026 thresholds below reflect the official HHS poverty guidelines updated in February 2026.

The income table below shows Delaware Medicaid's 2026 thresholds across the three primary covered populations. Delaware Medicaid uses MAGI (Modified Adjusted Gross Income) methodology for the non-elderly, non-disabled categories, meaning no asset test applies and income is calculated before most deductions. If household income exceeds the Delaware Medicaid adult limit but falls below 400% FPL, marketplace subsidies through Healthcare.gov are available instead. If a child's family income exceeds the children's Medicaid limit but is below 217% FPL, the Delaware Healthy Children Program covers the gap. Delaware residents 65 or older with limited income and Medicare coverage should review the Medicare Savings Programs section toward the end of this page.

Delaware Medicaid income limits by household size (2026)

The 2026 Delaware Medicaid income guidelines below are based on the 2026 Federal Poverty Level for the 48 contiguous states. Adult column = expansion-group threshold (138% FPL) for adults ages 19-64. Children column = highest child Medicaid tier for Delaware (217% FPL for infants under 1 year; children ages 1-5 qualify at 147% FPL; children ages 6-18 qualify at 138% FPL). Pregnancy column = 217% FPL for pregnant women. Add roughly $5,680 of annual income per additional household member.

Delaware Medicaid eligibility requirements (non-income)

Beyond income, Delaware Medicaid applicants must meet the following non-income requirements. These rules apply broadly across population groups, though some criteria differ for the aged, blind, and disabled (ABD) categories, which require an additional medical determination and carry an asset test not present in MAGI-based categories.

• Delaware residency: Applicants must be current Delaware residents with the intent to remain. DMMA verifies residency through utility bills, lease agreements, mortgage statements, or state-issued ID with a Delaware address. There is no minimum length-of-residency requirement; moving to Delaware and immediately applying is permitted.
• Citizenship and immigration status: U.S. citizens and certain qualified immigrants (lawful permanent residents, refugees, asylees, DACA recipients under limited state-funded programs, and other qualifying immigration statuses defined in the Social Security Act) may qualify. Lawful permanent residents are subject to the federal five-year bar before most Medicaid eligibility begins, with exceptions for emergency Medicaid and certain protected categories (children, refugees, asylees). Undocumented individuals generally do not qualify for full Delaware Medicaid but may receive emergency Medicaid for acute care.
• Social Security Number (SSN): Every household member applying for Delaware Medicaid must provide a valid SSN or apply for one simultaneously. Individuals who are not applying on their own behalf (such as a parent applying only for a child) do not need to provide their own SSN, though citizenship and immigration status may still be required for income-verification purposes.
• Age: Delaware Medicaid expansion covers adults ages 19 through 64. Children under 19 qualify under separate children's or CHIP eligibility rules. Adults 65 and older fall under the aged, blind, and disabled (ABD) category, which uses SSI-linked income and asset thresholds rather than the MAGI expansion rules. There is no upper age limit for ABD Medicaid.
• Asset test (MAGI categories): For expansion adults, pregnant women, and children covered under MAGI rules, Delaware Medicaid does NOT apply an asset test. There is no limit on savings accounts, vehicles, or other resources for these groups. Only the aged, blind, disabled (ABD), and long-term care categories apply an asset test (individual limit: $2,000; couple limit: $3,000).
• Other health coverage: Delaware Medicaid is payer of last resort. Applicants with other health insurance (employer-sponsored, VA, TRICARE) are generally still eligible for Delaware Medicaid, which then coordinates benefits. Having Medicare does not automatically disqualify a person from Delaware Medicaid; dual-eligible individuals can have both, with Delaware Medicaid covering premiums, copays, and services not paid by Medicare.

What income counts for Delaware Medicaid

Delaware Medicaid uses MAGI (Modified Adjusted Gross Income) methodology for expansion adults, children, and pregnant women. MAGI starts with federal taxable income and adds back certain items that are normally excluded from taxation. Delaware follows the federal MAGI definition without state-specific modifications. A 5% income disregard is built into the FPL percentages for these categories (the stated 138% threshold already incorporates the disregard, effectively covering individuals at up to 133% FPL before the disregard is applied).

Income sources included

• Wages and salaries: all W-2 employment income, including tips and bonuses, before payroll deductions.
• Self-employment net earnings: gross business income minus allowable business expenses as reported on Schedule C or F of the federal tax return.
• Social Security retirement and survivor benefits: the taxable portion of Social Security benefits (up to 85% may be taxable) counts as MAGI income. SSI (Supplemental Security Income) does NOT count.
• SSDI (Social Security Disability Insurance) benefits: the taxable portion counts as MAGI income, unlike SSI which is excluded.
• Interest, dividends, and capital gains: all investment income as reported on federal Schedule B and Schedule D, including from savings accounts, stocks, bonds, and mutual funds.
• Pension and retirement distributions: taxable distributions from 401(k), 403(b), IRA, and other retirement accounts count as MAGI income in the year of distribution.
• Unemployment compensation: all unemployment insurance benefits are fully counted as MAGI income.
• Rental and royalty income: net rental income (gross rent minus allowable expenses such as mortgage interest, taxes, depreciation) and royalties count as MAGI income.
• Alimony received under pre-2019 divorce decrees: alimony payments from divorce agreements finalized before January 1, 2019 remain taxable to the recipient and count as MAGI income. Alimony from post-2018 decrees is not taxable and does not count.

Income sources excluded

• SSI (Supplemental Security Income): SSI payments are excluded from MAGI income entirely. Having SSI automatically qualifies most Delaware recipients for Medicaid under the SSI-linked pathway without a separate income test.
• Child support received: child support payments received are not counted as income for the recipient household in MAGI calculations.
• Veterans' benefits: VA disability compensation, GI Bill education benefits, and VA pension payments are excluded from MAGI income.
• Workers' compensation: state workers' compensation benefits received after a workplace injury are not counted as MAGI income.
• Gifts and inheritances: money or property received as a gift or inheritance is not counted as MAGI income (though it may affect asset-tested categories).
• TANF cash assistance: Temporary Assistance for Needy Families cash payments are not counted as income for Delaware Medicaid MAGI calculations.
• Loan proceeds and tax refunds: borrowed money (student loans, personal loans) and federal or state tax refunds are not income for MAGI purposes.

How to apply for Delaware Medicaid in Delaware

Delaware Medicaid applications are submitted through Delaware ASSIST (Application for Social Services and Internet Screening Tool), the state's online benefits portal at assist.dhss.delaware.gov. ASSIST handles Medicaid, Delaware Healthy Children Program (CHIP), SNAP, and other DHSS benefit programs in one application. Applicants can apply online, by phone, by mail, or in person at a DMMA office. Delaware Medicaid is open year-round with no enrollment windows; applications are accepted on a rolling basis.

1. 1. Gather documents: photo ID (Delaware driver's license, state ID, or passport), Social Security cards for all household members, proof of Delaware residency (utility bill, lease, or mortgage statement), proof of citizenship or immigration status (birth certificate, passport, permanent-resident card), and income documentation (pay stubs from the past 30 days, most recent federal tax return, or self-employment income records).
2. 2. Apply online at assist.dhss.delaware.gov. Create a Delaware ASSIST account (or log in if you have one), click Apply for Benefits, and complete the Medicaid application. ASSIST allows you to save progress and return. Alternatively, call the DMMA Central Intake Unit at 1-866-940-8963 (TTY: 1-800-232-5460) to apply by phone or request a paper application.
3. 3. List all household members and report all household income accurately. Underreporting income is the most common reason for a future overpayment determination. Delaware DMMA cross-checks income against state tax records, Social Security Administration data, and employer wage reports.
4. 4. Attach supporting documents. In Delaware ASSIST you can upload documents directly. If applying by phone or mail, send copies (not originals) to the address on the DMMA notice. Keep your application confirmation number.
5. 5. Respond to any requests for additional information from DMMA within the timeframe stated in the notice (typically 10 days). Not responding is a leading cause of application denial. Call 1-866-940-8963 if you need an extension.
6. 6. Wait for the eligibility determination. DMMA issues a written notice of approval or denial. For appeals, you have 30 days from the notice date to request a Fair Hearing through the DHSS Division of Social Services or by calling 1-800-372-2022.

Official portal: Delaware ASSIST

Documents needed

• Photo ID for the primary applicant (Delaware driver's license, state ID card, U.S. passport, or other government-issued photo ID).
• Social Security Number (SSN) or proof of SSN application for each household member applying for coverage.
• Proof of Delaware residency: recent utility bill (electric, gas, water), current lease or rental agreement, mortgage statement, or official mail addressed to the applicant at a Delaware address dated within the past 60 days.
• Proof of citizenship or qualifying immigration status: U.S. birth certificate, U.S. passport, Certificate of Citizenship or Naturalization, Permanent Resident Card (green card), or other qualifying immigration document.
• Income documentation: past 30 days of pay stubs for all employed household members; most recent federal tax return (Form 1040) or signed statement if none was filed; 1099 forms or business profit/loss statement for self-employed applicants; award letter for Social Security, SSI, SSDI, pension, or unemployment.
• Health insurance information: if any household member currently has health insurance, provide the policy number, insurance company name, and effective dates. Delaware Medicaid coordinates with other coverage but existing coverage does not disqualify you.

Processing timeline: Standard Delaware Medicaid applications are decided within 45 days from the date the application is received. Pregnant women's applications are decided within 15 days under federal expedited-processing rules. Applications involving disability determinations (ABD category) may take up to 90 days because they require a separate medical determination. Coverage, when approved, is often retroactive to the date the application was filed.

Common reasons applications get denied

• Income above the applicable Delaware Medicaid threshold for the applicant's population group (the single most common denial reason in 2026).
• Failure to respond to a DMMA request for additional information within the stated deadline, typically 10 days.
• Delaware residency not verified: no utility bill, lease, or other address documentation in the applicant's name or confirming a Delaware address.
• Federal five-year bar for newly arrived lawful permanent residents who do not qualify for an exemption (emergency Medicaid remains available for acute care).
• Assets above the $2,000 individual or $3,000 couple limit for aged, blind, or disabled applicants seeking the ABD or long-term care Medicaid category (note: no asset test applies to expansion adults, children, or pregnant women).

If your child's family income is over the Delaware Medicaid children's limit

Delaware Healthy Children Program (DHCP) is Delaware's CHIP program for uninsured children under age 19 whose family income exceeds the applicable Medicaid limit but is at or below 217% of the Federal Poverty Level. For 2026, that upper limit is $34,633 per year for a household of one or $71,610 per year for a household of four. Children who are not eligible for full Delaware Medicaid because their family income is above 138% FPL (or above 147% FPL for ages 1-5, or above 217% FPL for infants under 1) may qualify for DHCP instead. DHCP covers doctor visits, hospital stays, prescriptions, mental health services, dental, and vision, often with low or no premiums depending on family income. Applications go through the same Delaware ASSIST portal at assist.dhss.delaware.gov.

Compare Medicaid and CHIP income limits across all 50 states

If you are 65 or older with limited income: Delaware Medicare Savings Programs

Delaware administers three Medicare Savings Programs (MSPs) for low-income Medicare beneficiaries. Qualifying Medicare Beneficiary (QMB) covers Medicare Part A and Part B premiums, deductibles, and copayments for individuals with income at or below 100% FPL ($15,960/year in 2026). Specified Low-Income Medicare Beneficiary (SLMB) covers Part B premiums only for individuals with income between 100% and 120% FPL ($19,152/year in 2026). Qualifying Individual (QI) covers Part B premiums for income between 120% and 135% FPL ($21,546/year in 2026). Delaware also covers Qualified Disabled and Working Individuals (QDWI) for workers who lost Medicare Part A due to returning to work, with income up to 200% FPL. Delaware residents who are dual-eligible (both Medicare and Medicaid) may have their Medicare premiums, deductibles, and cost-sharing fully covered by Delaware Medicaid, significantly reducing out-of-pocket costs. Delaware MSP applications also go through Delaware ASSIST or by calling DMMA at 1-866-940-8963.

Read the Medicare eligibility and dual-eligible guide

Frequently Asked Questions