Understanding Medicare Special Needs Plans in Sussex County, Delaware
Sussex County, DE offers 13 Special Needs Plans (SNPs) in 2025, including 8 with no monthly premium. Currently, about 3,203 beneficiaries are enrolled, and 44% of SNPs have a 4-star rating or higher. These plans are designed for Medicare beneficiaries who meet special eligibility criteria, such as dual coverage, qualifying chronic conditions, or residence in a long-term care facility.
Page last revised:
Enrollment data refreshed: September 16, 2025
* Each year CMS evaluates Medicare Advantage plans on a 5-star scale. Data sources
Dual Eligible Special Needs Plans (D-SNPs)
Dual Eligible Special Needs Plans (D-SNPs) are designed for people who qualify for both Medicare and Medicaid. These plans coordinate benefits to reduce costs and provide access to additional support services.
- Total D-SNP Plans: 9
- Average Premium: $7.72/mo
- Beneficiaries Enrolled: 2,490
- $0 Premium D-SNPs: 7
- Zero Cost D-SNP Plans: 7
- Most Popular D-SNP: UHC Dual Complete DE-S001 (D-SNP) with 823 enrollees
- D-SNPs Without Drug Coverage: 0
| Health Plan Name | CMS Rating* | Premium Per Mo | Network |
|---|---|---|---|
| Aetna Medicare Advantra Cares | $0 | HMO D-SNP | |
| UHC Dual Complete DE-S001 | $0 | HMO-POS D-SNP | |
| UHC Dual Complete DE-V001 | $46 | HMO-POS D-SNP | |
| HealthSpring TotalCare | $23 | HMO D-SNP | |
| HealthSpring TotalCare Plus | $0 | HMO D-SNP | |
| AmeriHealth Caritas VIP Care | $0 | HMO D-SNP | |
| Highmark Health Options Duals | $0 | HMO D-SNP | |
| Wellcare Dual Access | $0 | HMO-POS D-SNP | |
| Wellcare Dual Liberty | $0 | HMO-POS D-SNP |
What D-SNP plan has the highest enrollment in Sussex County?
UHC Dual Complete DE-S001 (D-SNP) is the most popular D-SNP in Sussex County, with 823 enrollees.
What is the total number of D-SNP options in Sussex County?
There are 9 D-SNP plans in 2025, covering 2,490 beneficiaries.
Institutional Special Needs Plans (I-SNPs)
These plans cater to individuals residing in long-term care facilities, such as nursing homes, or those requiring extended skilled nursing facility care at home. The CMS website provides more information about I-SNPs and their coverage details.
- Total I-SNP Plans
- 2
- Average Premium
- $47.00/mo
- Beneficiaries Enrolled
- 64
- $0 Premium I-SNPs
- 0
- Average MOOP
- $11,500
- Most Popular I-SNP
- UHC Nursing Home Plan EX-F002 (I-SNP) with 64 enrollees
- I-SNPs Without Drug Coverage
- 0
| Health Plan Name | CMS Rating* | Premium Per Mo | Network |
|---|---|---|---|
| UHC Nursing Home Plan EX-F002 | $48 | PPO I-SNP | |
| UHC Nursing Home Plan EX-F005 | $46 | PPO I-SNP |
What is the total number of I-SNP options in Sussex County?
Sussex County has 2 I-SNP options for 2025, serving 64 members.
How much do I-SNP plans cost on average in Sussex County?
The mean monthly I-SNP premium in Sussex County is $47.00, with 0 at no cost.
Chronic Condition Special Needs Plans (C-SNPs)
These plans are designed for individuals with severe or disabling chronic conditions. C-SNPs excel at coordinating your care among different medical specialists and often include extra benefits like prescription drug plans.
- Total C-SNP Plans 2
- Average Premium $34.00/mo
- Beneficiaries Enrolled 649
- $0 Premium C-SNPs 1
- Average MOOP $11,400
- Most Popular C-SNP UHC Complete Care DE-4 (C-SNP) with 631 enrollees
- C-SNPs Without Drug Coverage 0
| Health Plan Name | CMS Rating* | Premium Per Mo | Network |
|---|---|---|---|
| UHC Complete Care DE-4 | $0 | HMO-POS C-SNP | |
| HealthSpring Achieve Medicare | $68 | HMO C-SNP |
What is the typical monthly premium for C-SNPs in Sussex County?
On average, C-SNP plans in Sussex County cost $34.00 per month.
Which C-SNP plan do most beneficiaries with chronic conditions choose in Sussex County?
The leading C-SNP in Sussex County is UHC Complete Care DE-4 (C-SNP), with 631 members.
How many Chronic Condition SNPs are offered in Sussex County?
In 2025, Sussex County offers 2 C-SNPs with 649 enrollees.
Medicare Special Needs Plans have with strict enrollment windows. By knowing when and how to sign up, you’ll avoid missed deadlines and keep your healthcare coverage aligned with your needs.
Understanding Enrollment Windows
- Initial Enrollment Period (IEP): Beginning three months before you turn 65 and lasting until three months after, this is the initial chance to join Medicare. You may also select a Medicare Advantage plan if it fits your needs. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): Between January 1 and March 31, people already enrolled in Medicare Advantage can make a one-time change—switch to another plan or return to Original Medicare. Learn more
- Annual Enrollment Period (AEP): From October 15 through December 7 each year, you can make changes to your Medicare coverage for the following year. Learn more
- Special Enrollment Periods (SEPs): Life events like moving to a new service area, losing other health coverage, or becoming eligible for assistance may open a Special Enrollment Period to adjust your Medicare coverage. Learn more
Ways to Enroll in Medicare Advantage Special Needs Plans
- Consult a Licensed Agent: Call a licensed insurance agent at HealthCompare 1-833-748-3201 (TTY 711), available Monday through Friday 5am–6pm and Saturday 6am–5pm PST, for help reviewing your Medicare options.
- Contact the Plan Provider Directly: Start enrollment by reaching out to the plan provider through their website or by phone with their member services team.
- Use Medicare.gov: At Medicare.gov, you can compare Medicare Advantage plans side by side and enroll securely online.
The D-SNP, C-SNP, and I-SNP plans listed on this page are available to qualifying individuals enrolled in Medicare Part A and Part B living in Bethany Beach, Bridgeville, Dagsboro, Delmar, Ellendale, Frankford, Georgetown, Greenwood, Harbeson, Laurel, Lewes, Lincoln, Milford, Millsboro, Milton, Ocean View, Rehoboth Beach, Seaford, Selbyville, and all other areas of Sussex County, Delaware.
Plans Offered for Enrollment through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
CMS Plan IDs Presented
The Medicare Special Needs Plan pages listed in the tables above include localization to assist beneficiaries with plans available in their service area. However, most Part C plans are available in more than one service area, which can lead to confusion. The following list of CMS IDs links to our master plan pages without localization.
- CMS.gov, Landscape Source Files — Last accessed September 13, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed September 13, 2025
- CMS.gov, Plan Benefits Package — Last accessed September 13, 2025
- CMS.gov, Medicare Advantage/Part D Contract and Enrollment Data — Last accessed September 16, 2025
Some facts and percentages shown on this page (such as average premiums, distribution of plan types, and percentage of $0 premium plans) are calculated by Medicare.org using data from the CMS Plan Benefits Package (PBP) files and Part C & D Performance files. All underlying values originate from CMS, and calculations are refreshed whenever CMS issues updated data.
Medicare.org separates Medicare Advantage (MA/MAPD) plans and Special Needs Plans (SNPs) into different pages for clarity. As a result, plan counts, percentages, and other calculations shown here may differ from the aggregate totals published in the CMS Landscape files. All plan availability and benefit details originate from CMS.
Learn more about how we use CMS data.
- CMS.gov, "Medicare Advantage Plan Fact Sheet" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 23 May, 2025
- Medicare.gov, "Joining a plan" — Last accessed 21 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.