American Academy of HIV Medicine | Delaware State Insurance Exchange

Delaware State Insurance Exchange

The Delaware Insurance Exchange (Marketplace) is called the ChooseHealth Delaware.
ChooseHealth Delaware is a Partnership Marketplace jointly administered by the State and the federal government, under the Department of Health and Human Services (HHS).
General information about the ChooseHealth Delaware can be found at: http://www.choosehealthde.com/Health-Insurance.
Learn more:Background

PATIENTS

Providers must contract with each of the Qualified Health Plans offered in the marketplace individually to participate fully in the ChooseHealth Delaware.
This process is similar to enrolling in insurance or managed care organization provider networks. See below the list of insurers participating in the ChooseHealth Delaware, and information about contacting them.
As an HIV provider, you may qualify for designation as an “Essential Community Provider (ECP).” The Qualified Health Plansparticipating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.

HIV PROVIDERS

Providers must contract with each of the plans in the marketplace individually in order to fully participate in the Access Health Connecticut.

This process is similar to enrolling in insurance or managed care organization provider networks. See below for a list of insurers participating in the state marketplace, and information on contacting them.
As an HIV provider, you may qualify for the designation, of an “Essential Community Provider (ECP).” The participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.

REPORTING PROBLEMS

The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them. If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state office of insurance:
Delaware Department of Insurance
841 Silver Lake Blvd.
Dover, DE 19904
302-674-7300

www.delawareinsurance.gov/
Complaints: www.delawareinsurance.gov/services/filecomplaint.shtml
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.

QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE

Below is a list of the Qualified Health Plans that have publically announced that they will offer plans in the ChooseHealth Delaware.
Delaware has established Highmark- Blue Cross Blue Shield of DE as the “benchmark” plan.

This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates.

Aetna

Plan Website: http://www.aetna.com/

Provider Enrollment:

http://www.aetna.com/healthcare-professionals/join-aetna-network/join-provider-network.html

Plan types offered: Individual

Aetna Health, Inc.

Plan Website: http://www.aetna.com/statede/

Provider Enrollment: https://www.aetna.com/health-care-professionals.html#open

Plan types offered: Individual, SHOP

Aetna Life Insurance Company

Plan Website: https://www.aetna.com/about-us.html