Delaware Medicaid Renewal & Recertification (2026)

Missing a renewal form is one of the most common ways Delawareans lose Medicaid coverage they still qualify for. Federal law requires the state to try to renew you automatically from data it already holds before it ever asks you for paperwork, but when a renewal form does reach your mailbox, it has to come back on time. This guide explains how Delaware Medicaid renewal and recertification works in 2026, what to do when your form arrives, and the 90-day window to recover if you miss the deadline.

Renew online at Delaware ASSIST

Eligibility for Medicaid is set once at application and then re-checked on a schedule: most enrollees sit on the standard 12-month renewal cycle, and a federal law change moves one group to a faster clock starting in 2027 (covered below).3 When a renewal closes for procedural reasons, the person usually remained eligible and simply did not return the form in time, which is what the 90-day reconsideration window fixes.

In Delaware, the renewal comes from DMMA, the state Medicaid agency within DHSS, and the state's online front door for benefits is the ASSIST portal at assist.dhss.delaware.gov.1 Most of what follows is federal renewal law that binds every state, but the Delaware specifics, from the state's long-term-care income cap to its three managed care plans, decide how the process plays out for you.

In This Guide

• How the Delaware Medicaid Renewal Cycle Works
• Ex Parte Renewal: The Automatic First Step
• How to Renew Delaware Medicaid
• The 90-Day Reconsideration Window
• Returned Mail and Address Changes
• Children, Pregnancy, and Continuous Coverage
• Long-Term Care and DSHP-Plus Renewals
• Managed Care Plans at Renewal
• If Your Renewal Is Denied: Appeals
• What Changes After 2026
• Common Delaware Medicaid Renewal Mistakes
• Frequently Asked Questions
• Learn More

How the Delaware Medicaid Renewal Cycle Works

Most Delaware Medicaid enrollees are renewed on the standard 12-month cycle federal law sets for Medicaid redeterminations.3 Your renewal notice tells you when your redetermination is due, so treat any mail from DMMA or DHSS as time-sensitive.

Renewals split into two procedural paths depending on your eligibility category:

• MAGI populations are renewed using Modified Adjusted Gross Income methodology, checked largely against electronic data. Delaware's MAGI income standards, expressed as a share of the Federal Poverty Level (FPL), are: children under age 1 up to 212% FPL, ages 1 through 5 up to 142% FPL, and ages 6 through 18 up to 133% FPL; pregnant women up to 212% FPL; parents and caretaker relatives up to 87% FPL; and adults age 19 to 64 in the Affordable Care Act expansion group at a base standard of 133% FPL, which reaches an effective ceiling of 138% FPL with the mandatory 5-percentage-point income disregard.5 Delaware's separate CHIP program, the Delaware Healthy Children Program, covers children up to age 19 at 212% FPL.5
• Non-MAGI populations (aged, blind, and disabled coverage, nursing-facility Medicaid, and DSHP-Plus long-term care) are renewed under a framework that includes an asset test. Federal law requires every state to verify assets at determination and redetermination through an electronic Asset Verification System (Section 1940 of the Social Security Act), so these renewals clear automatically less often and usually require bank statements and other resource documentation.6 For a single Delaware long-term-care recipient, the countable-resource limit is $2,000 ($3,000 for a couple when both spouses receive care).1

Ex Parte Renewal: The Automatic First Step

The most important federal rule in modern Medicaid renewal is the ex parte default at 42 CFR 435.916(b)(1). Before the agency asks you for any information at renewal, it must make the redetermination without requiring anything from you whenever it can do so from reliable information already in your account or otherwise available to it, including electronic data sources. Only if it cannot renew on that basis may it request information from you.2 When the ex parte renewal succeeds, the state notifies you of the determination and its basis, and you do not need to sign and return the notice if everything on it is accurate.2

Ex parte renewal works best when your income is visible in government data: Social Security Administration benefit records, tax data, and wage records. It fails most often when income is hard to verify from data alone (self-employment, gig work, cash or seasonal income), when the household changes, when income sits close to a cutoff, or, for aged, blind, disabled, and long-term-care cases, when the asset test cannot be confirmed without your bank records.6

When ex parte fails, the agency must mail a renewal form containing the information it already holds and must give you at least 30 days from the date on that form to respond, provide any missing information, and sign. It may not require an in-person interview as part of the renewal. That package is federally required under 42 CFR 435.916(a)(3) for eligibility based on modified adjusted gross income (MAGI). For non-MAGI eligibility (age 65 or older, blindness or disability, long-term care, an MSP, or medically needy), Delaware may follow the same procedure but need not, so go by the deadline on your notice.2

How to Renew Delaware Medicaid

Delaware ASSIST at assist.dhss.delaware.gov is the state's online portal for Medicaid, and it is where DMMA points residents to handle their case online.1 Whichever channel you use, the instructions printed on your own renewal notice govern, so read the packet before you pick a route. If you prefer working with a person, DMMA's Medicaid Central Intake Unit is 1-866-940-8963,1 and the Delaware Aging and Disability Resource Center helps families get answers about eligibility, benefits, and how to apply.4

The 90-Day Reconsideration Window

If your coverage closed because you missed the renewal paperwork, you usually do not have to start over. Under 42 CFR 435.916, when Medicaid is terminated for failure to return the renewal form or requested information (a procedural termination, not an eligibility-based one), the agency must reconsider your eligibility without requiring a new application if you submit the renewal form within 90 days after the termination date, or a longer period if the state elects one. That duty covers MAGI-based eligibility; for non-MAGI groups federal law lets Delaware adopt the same window but does not require it, so ask DMMA.2 Send back the form together with whatever information DMMA had asked for, since either omission triggers the closure.2

Two distinctions decide whether the window applies:

• Procedural termination. You did not respond, did not provide requested documentation, or missed the signature. The 90-day reconsideration applies.2
• Eligibility-based termination. DMMA determined you no longer meet income, residency, or another requirement. The reconsideration does not apply; your options are a new application or an appeal.

To use the window, submit the renewal form or missing information through any of the channels above, and note the closure date from your notice so your case is routed as a reconsideration. If you no longer have the form, contact DMMA or log into Delaware ASSIST to request what you need.

Returned Mail and Address Changes

A renewal packet returned as undeliverable can lead to a termination. The federal rule requiring the state to search for a new address first, 42 CFR 435.919, was removed effective July 31, 2026. Federal law now says only that the agency may act without advance notice when your whereabouts are unknown (42 CFR 431.213(d)), and that coverage must be reinstated if your whereabouts become known while you are still eligible (42 CFR 431.231(d)).7 Delaware may still have its own procedures, so call DMMA if your mail has come back.

Update your address in Delaware ASSIST when you move, tell your managed care plan, and file a USPS change-of-address form.

Children, Pregnancy, and Continuous Coverage

Section 5112 of the Consolidated Appropriations Act, 2023 requires every state to give children under age 19 enrolled in Medicaid or CHIP 12 months of continuous eligibility from the date of enrollment, effective January 1, 2024. Once a child is determined eligible, coverage stays in place until the earlier of the end of the 12-month period, the child's 19th birthday, or the child moving out of state, regardless of changes in family income.3 If a parent loses Medicaid mid-year because household income rose, the children stay covered until their next renewal. Report income changes accurately: reporting protects you, and your children keep coverage through their 12-month period either way.

Federal law also gives every state a permanent option to extend Medicaid coverage for 12 months after the end of pregnancy, up from the historic 60-day window, with full benefits throughout.3 How that option applies to your own postpartum coverage is a question for DMMA or your renewal notice.

One more federal protection matters at renewal. If you declare U.S. citizenship or a satisfactory immigration status and the agency cannot promptly verify it, 42 CFR 435.956 requires a reasonable opportunity period, generally ending at verification or 90 days after the notice, during which the agency may not delay, deny, reduce, or terminate benefits for someone it otherwise finds eligible.8

Long-Term Care and DSHP-Plus Renewals

If you receive Delaware Medicaid long-term care, in a nursing facility or through home- and community-based services, your renewal reviews both your finances and your care needs, and both must stay current.

The financial redetermination

Delaware is an income-cap state: the long-term-care income limit is 250% of the Supplemental Security Income standard, which for 2026 (individual SSI standard of $994) equals $2,485 per month. That standard has applied to Delaware's nursing-facility and HCBS populations alike since October 1, 1994. An applicant or recipient whose gross monthly income exceeds the cap qualifies by maintaining a Miller Trust (Qualified Income Trust).1

The renewal also re-runs the resource test, which federal law requires the state to verify through its Asset Verification System.6 The figures that govern a 2026 Delaware review:1

• Countable assets are limited to $2,000 for a single recipient ($3,000 for a couple when both receive long-term care). Delaware excludes the principal residence only if certain conditions are met, either that you intend to return home or that a spouse or dependent relative uses the home during your absence, and it also excludes one automobile per household, burial funds of $1,500 that are separately identifiable and designated for burial, and a prepaid burial contract that cannot be revoked.1
• Home equity is a second, separate test. Equity above the federal home-equity cap blocks Medicaid payment for long-term care even when the residence itself is excluded, unless a spouse, a child under 21, or a blind or disabled child of any age lawfully occupies the home. Delaware's manual defers to "the home equity cap as set by federal regulations" and its own table stops at $525,000 from 2012, so the state names no current figure, while CMS publishes 2026 federal limits of a $752,000 minimum and a $1,130,000 maximum. Ask DMMA which cap it is applying rather than assuming either one.1
• A nursing-facility resident keeps a Personal Needs Allowance of $75 per month ($150 for married couples), raised from $50 and $100 effective January 1, 2025. The $75 is not universal: in the post-eligibility calculation for an institutionalized spouse, DSSM 20995.1.1 sets the allowance at $30 per month for SSI recipients and $75 for everyone else, so an SSI recipient in a facility should confirm with DMMA which amount applies.1
• A community spouse keeps the greater of Delaware's state spousal share or half the couple's combined countable resources as of the start of the first continuous period of institutionalization, and in no case more than the 2026 federal maximum Community Spouse Resource Allowance of $162,660. The floor is genuinely unsettled in Delaware and this guide does not assert one: DSSM 20910.10 still prints a $25,000 state spousal share set by Senate Bill 99 in 1993, while the same section says the minimum and maximum resource allowances rise each January under federal law, and the 2026 federal minimum resource standard published by CMS is $32,532. Ask DMMA which floor it applies before relying on either number.1
• The community spouse's monthly income allowance is not a flat amount. Delaware computes it as the income needed to bring that spouse's own available income up to the applicable percentage of the federal poverty level for two, plus an additional amount for excess shelter costs, subject to a cap. Two separate federal 2026 standards bound that calculation, and they sit on two different annual clocks rather than forming the two ends of one published range: the Minimum Monthly Maintenance Needs Allowance is $2,705.00, effective July 1, 2026, and the Maximum Monthly Maintenance Needs Allowance is $4,066.50, effective January 1, 2026.1

DSHP-Plus and the level-of-care review

Delaware delivers home- and community-based long-term care for residents who are elderly or physically disabled through Diamond State Health Plan Plus (DSHP-Plus), a mandatory managed-care program authorized under a Section 1115 demonstration rather than a standalone 1915(c) waiver, administered by DMMA in partnership with the state's Division of Services for Aging and Adults with Physical Disabilities.4 Long-term-care coverage rests on a nursing-facility level-of-care determination and clinical criteria in addition to the financial rules, so confirm with DMMA or your case manager how and when your level of care is reassessed.4

Our guides to Delaware Medicaid nursing home coverage and home and community care through DSHP-Plus cover both tracks in detail.

Managed Care Plans at Renewal

Delaware Medicaid members are served by three participating managed care plans: AmeriHealth Caritas, Delaware First Health, and Highmark Health Options.9 Your eligibility renewal and your plan membership are different things, but losing Medicaid eligibility at renewal ends the coverage your plan delivers. Your plan's address file is separate from DMMA's, and no federal rule requires the state to check it when your mail comes back, so update both yourself.7

If Your Renewal Is Denied: Appeals

If your renewal is denied or your coverage is terminated, you have a federal right to a fair hearing under Section 1902(a)(3) of the Social Security Act and 42 CFR 431.220,3 and federal law caps the request window at 90 days from the date the notice of action is mailed.10

In Delaware, the deadline to request a Medicaid fair hearing matches that federal standard: 90 days from the date the notice is mailed. The request must be made in writing, following the instructions on your notice, and DHSS procedures must let you submit it online, by telephone, by mail, in person, or through other common electronic means. The hearing is held by a Hearing Officer in the Division of Social Services (DSS), whose decision is the final decision of DHSS, and a final decision must be issued within 90 days of the date you file.9

Two timing rules deserve special attention:

• Keeping coverage while you appeal. Federal law continues your benefits during the appeal (aid paid pending) only when you request the hearing before the action's effective date.11 Delaware provides continued benefits within 5 working days of receiving the request.9 If the action is later upheld, the agency may recoup the cost of services furnished only because benefits continued.11
• Managed care denials add a step. For a plan's adverse benefit determination, you must first appeal to the plan itself within 60 calendar days of its notice, and after the plan upholds its decision (or fails the federal notice and timing requirements), you have 120 calendar days to request a state fair hearing.9

If you disagree with the Hearing Officer's decision, you can seek judicial review in Delaware Superior Court within 30 days.9 The full process, including what to bring to the hearing, is covered in our guide to Delaware Medicaid appeals and fair hearings.

What Changes After 2026

Section 71107 of the 2025 budget-reconciliation law (H.R.1, Public Law 119-21) requires states to redetermine eligibility once every 6 months, rather than every 12 months, for the ACA expansion-adult population, for renewals scheduled on or after January 1, 2027. Its only exemption covers an Indian or Urban Indian as defined in the Indian Health Care Improvement Act, a California Indian, and anyone otherwise determined eligible as an Indian for the Indian Health Service.3 Delaware adopted the ACA Medicaid expansion effective January 1, 2014,1 so this change reaches the state's expansion adults directly: they will face a renewal twice a year instead of once.

The same law separately excuses a longer list of people from its new community-engagement (work) requirement, including someone who is medically frail or the parent or caretaker relative of a dependent child 13 and under. A work-requirement exemption is not a renewal exemption: an expansion adult who is medically frail still renews every six months.3

The same law shortens retroactive eligibility for applications filed on or after January 1, 2027, to a maximum of two months before the application month for most enrollees and one month for the expansion group, down from the long-standing three-month default.3 The takeaway does not change: the renewal form is the failsafe, and returning it on time is the cheapest way to protect your coverage.

Common Delaware Medicaid Renewal Mistakes

1. Treating the packet like junk mail. Anything from DMMA, DHSS, or Delaware ASSIST is time-sensitive. Open it the day it arrives.
2. Updating your address with Social Security or your plan but not with the state. Address updates do not automatically flow between agencies. Update Delaware ASSIST, and your plan, every time you move.
3. Missing the asset documentation for long-term-care and disability-based renewals. The state cannot finalize a non-MAGI renewal until the resource test is confirmed through the Asset Verification System, so a missing bank statement or signature stalls the whole case.6

If you are unsure whether your renewal has been processed, log into Delaware ASSIST or contact DMMA. Brevy's guides to how to apply for Delaware Medicaid, Delaware Medicaid income and asset limits, and the Delaware Medicaid hub cover the broader eligibility picture and can help you judge whether you remain eligible at renewal.

Learn More

Find personalized help renewing your Delaware Medicaid coverage at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.