Medicare & Medicaid in Delaware (DE)
2026 healthcare costs, coverage, and spending data for Delaware.
$12,778
Spending/Capita
1,813,491
Medicare Enrollees
2,451,321
Medicaid Enrollees
4.8%
Uninsured Rate
Medicare Premiums in Delaware
Part B Premium
$185/mo
Part D Premium (Avg)
$27/mo
Medigap Premium (Avg)
$163/mo
Medicaid Expansion: Yes - Delaware expanded Medicaid under the ACA
Procedure Costs in Delaware
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $218,521 | $174,817 | $43,704 |
| Kidney Transplant | $112,325 | $89,860 | $22,465 |
| Coronary Artery Bypass Graft (CABG) | $76,424 | $61,139 | $15,285 |
| Heart Valve Replacement | $71,838 | $57,471 | $14,368 |
| Spinal Fusion | $61,165 | $48,932 | $12,233 |
| Defibrillator Implantation (ICD) | $49,431 | $39,545 | $9,886 |
| Total Knee Replacement | $43,613 | $34,891 | $8,723 |
| Total Hip Replacement | $34,502 | $27,601 | $6,900 |
| Laminectomy | $31,375 | $25,100 | $6,275 |
| Sepsis Treatment | $30,124 | $24,099 | $6,025 |
| Cardiac Catheterization with Stent | $25,842 | $20,674 | $5,168 |
| Pacemaker Implantation | $24,899 | $19,919 | $4,980 |
| Carotid Endarterectomy | $24,224 | $19,379 | $4,845 |
| Colectomy | $23,613 | $18,890 | $4,723 |
| Hip Fracture Repair | $23,496 | $18,797 | $4,699 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Arthroscopic Knee Surgery | $9,483 | $7,586 | $1,897 |
| Endoscopic Sinus Surgery | $7,994 | $6,395 | $1,599 |
| TURP (Prostate) | $7,791 | $6,232 | $1,558 |
| Lithotripsy (Kidney Stones) | $6,920 | $5,536 | $1,384 |
| Dialysis Access Surgery | $6,454 | $5,163 | $1,291 |
| Bunionectomy | $5,699 | $4,559 | $1,140 |
| Septoplasty | $4,949 | $3,959 | $990 |
| Tonsillectomy | $4,458 | $3,567 | $892 |
| Nasal Polyp Removal | $4,455 | $3,564 | $891 |
| Hemorrhoid Surgery | $4,348 | $3,479 | $870 |
| Adenoidectomy | $4,321 | $3,456 | $864 |
| Pilonidal Cyst Surgery | $4,147 | $3,318 | $829 |
| Ganglion Cyst Removal | $3,945 | $3,156 | $789 |
| Carpal Tunnel Release | $3,559 | $2,847 | $712 |
| Trigger Finger Release | $3,353 | $2,682 | $671 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $2,950 | $2,360 | $590 |
| Nuclear Stress Test | $2,160 | $1,728 | $432 |
| CT Scan Abdomen/Pelvis | $1,425 | $1,140 | $285 |
| CT Angiography | $1,318 | $1,054 | $264 |
| MRI Hip | $1,310 | $1,048 | $262 |
| MRI Spine (Lumbar) | $1,250 | $1,000 | $250 |
| MRI Spine (Cervical) | $1,246 | $997 | $249 |
| MRI Brain | $1,209 | $968 | $242 |
| Bone Scan | $1,184 | $947 | $237 |
| MRI Shoulder | $1,160 | $928 | $232 |
| CT Scan Head | $986 | $788 | $197 |
| MRI Knee | $914 | $731 | $183 |
| CT Scan Chest | $785 | $628 | $157 |
| CT Colonography (Virtual) | $738 | $590 | $148 |
| Fluoroscopy | $647 | $517 | $129 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $333 | $266 | $67 |
| Allergy Testing | $287 | $230 | $57 |
| Bone Density Test (DEXA Scan) | $241 | $193 | $48 |
| Mental Health Counseling | $231 | $185 | $46 |
| Shingles Vaccination | $229 | $229 | $0 |
| Psychiatry Visit | $218 | $175 | $44 |
| Annual Wellness Visit | $207 | $207 | $0 |
| Wound Care Visit | $202 | $162 | $40 |
| Mammogram (Screening) | $194 | $194 | $0 |
| Occupational Therapy Session | $186 | $148 | $37 |
| Office Visit (Established Patient) | $179 | $143 | $36 |
| Vision Exam (Diabetic) | $172 | $138 | $34 |
| EKG (Electrocardiogram) | $164 | $131 | $33 |
| Physical Therapy Session | $164 | $131 | $33 |
| Office Visit (New Patient) | $158 | $126 | $32 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PSA (Prostate-Specific Antigen) | $46 | $37 | $9 |
| Blood Culture | $46 | $36 | $9 |
| Blood Type and Crossmatch | $45 | $36 | $9 |
| Vitamin D Level | $44 | $35 | $9 |
| BNP (Heart Failure Marker) | $43 | $35 | $9 |
| Troponin Level | $42 | $34 | $8 |
| Glucose Tolerance Test | $40 | $32 | $8 |
| Lipid Panel | $39 | $31 | $8 |
| Thyroid Panel (TSH) | $39 | $31 | $8 |
| Urine Drug Screen | $36 | $29 | $7 |
| Complete Blood Count (CBC) | $36 | $29 | $7 |
| Liver Function Panel | $35 | $28 | $7 |
| Comprehensive Metabolic Panel | $35 | $28 | $7 |
| Basic Metabolic Panel | $30 | $24 | $6 |
| Hemoglobin A1C | $28 | $23 | $6 |
Compare Delaware With Other States
Frequently Asked Questions
How much does Medicare spend per person in Delaware?
In 2026, the average Medicare spending per beneficiary in Delaware is $12,778.
How many people are enrolled in Medicare in Delaware?
Delaware has approximately 1,813,491 Medicare beneficiaries.
Did Delaware expand Medicaid?
Yes, Delaware expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in Delaware?
The uninsured rate in Delaware is 4.8%.
What is the average Medigap premium in Delaware?
The average Medigap (Medicare Supplement) premium in Delaware is $163 per month.