All three of Delaware's MCOs (AmeriHealth Caritas Delaware, Delaware First Health, and Highmark Health Options of Delaware) cover the state on a statewide basis, with 219,167 combined Medicaid managed care members in 2024 (AmeriHealth 70,089, Delaware First Health 29,825, Highmark 119,253). Each MCO subcontracts its own dental benefit administrator: AmeriHealth Caritas uses DentaQuest, Delaware First Health uses Centene Dental, and Highmark Health Options uses United Concordia. DSHP-Plus, Delaware's LTSS-focused segment, runs through these same three MCOs rather than a separate contract or vendor; medical and long-term care coverage run through one combined program, not separate contracts.

• AmeriHealth Caritas Delaware
• Delaware First Health (Centene)
• Highmark Health Options of Delaware

General long-term services and supports for elderly and physically disabled members are integrated into the MCOs through DSHP-Plus, Delaware's combined LTSS/dual-eligible managed-care segment. A narrower population is carved out of that structure: the DE DDDS Lifespan Waiver, a currently active Section 1915(c) HCBS waiver run separately from the MCOs, serves individuals age 12 and older with autism or intellectual disabilities who meet an ICF/IID level of care, providing day habilitation, personal care, prevocational services, residential habilitation, respite, and supported employment. Two older, narrower 1915(c) waivers (the DE Elderly and Disabled Waiver and the DE AIDS/HIV Related Diseases Waiver) have both since terminated, consistent with DSHP-Plus's own managed-care LTSS structure absorbing that population once it launched.

Partially integrated into managed care

• AmeriHealth Caritas Delaware
• Delaware First Health (Centene)
• Highmark Health Options of Delaware

Delaware has no separate behavioral health administrative services organization or carve-out vendor. Behavioral health benefits are administered directly by the three DSHP MCOs alongside physical health, the same combined-coverage structure the MCOs use for the rest of the benefit package.

Carved in

Dental benefits are administered per-MCO rather than through one statewide dental vendor: AmeriHealth Caritas Delaware subcontracts to DentaQuest, Delaware First Health subcontracts to Centene Dental, and Highmark Health Options subcontracts to United Concordia.

DMMA's Diamond State Health Plan page states that prescription drugs and non-emergency medical transportation are covered directly by Medicaid rather than through the MCOs, pointing to a statewide fee-for-service pharmacy carve-out. AmeriHealth Caritas Delaware's own provider site instead states it provides pharmacy services through its pharmacy benefits manager, PerformRx, a per-MCO PBM relationship. Both are current; which characterization applies to Delaware First Health and Highmark Health Options is unclear, and no single statewide PBM vendor is named.

Modivcare operates Delaware's statewide non-emergency medical transportation program as a separate carve-out from the three MCOs, covering a combined 236,213 Medicaid-only and dual-eligible enrollees in 2024. Non-emergency medical transportation is covered directly by Medicaid rather than through the MCOs, consistent with this carve-out structure.

• Modivcare

Gainwell Technologies is Delaware's current Medicaid Management Information System fiscal agent, operating the Delaware Medical Assistance Portal, DMMA's provider and member web portal.

4 agency updates tracked for Delaware. Available with Pro.