Maryland Health Insurance: 2023 Coverage Guide

Maryland Affordable Healthcare Insurance

You can buy health insurance in Maryland during Open Enrollment beginning in November. You have many options for health insurance plans and should compare rates carefully. If you’re purchasing an individual or you’re buying coverage for a family, you can get the coverage you need at the best prices by comparing your options with SmartFinancial. If you don’t sign up now or through the end of the Open Enrollment date and your state closes enrollment, you can sign up during a Special Enrollment Period if you have a qualifying event.

When Is Open Enrollment in Maryland?

November 1, 2022 – January 15, 2023

How to Get Health Insurance in Maryland

Estimate what your healthcare needs will be for the following year. The best way to do this is to look back at the previous year. How many times did you visit the doctor or receive care? How many prescription drugs do you take regularly? What was your monthly premium and how much did you spend on copays? Based on this information, you can choose a plan that will save you the most money.

It’s important to compare health insurance companies and health insurance quotes after you figure out what your projected costs are. When you submit a form to SmartFinancial you’ll get several rates to choose from within minutes. You’ll also be connected with an agent in your area who can answer your questions and help you determine which policy is right for you.

What Types of Health Insurance Are Available in Maryland?

Most people in Maryland purchase HMOs, EPOs, PPOs and POS plans.

Does Health Insurance Cover Pre-existing Conditions?

The Affordable Care Act made it illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

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Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

• Lost or quit a job. You may be without health insurance if you lost a job, changed jobs or started your own business. In these instances, you may buy a new health plan.
• Turned 26. When you turn 26, you can no longer get coverage through a parent’s health insurance policy, but you can buy a new one outside the open enrollment period.
• Moved to another state or out of an HMO coverage area. If your health insurance become invalid after a move, you can buy a new plan in your coverage area.
• Cobra coverage ended. When your Cobra extension reaches its deadline, you can buy a new health insurance plan.
• Divorce. If you were married and shared a health plan with your spouse but divorced, you can purchase a new health plan.
• Marriage. If you get married, you may be added to your spouse’s policy or you can start an entirely new one together.
• Birth or adoption of a child. You can buy health insurance for the new member of your family.
• Death of spouse or partner. If you shared health insurance with your spouse or partner but he/she passed away, you can enroll in a new individual plan.
• Spouse or partner loses coverage. If you shared a health insurance policy with a partner or spouse who lost his/her coverage for any qualifying reason, you are eligible to buy coverage individually or with that spouse/partner again.

Is Health Insurance Required in Maryland?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in Maryland?

The average cost of health insurance in Maine for a 40 year old is about $404 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Maryland

The best way to save on health insurance in Maine is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs

Medicare in Maryland

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Maryland?

17% of the people in Maryland are insured through Medicare.

How Much Is Medicare in Maryland?

If you do not qualify for Medicare, you can buy it for $499 a month for Part A in 2022 and a standard monthly premium for Medicare Part B was $170.10, or even higher depending on income. 

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2022, it was $7,550 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Maryland

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Maryland?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Maryland State Health System Ranking

Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Maryland Health System are listed below:

• Maryland: Overall Ranking: 14 of 51
• Maryland: Overall Performance: Above U.S. Average
• Maryland: Access and Affordability: 13
• Maryland: Prevention and Treatment: 14
• Maryland: Avoidable Hospital Use and Cost: 23
• Maryland: Healthy Lives: 22
• Maryland: Health Care Disparities: 24

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Maryland Health Insurance Coverage

The people of Maryland have different kinds of health insurance while some Maryland residents are not insured at all. See the breakdown below:

• Private coverage: 58%
• Medicaid: 18%
• Medicare: 17%
• Uninsured: 7%

Report: America's Health Insurance Plans

Maryland Health Insurance Companies

• John Hopkins US Family Health Plan
• Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
• Aetna Life Insurance Company (MD/DC)
• CareFirst of Maryland, Inc.
• Group Hospitalization and Medical Services, Inc. (GHMSI)
• MD - Individual Practice Association, Inc.
• Aetna Health Inc. (Pennsylvania) - Maryland
• CareFirst BlueChoice
• CareFirst of Maryland, Inc.
• Cigna Health and Life Insurance Company - Maryland
• Connecticut General Life Insurance Company - Maryland
• Group Hospitalization and Medical Services, Inc (GHMSI)
• John Hopkins Employer Health Programs
• Optimum Choice, Inc.
• United Healthcare Services, Inc. (Maryland)
• UnitedHealthcare Insurance Company (Maryland)
• UnitedHealthcare of the Mid-Atlantic, Inc.
• Mamsi Life and Health Insurance Company
• Evergreen Health Cooperative Inc.
• Compass Rose Health Plan