TABLE OF CONTENTS
Residents of Maryland looking for cheap health insurance have several options. These options range from purchasing insurance on Maryland’s Health Connection (Maryland’s equivalent to Healthcare.gov), to being eligible for Medicare or Medicaid.
This guide examines how each option works, potential costs, eligibility requirements, and how you enroll in, join, or purchase an affordable health insurance plan.
Maryland is one of a handful of states with its own ACA exchange, the Maryland Health Connection. Like Healthcare.gov, your first step is to create an account. You’ll be asked for certain personal information including your address, your phone number, and your household income. Once you’ve created your account, the Maryland Health Connection will direct you to the appropriate coverage for your eligibility, whether it’s Medicare, Medicaid, or a marketplace plan.
You’ll be able to view several affordable health insurance plans simultaneously to judge which plan best suits your health care needs, those of your family, and your budget.
Four companies offer health care plans on the Maryland Health Connection in 2022:
If you don’t wish to use the Maryland Health Connection you can purchase plans through a broker, an insurance agent, or a private company. When purchasing an off-exchange plan, there are some important considerations when shopping for individual coverage, whether for yourself or for multiple people. These considerations include:
If you’re healthy and make few trips to the doctor and don’t require many prescriptions, your best bet is to look at a plan that has a low monthly premium but high deductibles. This will help you keep your health care costs to a minimum.
On the other hand, if you have a chronic health condition requiring regular visits to a doctor or a specialist, and many medications, the best plan for you will likely be one with a higher monthly premium but lower deductibles. This will help you reduce your out-of-pocket expenses.
Health companies offer several different kinds of plans.
Concerns about which health plan is the right one become more complicated when you’re thinking about an entire family. Your children may be healthy, but if you or your spouse have a chronic illness such as high blood pressure, asthma, or hypertension, you’ll need to balance your family’s overall health needs with your budget.
An HMO plan that can help reduce your overall costs may be the best option for a healthy family. If you or a family member have a chronic health issue, a PPO plan or a POS plan may be the best option since both plans allow you to visit out-of-network providers.
The main difference between an off-exchange plan and one offered on the Maryland Health Connection is the premium tax credits available to you if your income is between 100% to 400% of the Federal Poverty Level (FPL). Off-exchange plans do not offer these benefits. Plus, if you choose a silver plan on the Maryland Health Connection, you may be able to lower your out-of-pocket costs through cost-sharing reductions (CSRs).
The Maryland Health Connection works with a similar structure of metal tiers as Healthcare.gov. Available plans fit into categories: Bronze, Silver, Gold, or Platinum. However, don’t think that if you choose a Bronze plan, you’re selecting a lower level of coverage than if you picked a Gold one. There are no differences in the quality of care in any ACA-compliant plan. The difference comes in how you choose to pay for that plan.
|Average premium in Maryland||2020||2021||2022||2023|
|Most affordable Bronze plan||$380||$358||$343||$242|
|Most affordable Silver plan||$506||$470||$445||$334|
|Most affordable Gold plan||$510||$464||$435||$323|
As part of a health care reform enacted by Maryland in 2018, the state expanded Medicaid (also known as Medical Assistance or MA) to cover nearly all adults between the ages of 19 and 64 with incomes at or below 138% of the federal poverty level. Nearly 1.5 million people are enrolled in Maryland Medicaid and MCHP (the Maryland Children’s Health Program).
To be eligible for Medicaid in Maryland, you need to live in the state, be a U.S. citizen, national, permanent resident, or legal alien who needs health care or insurance assistance, and have a low or very low income.
You must also meet one of the following criteria:
You must also meet certain income and resource requirements to be eligible for Medicaid in Maryland. These income and resource requirements are different for different categories of individuals.
If you’re between 19 and 64, you have a financial limit of $18,075 a year, while a household of three people has a financial limit of $30,630. If your household has more than eight people in it, you can add $6,277 for each additional person.
Asset or resource limits depend on how Medicaid is being used. For nursing home care, you can’t have assets greater than $2,500, while a couple can’t have assets of more than $2,500, and this drops to $5,000 after six months, with each spouse having no more than $3,000 in their name.
MCHP provides health benefits for uninsured children up to 19 and pregnant women of any age who meet income guidelines. For children, adjusted family income must be at or below 211% of the federal poverty level. In 2022, for a family of four, this amounted to about $4,880 a month.
Uninsured children receive health benefits which include doctor’s visits, lab work and tests, immunizations, prescription drugs, hospitalizations, dental and vision care, transportation to medical appointments, and mental health services.
You can apply for MA or the Maryland Children’s Health Program through the Maryland Health Connection.
Medicare is the federal government’s health care insurance program that covers you if you’re 65 and older or have a qualifying disability.
If you’re concerned about out-of-pocket costs with Original Medicare, you can cover some of these expenses with a Medicare Supplemental Insurance plan. It covers deductibles, co-pays, and coinsurance fees. However, it doesn’t cover vision, dental, hearing, or long-term care. One advantage to a Medicare Supplement Insurance Plan is that many plans will provide health coverage if you travel outside the United States. Currently, you cannot purchase a Medicare Supplemental Insurance Plan if you have chosen a Medicare Advantage Plan.
If you start receiving your Social Security or Railroad Retirement Board benefits at least four months before you turn 65, you’ll be automatically enrolled in Medicare. Otherwise, you must fill out an application online or contact your local Social Security office. You can enroll in Medicare during the following periods:
The Maryland State Health Insurance Assistance Program (SHIP) provides free, unbiased, and confidential counseling to you, your family, or your caregivers. This counseling includes guidance on all aspects of Medicare, including Original Medicare, Medicare Advantage, Medicare Part D, billing issues, Medicare fraud, and how to appeal denials. None of the certified, trained volunteers works for a health insurance company, nor will they ever try to sell you a plan.
Yes, but a short-term insurance operates under specific rules. In 2018 the state enacted legislation that limits a short-term plan to three months with no renewals. In 2019, a new law required short-term health insurance to cover mental health care, including substance abuse disorders. A short-term plan also needs to provide a level of coverage for inpatient room and board, hospital care, emergency room care, diagnostic services, surgical care, doctor’s visits, and outpatient treatment.
Although the Affordable Care Act requires you to have health insurance, changes in Congress and federal court rulings repealed the original mandate’s tax penalty. While some states have enacted their own health care law, Maryland is not one of them.
No, you can also purchase health care in Maryland through a broker, an insurance agent, or a health insurance company.
The most common kind of cost-sharing plan in Maryland is a faith-based plan. In a faith-based plan, members share health costs with other members. You don’t need to belong to a particular denomination or follow any religious tradition to take part in a plan. Since these plans aren’t regulated by the federal government or Maryland, they’re not required to provide coverage for pre-existing conditions or other essential health care benefits. Before you purchase a faith-based plan, make sure it provides coverage for any health conditions that affect you or your family.
Most likely. It’s difficult, if not impossible, for you to save enough money in an HSA/FSA plan to pay your bills if a serious illness or injury occurs. HSA/FSA plans work best when you use them to cover out-of-pocket costs like deductibles, copays, or dental or vision care.
Do you have a dangerous job? If you answer yes, then it would be wise to obtain some form of disability coverage that pays for household expenses like groceries, utilities, or mortgage payments if you’re injured and unable to work. Health insurance will not cover these types of expenses.
It depends on how dangerous your job is. If you work in an industry like construction, purchasing a long-term disability plan is a good idea. Health insurance will not pay for household expenses like groceries, utilities, or mortgage payments.
Uninsured children receive health benefits that include doctor’s visits, lab work and tests, immunizations, prescription drugs, hospitalization, dental and vision care, transportation to medical appointments, and mental health services.