Maryland Health Insurance

Planning to buy health insurance plans in Maryland? Our site offers instant and accurate Maryland health insurance quotes from trusted providers. We’ll also show you how to save on your health coverage. Start by entering your zip code above and get more information on Maryland health insurance plans in your area.

Facts and Figures

Place in State
Health Report Card 22^nd
Insured 1,174,770
Uninsured 134,700
Insurance
Carriers 7
Number of
Primary Care Physicians 14880
Number of
Hospitals 49

Breakdown of Insureds

Employer-sponsored health insurance 69%
Private plans 5%
Medicaid 11%
Medicare 13%
Others 2%

Insurance Carriers

State Health Report Card

While smoking has decreased from 20.5 percent to 15.2 percent of adults in the past ten years, 672,000 people still smoke in Maryland. More than 1.2 million adults in Maryland are obese, 437,000 more adults than 10 years ago. In the past year, the percentage of children in poverty increased from 12.3 percent to 13.6 percent of persons under age 18. Children in poverty was only 6.9 percent in 2001. In the past five years, the violent crime rate decreased from 704 to 548 offenses per 100,000 population. In the past ten years, diabetes increased from 6.4 percent to 9.3 percent of the adult population; 411,000 adults now have diabetes. Maryland ranks higher for determinants than for outcomes, indicating that overall healthiness should improve over time.

Maryland Health Insurance Laws and Regulations

Maryland health insurance plans are required to be sold with a guaranteed renewability clause. With this, subscribers can renew their coverage as long as they want to provided they pay the premiums and do not violate the terms of the contract. A policy cannot be cancelled based on the customer’s health status. Newborns and newly adopted children are automatically covered for up to 31 days as long as their parent’s policy includes coverage for dependents. When writing new Maryland health insurance plans, insurers can exclude coverage for a pre-existing condition. This exemption period may vary depending on the company and the type of plan but normally cannot last for more than two years. However, in some instances, the exclusion may be permanent. Policyholders can change their coverage without going through the entire exclusion period again. Health insurers not under SAAC have the liberty to deny coverage to any applicant based on age, health, and other related factors. These insurers can also refer to these factors to detrmine a client’s cost of coverage. On the other hand, SAAC-companies should provide coverage to all applicants during the annual open-enrollment period. Small businesses with 2 to 50 employees, can choose to purchase group health plan. Providers must sell the same or comparable group insurance available to other small businesses in the state. However, to maintain coverage, small businesses should follow conditions like a minimum number of employees, a minimum contribution by the employer, and more. Maryland health insurance quotes for group coverage can vary according to the risk factors of its members. However, insurers cannot use clients’ health to determine the cost of insurance. Group health plans cannot be cancelled based on the insured employees health status. Self-employed workers are considered as small businesses in Maryland. As such, they can purchase group health insurance if they want to even if they are the only employee. They can also choose individual health plans. Premiums for these plans may be tax-deductible.

Heath Care Reform

With the new health care law, children under the age of 26 can choose to stay under their parent’s Maryland health insurance as long as they are not offered an employer-based health insurance. This provision enabled 2.5 million young adults to have insurance nationwide. In Maryland, 51,868 young adults have insurance coverage through this provision as of June 2011.

The new health care law allowed 55,107 Medicare policyholders in Maryland to receive a $250 rebate check to help with prescription drug costs when they fell into the Medicare gap in 2010. In 2011, 52,243 Medicare plan holders were given a 50% discount on brand-name prescription drugs covered by their plans when they hit the donut hole. An average of $589 per person or a total of $30,770,301 was saved in Maryland.

Previously uninsured individuals without health coverage because of a pre-existing condition can now apply for a Pre-Existing Condition Insurance Plan. This plan is available to U.S. citizens or legal residents with a pre-existing condition and have been uninsured for at least 6 months. In 2011, 741 individuals in Maryland have benefited from this new law.

When looking at Maryland health insurance quotes, applicants are assured that at least 80 percent of the price will go directly to health care services and other related improvements. A rebate or premium discount shall be provided if the minimum is not met. The 1,573,000 private policyholders in Maryland will get greater value for their premium payments because of this 80/20 rule.

Preventive care services like immunizations, colonoscopies, mammograms, or annual wellness doctor visits must be included in all Maryland health insurance with no deductibles or co-pays. In 2011, 187,251 Medicare subscribers and 226,000 individuals with private policies received such services in Louisiana.

Under the new law, insurance companies are no longer allowed to impose an annual dollar limit – a cap on the yearly spending for your benefits, or a lifetime dollar limit – a lifetime cap for spending for your covered benefits. This law frees chronically ill individuals like cancer patients from worrying about getting further treatment because of such limitations. In 2011, 2,251,000 Maryland residents have benefited from this law.

If insurance companies want to raise their premium rates by ten percent or more, they are required by federal law to publicly announce and justify their actions. To guard against such unreasonable increases, the state of Maryland received a total of $5 million.

All fifty states receive increases in funding for community health centers under the Affordable Care Act. This will help construct new health centers, provide medical services to more patients, improve preventive and primary health care services, and fund infrastructure projects. In Maryland, 137 community health centers received a total of $21.4 million to fund these improvements.

In 2010, the Affordable Care Act created the Prevention and Public Health Fund. This new fund was created for wellness promotion, disease prevention, and protection against public health emergencies. Maryland has already received a total of $16 million to support its policies, programs, and communities to help its residents lead healthier lives.

State Government Insurance Programs Offered

Maryland Health Insurance Plan (MHIP)

888-444-9016

MHIP Federal Plan provides coverage for individuals who may have problems obtaining health insurance insurance due to a pre-existing condition. Coverage includes a wide range of benefits which includes hospital care, primary care, specialty care, and prescription drugs. Eligibility: 1. Must be a U.S. resident living in Maryland. 2. Must be uninsured for at least six months. 3. Must have a qualified pre-existing health condition.

Medicaid

410-767-5800 800-492-5231 800-735-2258 (TDD)

Medicaid offers coverage to low-income individuals and families who find it extremely difficult to pay for their medical care. To qualify for this plan, applicant should meet certain conditions including income limits. Benefits for this program include physician services, medical and dental check-ups, diagnostics, prescriptions, hospital services, hospice, dental care, eye care, family planning, maternity, prenatal, newborn care, drug and alcohol treatment, mental health services and many more. Eligibility: 1. Must be U.S. citizens or legal residents living in Maryland. 2. Must not exceed income limits: Pregnant women: 150% of the FPL. Parents and caretakers living with children aged 0 to 18 years: 116% of the FPL. Aged, blind, or disabled: 75% of the FPL, with assets not exceeding $2,500 for singles. 83% of the FPL with assets not exceeding $3,000 for couples. Medically-needy: $350 monthly income with asssets not exceeding $2,500 for singles. $392 monthly income with assets not exceeding $3,000 for couples.

Medical Assistance for Families

800-456-8900

Medical Assistance for Families offers health coverage to qualified parents and other family members living with children. Plan includes comprehensive benefits including doctors visits, hospital care, emergency room visits, laboratory and x-ray, prescriptions, and many more. Eligibility: 1. Must be U.S. citizens or qualified residents living in Maryland. 2. Must not exceed income limits of 121% of the FPL.

Maryland Children’s Health Program (MCHP)

800-456-8900 800-735-2258 TTD

Maryland Children’s Health Program (MCHP) offers health coverage to low-income pregnant women and children not qualified for Medicaid. Benefits for children include: doctor visits, prescription medicines, hospital care, immunizations, laboratory and tests, dental care, vision care, mental health services, and more. Benefits for pregnant women include: prenatal and post-partum doctor visits, non-pregnancy related doctor visits, hospital delivery bill, after delivery and family planning services, laboratory and tests, prescription medicines, substance abuse services, and more. Eligibility: Must be U.S. citizens or qualified residents living in Maryland; currently uninsured or did not voluntarily give up an employer-sponsored group health plan within the last 6 months (those with health insurance may still apply and inquire whether they are eligible); ineligible for Medicaid. 1. Children 18 years and below, who are not qualified for Medicaid coverage, with income not exceeding 200% of the FPL. 2. Pregnant women, with income not exceeding 250% of the FPL.

MCHP Premium

410-767-6883 800-456-8900 800-735-2258 (TDD)

Maryland Children’s Health Program (MCHP) Premium offers health coverage to pregnant women and children who cannot qualify for regular MCHP because of too much income. Some benefits of the program include: inpatient and outpatient hospital services, primary and preventive care visits, specialist visits, emergency services, laboratory services and x-ray, mental health services, and prescription drugs. Eligibility: Must be U.S. citizens or qualified residents living in Maryland; currently uninsured or did not voluntarily give up an employer-sponsored group health plan within the last 6 months (those with health insurance may still apply and inquire whether they are eligible); Must meet income requirements: Children 18 and below with income between 201% and 300%.

Women-Infant-Children (WIC)

800-242-4942

Women-Infant-Children (WIC) provides assistance for low-income pregnant, breastfeeding, and non-breastfeeding post-partum women; and children five years and below who may have nutritional deficiencies. The program offers offers free healthy food, supplemental food, nutrition education, health care and social agency referrals. Eligibility: The program is available to pregnant or post-partum women and children aged 5 years and below. Women and children must be residents of Maryland, must be at risk nutritionally or medically, must meet income requirements.

Breast and Cervical Cancer Diagnosis and Treatment Program

410-767-6787 800-477-9774

Breast and Cervical Cancer Screening Program aims to identify the early stages of breast and cervical cancer among women in Maryland. Early detection increases survival rate and minimizes the cost of treatment. Services offered include clinical breast exam, breast ultrasound, breast biopsy, screening mammogram, diagnostic mammogram, Pap test and pelvic exam cervical biopsy, colonoscopies, surgical consultation, colposcopy surgery, adjuvant therapy (chemotherapy, radiation therapy), home health, pharmacy, DME (including prosthesis and bras), physical therapy, occupational therapy, wigs and breast reconstruction. Eligibility: 1. Must be a woman, residing in Maryland. 2. Must be 40 to 64 years old. 3. Those over 65 can qualify provided they do not have Medicare coverage, or with Medicare Part A only. 4. Must be uninsured or current health insurance does not cover screening procedures. 5. Income must not exceed 250% of the federal poverty level (FPL).

Medicare

800-633-4227

Medicare is administered by the federal government and provides health insurance coverage to Americans aged 65 and above or those younger than 65 but have a disability or end-stage renal disease. Coverage has four parts: Part A: provides inpatient care in hospitals and rehabilitative centers. Part B: provides doctor and some preventive services and outpatient care. Part C: provides Medicare benefits through Medicare Advantage. Part D: provides prescription drug coverage. Eligibility: 1. Must be a U.S. citizen or permanent U.S. resident. 2. Must be 65 years or older, with you or your spouse having worked in a Medicare-covered employment for at least ten years; or have a qualified disability or end-stage renal disease, regardless of age.

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