En Español | Most Marylanders are eligible to buy health insurance through Maryland Health Connection, the state’s Affordable Care Act (ACA) marketplace during open enrollment, which began on Nov. 1 and runs through Jan. 15, 2023.
If you experience a qualifying life event — such as the birth of a child, a move, a marriage, a divorce or the loss of your employer-provided health insurance — you may be able to enroll or change your coverage during a special enrollment period.
Most people already enrolled in ACA marketplace plans have seen their premiums go down this year because the 2021 American Rescue Plan Act (ARPA) increased tax credits for insurance premiums and expanded the number of households who qualify for them. Every household that pays more than 8.5 percent of its household income now qualifies for federal tax credits to help them afford health insurance. These enhanced subsidies are now available through 2025.
Prior to the 2021 law, such tax credits were only available to people earning less than a certain salary ($54,360 for one person). Most Americans with a marketplace plan can save an average of about $800 per year, according to the federal government.
Who is eligible:
- Most Marylanders, including non-U.S. citizens with worker or student visas, regardless of whether they are currently insured.
- You may also qualify for Maryland’s Medicaid program, which offers free or low-cost coverage to low-income people and families and to those who live in skilled nursing facilities or have certain disabilities. Non-citizens with qualified immigration status and pregnant women and children under age 21 are eligible for some Medicaid coverage.
When can I enroll?
- Maryland’s open enrollment starts on Nov. 1 and lasts through Dec. 15.
- Maryland also offers the Easy Enrollment Program available during tax season. Check a box on your tax return if you would like the Maryland Health Benefit Exchange (the state agency that runs Maryland Health Connection) to estimate your eligibility for coverage, including free or low-cost health insurance. Filing by July 15 will launch the enrollment process.
- You can enroll anytime if you experience a qualifying event. In most cases, you have 60 days from that event to enroll. Qualifying events include certain moves, births and adoptions, loss of employer-provided coverage, marriage, divorce and other special circumstances.
- Enrollment in Medicaid and the Maryland Children’s Health Program is available any time of year.
How do I sign up?
You apply for coverage and choose your plan at the same time. Once you’re approved for a plan, you’ll need to pay your first monthly premium for your coverage to begin. To apply and enroll:
- Online: Go to the Maryland Health Connection website and click “How to Enroll” to get started. You can also apply via the state exchange’s mobile app on Apple or Android devices. You’ll need to create an account to begin the enrollment process.
- By phone: Call the Maryland Health Connection customer service center at 855-642-8572, Monday-Friday from 8 a.m.–6 p.m., and follow the prompts. Multilingual agents are available in dozens of languages, including Spanish, Arabic, Chinese, Farsi and French. Relay services for the deaf or hard of hearing are offered free of charge.
- In person: Representatives called “navigators” and “brokers” are available to help you and your family understand your options and determine if you qualify for financial assistance. Find a navigator in Maryland counties to help you apply in person or check out the events section of the Maryland Health Connection website. You can also access an online map of brokers across Maryland. Or call customer service at 855-642-8572 to find locations.
What is covered, and how much will it cost?
Coverage and cost depend on where you live, the type of plan you choose, your household income and the age and disability status of you and your family.
If you qualify for Medicaid, you will be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income.
All Maryland Health Connection plans cover 10 “essential” benefits, including:
- Emergency services and hospitalization
- Maternity and newborn care
- Mental health services (including counseling)
- Chronic disease management and pediatric care
- Prescription drugs
Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family.
All Maryland Health Connection plans cover basic dental services for children, including cleanings and exams. But adults who want dental coverage must add it to their policy. Deductibles and out-of-pocket costs vary between plans; enrolling in a family plan can cut costs.
What about federal assistance for premiums?
Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income qualifies for federal tax credits for insurance premiums through 2025.
According to Megan O’Reilly, AARP vice president of government affairs for health and family, subsidy recipients ages 50 to 64 have already seen average annual savings of over $950.
Is there any other financial assistance available?
Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for such out-of-pocket expenses as deductibles and copays. You must enroll in a silver-level plan to get this assistance.
What plans are available?
Maryland Health Connection plans are organized into four categories:
- Bronze plans have the lowest monthly premiums and the highest deductibles and copays and cover roughly 60 percent of care costs. They’re designed to help you in case of serious illness or injury.
- Silver plans have moderate monthly premiums, deductibles and copays. They cover between 70 and 94 percent of care costs, depending on whether you qualify for a basic plan or an enhanced silver plan for lower-income households. They’re the only plans eligible for cost-sharing subsidies.
- Gold plans have higher monthly premiums and lower deductibles and copays and cover roughly 80 percent of care costs.
- Platinum plans have the highest monthly premiums and the lowest deductibles and copays and cover roughly 90 percent of care costs. These are for people who have significant health care needs and are willing to pay the highest premiums.
Maryland residents age 30 and younger can apply for a catastrophic plan, which covers emergency medical care for an individual or family for low monthly premiums. You must apply for an exemption to show that other coverage options are unaffordable.
You can shop, compare plans and see if you’re eligible for financial assistance with Maryland Health Connection’s online “Get an Estimate” tool.
What if I already have health insurance?
If you have coverage through your employer or directly through an insurance provider but are eligible for lower premiums, you can switch to Maryland Health Connection. But you may not qualify for tax credits if you opt out of your employer’s plan — unless those premiums exceed a certain portion of your household income. The premiums would need to be more than 9.12 percent of your household income for individual coverage.
If you lose your COBRA coverage, you may be able to sign up for a Maryland Health Connection plan during a 60-day special enrollment window. Try to apply and select your Maryland Health Connection plan before your COBRA coverage ends to make sure there's no gap.
Will I need to get a new doctor?
That depends. Major insurance providers, including CareFirst BlueCross Blue Shield, Kaiser Permanente and UnitedHealthcare, offer Maryland Health Connection plans, but not all doctors accept them. You can talk to your primary care physician or use the online “Get an Estimate” tool to see whether a certain doctor or practice will accept a marketplace plan.
Will my family members qualify for the same health plan that I do?
It depends. You can enroll as a family. But in some cases, some family members may also be eligible for subsidies or other programs, depending on age, income and disability, or caregiver status. Such families may choose to enroll separately and still be able to see the same doctor or go to the same medical practice, depending on the types of insurance plans accepted.
This guide was updated on Nov. 7, 2022, with information about open enrollment.