• Aetna
• Assurant
• CareFirst BlueCross BlueShield

Click for more options

• HumanaOne
• Kaiser Pemanente

• Supplemental Medigap Insurance
• Medicare Advantage Insurance
• CareFirst BlueCross BlueShield

Click for more options

• Monumental Life Insurance Company
• Unicare Life & Health Ins. Company
• Universal American
• WellCare

Selecting the Right Maryland Health Insurance Coverage

How To Select the Health Coverage that is Right for You

What Options Are Available To Maryland Consumers To Pay For Medical Care

Although many employers still offer some form of health benefits, many employees are finding that the type of care covered has decreased while the employee's required contribution has increased. As a result, some employees are purchasing additional coverage to fill in gaps and others must pay the full cost of health benefits. The purpose of this section is to give consumers an overview of what options are available and to help them know what questions to ask when they are making purchasing decisions.

What Is Available

Consumers have a wide array of options to choose from, depending upon their employment status, coverage needs and ability to pay. These options include:

1. group health plans;
2. small employer health plans;
3. individual health plans;
4. Maryland Health Insurance Plan;
5. medical discount plans;
6. health savings accounts;
7. self-funded/self-insured plans;
8. Government Assistance Programs (i.e. Medicaid/Medicare); and
9. COBRA/Maryland Continuation Coverage.

Each of these options is described in general below. Questions to consider when making a choice, and tips for selecting and purchasing a health benefit policy appear after this section.

A. Group Health Plans - A group health plan is generally offered by employers, but can sometimes be obtained through a membership organization as well. If your employer offers health coverage to all of its employees, then it cannot refuse to offer this coverage to you because of your current medical status or medical history. (An employer may, however, refuse to provide you with coverage for another reason, such as you are a part-time employee and coverage is not given to any part-time employee.) Federal law also restricts group plans from denying coverage for "preexisting conditions." Under this law, called "HIPAA", the only preexisting conditions that may be excluded under a preexisting condition exclusion in a policy are those for which medical advice, diagnosis, care or treatment was recommended or received within the 6-month period before your enrollment date. If the condition is "preexisting," then coverage can only be denied for a maximum of twelve (12) months. (If you join the health plan after you are hired and not during a regular or special enrollment period, the waiting period can be 18 months.) Even if your employer has a waiting period, if you previously had continuous insurance coverage, you may be eligible for an offset of some or all of the waiting period. This is referred to as "creditable coverage." You will need to obtain a "Certificate of Coverage" from your former carrier as proof that you had health insurance coverage that was not interrupted by a break of 63 days in a row.

An individual who wishes to obtain group coverage through his employer must do so either 1) at the start of his employment (usually 30 to 60 days from the first day), 2) during the annual "open enrollment" period or 3) within 30 days of the date of a "qualifying event" such as marriage, divorce, death of a spouse, birth or adoption of a child, or if you or a dependent was covered under another employer group health plan and that coverage is terminated. Open enrollment is the term used to describe a period when you can join a health benefit plan without having to prove you are healthy. There is no state law regarding open enrollment periods. Most employers have an open enrollment period once a year. Typically, this is the only time when you may enroll in or make changes to your health benefit plan.

Employers may offer different types of health plans. Insurers and non-profit health service plans can be divided into two categories; (1) Major Medical, and (2) Preferred Provider Organization Plans. Employers may also offer a third option of coverage through a health maintenance organization (HMO).