Maryland Health InsuranceIndividuals and Families
Maryland Health Insurance
How to find an affordable plan.
Finding affordable health insurance in Maryland has never been easier. The resources currently available to residents of Maine have made choosing the proper health care plan less stressful and more straightforward. The Internet is a huge resource that offers the ability to research multiple providers and examine the intricacies of each plan. Whether you belong to an employer based plan or looking for private insurance for you or your family, understanding the details of the types of health plans offered is essential. Shopping for health care coverage can be confusing because of the wide array of options available from different sources. To make an informed choice it is important to understand what services and conditions are covered under the plan, the premium (the price of the policy), and whether there are any additional fees involved such as coinsurance or copays. Before choosing a plan it is important to do careful research to make certain that you pick a health care plan that you can afford and that provides coverage and services that meet your needs. Policies differ widely in coverage and cost. If your employer offers different health benefit options, or if you are purchasing a policy on your own, you should carefully consider how you use health care to select the best value for you.
Leading Maryland Health Insurance Companies
Options and Noteworthy Changes
Although the majority of Maryland residents belong to a health plan through their employer, there are many more options available within the state. For those looking for private health insurance there are plans that are customized for individuals and families. For individuals that are in between jobs, there is a short-term health plan called COBRA that allows individuals to remain on their group insurance while they take the time to select a new health plan. The Obama Administration has also made it easier for people to obtain health coverage with the passage of the Affordable Care Act. This new federal law has implemented new rules in the state requiring health carriers to provide Maryland residents with more benefits than previously offered.
Some of the noteworthy changes that affect Maryland residents are:
- Your child may stay on your health insurance policy or HMO contract until age 26, even if your child doesn’t live with you or is not financially dependent on you, whether or not he or she is married. Talk to your health insurer, HMO or employee benefits manager to see when this change takes effect for you.
- In the individual market, insurers and HMOs can no longer sell new health policies with an annual limit below $750,000 per year for essential benefits like hospitalization, ambulatory patient services, emergency services, or prescription drugs; or that exclude or limit coverage for children under the age of 19 because of a pre-existing medical condition.
Types of Health Insurance Plans Offered in Maryland
It is important to understand the difference between the types of health insurance offered in Maryland in order to make a proper decision. The three main types of health care offered in Maryland are Preferred Provider Organizations (PPO), Health Maintenance Organizations (HMO), and Point of Service Plans (POS). Preferred Provider Organizations (PPO) is a group of doctors, hospitals, and other providers who have agreed to provide services to members of a health plan through participation in a network. However, benefits also are available when you use providers who are not participating, commonly known as out-of-network. If you use a provider who is not on the approved PPO list, your out-of-pocket expenses may be higher. You may want to go with a PPO if you want to see specialists without approval by your primary physician or don’t mind paying more for greater freedom outside of your network.
Health Maintenance Organizations (HMO) plans provide services through a network of doctors, hospitals, laboratories, and other providers. When you enroll in an HMO, you may be required to select one doctor as your primary care physician (PCP) to manage all your health care needs. In most cases, you will have to contact your primary care physician first, regardless of the type of care you need. Your physician will then refer you to an HMO-approved specialist for additional care, if necessary. With an HMO you have limited out-of-network access compared to a PPO. Copayments and deductibles are generally lower with an HMO but you do need to obtain a referral from your primary care physician in order to see a specialist.
Point of Service (POS) is similar to an HMO in that you select a primary care physician (PCP) to manage your health care needs and give referrals to network providers. A POS also gives you the option to see a provider outside the network. However, if you leave the network, the plan pays at a reduced rate and you will have more out-of-pocket expenses. You may want like the POS plan if you like the structure of an HMO but would like the flexibility of seeing out of network providers.
Resources and Information
Maryland Medicare Plans
Seniors age 65 and older are eligible for a variety of Medicare plans in Ohio. Medicare plan options include Medigap and Medicare Advantage policies:
Maryland Doctor Directory
Doctors practicing medicine in the State of Maryland are licensed by the state. Doctors accept different forms of health insurance which you can verify before setting an appointment.