Maryland Health Insurance Consumer Guide

To qualify for Marketplace coverage in Maryland, you must:³

• Live in Maryland
• Be a U.S. citizen, national, or lawfully present in the U.S.
• Not be incarcerated
• Not be enrolled in Medicare

Whether or not you qualify for financial assistance with your premium, deductible, or out-of-pocket costs depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your zip code. 

Additionally, to qualify for subsidies, you must: 

• Not have access to affordable health coverage through an employer. If you think your employer-sponsored health plan is too expensive, use our Employer Health Plan Affordability Calculator to check if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP in Maryland.

Maryland’s open enrollment period for individual and family health plans runs from November 1 to January 15.⁴

• Enroll by December 31 for coverage to start January 1.
• Enroll between January 1 and January 15 for coverage to begin February 1.

Note that the deadline to get a January 1 effective date in Maryland is December 31. This is different than most states, where deadline is December 15.⁴

Outside of open enrollment, you generally need a qualifying life event, such as losing coverage, getting married, or permanently moving, to enroll or make changes. This is known as a special enrollment period (SEP). 

But some people can sign up without a qualifying life event. For example:

• Native Americans can enroll year-round.

People who qualify for Medicaid, the Maryland Children’s Health Program (MCHP), or MCHP Premium can enroll anytime.⁴

There are three ways to enroll in an ACA Marketplace plan in Maryland:⁴

• Online: Go to MarylandHealthConnection.gov to create an account and apply. 
• Phone: Contact the Call Center at 855-645-8572. Those who are deaf and hard of hearing use the Relay service. Help is available in over 200 languages. 
• Talk to a broker: Get help from an authorized insurance broker through Broker Connect.⁵
• Mobile app: Apply from your phone by downloading the mobile app, Enroll MHC.

You can find affordable individual and family health plans in Maryland through MarylandHealthConnection.gov, the state’s ACA exchange.

More than seven out of ten eligible enrollees receive subsidies, saving about $382 monthly on their 2023 premiums.⁶ These subsidies are called Advance Premium Tax Credits (APTC). With subsidies, Maryland residents pay about $117 monthly on average in premiums.⁶

If your income is under 250% of the federal poverty level, you may qualify for cost-sharing reductions (CSR) to lower your deductibles and out-of-pocket costs.⁷

Source: CMS.gov⁸

Thanks to a new state program, young adults aged 18 to 34 may qualify for help paying their monthly premiums. This assistance is in addition to the Advance Premium Tax Credit (APTC).⁹

For Maryland residents who aren’t eligible for premium subsidies or Medicaid, short-term health insurance is a lower-cost coverage option. In Maryland, two insurers offer short-term plans.

In 2023, the following insurance companies are providing coverage through the Maryland exchange:¹⁰

• CareFirst BlueChoice
• CareFirst of Maryland, Inc. (CareFirst Blue Cross BlueShield)
• Group Hospitalization and Medical Services, Inc. (GHMSI) 
• Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
• Optimum Choice, Inc.

The 2024 proposed individual market rate increases in Maryland are as follows:¹¹

Source: Maryland Insurance Administration¹¹

Note that the average rate changes affect full-price premiums, and many enrollees don’t pay the full amount. Around 77% of the people who signed up for private plans through Maryland Health Connection in 2023 received financial assistance with their costs through premium subsidies.⁶ These subsidy amounts are adjusted annually to match the cost of the second-lowest-cost Silver plan. 

If your premiums are increasing next year, consider other Maryland Health Connection plans that better fit your budget and offer the benefits you need.

More than 182,000 people enrolled in private plans through Maryland’s Marketplace during the 2023 open enrollment period.⁶

This surge in enrollment was mainly due to the American Rescue Plan, which improved affordability starting in 2021. The Inflation Reduction Act extended these improvements until 2025, ensuring coverage remains more affordable in 2023 than before the ARP became law.

Source: 2014,¹² 2015,¹³ 2016,¹⁴ 2017,¹⁵ 2018,¹⁶ 2019,¹⁷ 2020,¹⁸ 2021,¹⁹ 2022,²⁰ 2023,⁶ 2024²¹

Maryland Health Connection
This is the state’s official health insurance Marketplace, where residents can shop for and enroll in health coverage plans.

Maryland Department of Health
This department oversees various health-related programs in the state, including providing information and managing enrollment for Medicaid.

Maryland Health Education and Advocacy Unit
This unit offers education and support to help individuals understand and navigate their health insurance options, making informed decisions about their coverage.

Health Care Access Maryland
This organization ensures that Maryland residents can access quality healthcare services, assisting with enrollment, navigation, and resources.

Maryland Senior Health Insurance Program
Designed for older adults, this program offers valuable information and assistance related to Medicare.