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 begins Nov. 1, 2023, for 2024 health insurance coverage.
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 enrolled in ACA marketplace plans have seen their premiums go down because the 2021 American Rescue Plan Act (ARPA) increased tax credits for insurance premiums and expanded the number of households that qualify for them. Every household that pays more than 8.5 percent of its income qualifies for federal tax credits to help afford health insurance. These enhanced subsidies are available through 2025.
Before 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.
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:
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:
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.
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 seen average annual savings of more than $950.
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.
Maryland Health Connection plans are organized into four categories:
Maryland residents 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 whether you’re eligible for financial assistance with Maryland Health Connection’s online “Get an Estimate” tool.
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.
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.
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 type of insurance plans accepted.
This guide was updated on Jan. 23, 2023, with information about open enrollment and the Easy Enrollment Program.
This story is provided by AARP Maryland. Visit the AARP Maryland page for more news, events, and programs affecting retirement, health care, and more.
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