This Mid-Atlantic state is full of coastlines, history, and promising health care. According to a study by U.S. News, Maryland has the 16th best health care in the country. That ranking comes from access, quality, and good public health.
Health insurance options in Maryland
According to the Maryland Insurance Administration, there are several ways for residents to get health insurance:
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Maryland residents get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 56% | ||
| Individual or family | 5% | ||
| Medicaid | 19% | ||
| Medicare | 13% | ||
| Military | 2% | ||
| Uninsured | 6% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
Six percent of Maryland residents are uninsured, less than the national average. That's great news for policyholders, because a high amount of uninsured people boosts costs for insured people.
Maryland health insurance companies
What are the best health insurance companies in Maryland? These are some of the top insurers in the state that offer both individual and family plans:
- CareFirst BlueChoice
- Kaiser
- Care First of Maryland Inc.
Maryland health insurance costs and rate factors
How much should you expect to pay in your state? Maryland residents spend an average of $8,602 per year on health care expenditures. That’s only a few hundred more than the national average. Health care costs differ quite a bit from person to person, based primarily on these factors:
Plan type
Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. To get a higher level of health care coverage, you’re going to pay more in monthly premiums.
How much will you be paying for health insurance in Maryland? These are the average monthly premiums for a 40-year-old MD resident in 2020.
| Bronze | Silver | Gold | |
|---|---|---|---|
| $266 | $388 | $373 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
Jumping from a bronze plan to a gold plan in Maryland will cost you about 40 percent more. The higher price may be worth it though, as gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent. Interestingly, data shows that a gold plan is actually a hair cheaper than a silver plan.
The lowest level of health care coverage is called a catastrophic plan. These plans have low monthly premiums but a $7,150 yearly deductible. A low-level metal tier plan may save you money when it comes to using your health insurance.
Body mass index
According to the CDC, a high body mass can lead to several serious health conditions. That’s why insurers will take a look at your BMI to assess your risk level. A higher BMI often leads to higher insurance premiums.
In 2018, Maryland had a 31 percent obesity rate<, the 25th highest rate in the country. Out of the many MD residents who used QuoteWizard to compare health insurance policies, 27 percent have a BMI in the obese range.
Tobacco use
Tobacco users pay more for health insurance because of the high risks from smoking. About 13.8 percent of Maryland residents are smokers, the eighth lowest rate in the country.
Age
According to HealthCare.gov, older people pay up to three times more for health insurance than younger people. Maryland residents that used QuoteWizard to shop for health insurance are, on average, 40 years old.
Location
One of the main factors in your policy price comes from where you live. That’s because every state has different rules, regulations, and providers surrounding their health care marketplace.
Another reason is because health insurance rates are community rated. Prices are based in part on the combined claims everyone files. That means if you have a neighbor that files an abnormally high amount of claims, your rates could rise.
So, living in a health-conscious state could keep your prices low. According to America's Health Rankings, Maryland is the 16th healthiest state in the country.
Maryland health insurance laws
The Affordable Care Act limits what insurers can take into consideration while pricing your policy.
- Pre-existing conditions: The ACA prohibits insurance companies from charging more to people with pre-existing conditions. That’s a change from the past, when people with pre-existing conditions paid a lot more for health insurance.
- Gender: According to a study by Health Services Research, women historically pay more for health care. The ACA mandates that insurance companies can’t charge men and women different premiums for the same plan.
- Insurance and medical history: Insurance companies used to charge you more If you had a previous medical problem or a lapse in insurance. Now, insurance companies can’t analyze these factors to price your policy.
There’s a cap on how much you’ll be paying out-of-pocket for a marketplace plan. In 2020, that limit is $8,150 for an individual plan and $16,300 for a family plan.
Maryland state law requires that insurance companies provide at least some coverage for these services:
- Hearing aids for children
- Diabetes education
- Prosthetic devices
- Ambulance services
- Emergency services
- Pregnancy and maternity services
- Prescription drugs
There are additional health care services that providers must offer. To see more, read the full list from cms.gov.
Medicare and Medicaid in Maryland
Medicare and Medicaid are government-funded health care programs that offer coverage for two different groups of American residents. Medicare provides coverage for seniors, and Medicaid aids low-income families and children.
Medicare
Medicare is meant for people 65 and over. There are several options within the program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for Maryland’s Medicare Savings Programs with these income limits:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
These are the state's Medicaid financial requirements:
| Household Size | Maximum Yearly Income |
|---|---|
| 1 | $16,971 |
| 2 | $22,930 |
| 3 | $28,888 |
| 4 | $34,846 |
| 5 | $40,805 |
| 6 | $46,763 |
| 7 | $52,722 |
| 8 | $58,680 |
Maryland Office of the Insurance Commissioner
- Website:
- Homepage
- Insurance Commissioner:
- Al Redmer, Jr.
- Insurance Hotline:
- (800) 492 – 6116 (Ext. 2458)
- Office Hours:
- Monday - Friday
8:00 am to 5:00 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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