Whether you live in the bustling city of Baltimore, or you call smaller towns like Easton your home, finding affordable health insurance in Maryland doesn’t have to be a chore. All across the Free State, residents look for quality insurance coverage that can save them money without breaking the bank.
Here at Benzinga, we’ve done the research to help you find the best Maryland health insurance so that you can get the quality coverage you deserve.
Quick Look: The Best Maryland Health Insurance
- Best for Access to Medical Specialists: Kaiser Permanente
- Best for Nationwide Coverage: CareFirst - BCBS
- Best Affordable option: Coventry Health Care
- Best for Same-Day Coverage: UnitedHealthcare
- Best for custom plans: Assurant
Best Maryland Health Insurance
Finding the best health insurance provider depends heavily on your coverage needs. We recommend getting individualized quotes from the companies featured below to better understand what you’ll pay for health care according to your specific medical needs and budget.
1. Kaiser Permanente
As the largest nonprofit health plan in the U.S., Kaiser Permanente serves nearly 12.6 million members across the country, including Maryland. Kaiser is well known for its integrated health system, which includes a full spectrum of care for members.
This means that one plan covers preventive care, prenatal care, immunizations, emergency care, hospital and medical care, pharmacy services and diagnostic services. A large, comprehensive network means your doctor or specialist may already accept Kaiser insurance.
2. CareFirst – Blue Cross Blue Shield
Through affiliates and subsidiaries, CareFirst has become the largest health insurance company in the Mid-Atlantic region, serving over 3 million members. CareFirst’s physician network includes over 1 million physicians, hospitals and medical facilities.
In addition, a robust prescription drug plan provides coverage for nearly 5,000 different medications. A health and wellness program rewards users for staying healthy and allows them to use those rewards toward copays or out-of-pocket expenses.
3. Coventry Health Care
Coventry Health Care serves members in Maryland with a variety of health plans, including HMOs, PPOs and POS plans. Its HMO plan offers low copays and low monthly premiums, while PPO and POS plans cover doctors, specialists and hospitals, regardless of whether they are in the Coventry Network.
One of the areas of care that makes Coventry unique is its Total Behavioral Solution that provides ongoing support and treatment to members suffering from chronic conditions to better coordinate their care and help them benefit from preventive health steps that can improve quality of life.
Known as the Golden Rule Insurance Company in Maryland, this subsidiary of UnitedHealthcare serves over 26 million people across the country. It offers a variety of healthcare plans that allow members to choose the right amount of insurance coverage to fit their needs.
Coverage options generally range from $31–$208 per month for individuals and $112–$898 per month for families. Dental insurance coverage is also available.
5. Assurant Healthcare
Assurant Healthcare is a network of companies that provides competitive health insurance plans. Although the benefits provided by Assurant are not as exhaustive as CareFirst or Kaiser, it nevertheless provides individual health insurance plans with a focus on high deductible health insurance plans and health savings accounts.
In addition to providing individual and family plans, members can further customize their plans to suit their needs, allowing them to get the right coverage at the right price.
What is Health Insurance?
Health insurance helps cover medical costs for illnesses and injuries, including chronic conditions like diabetes or asthma. Many people get health insurance through their employer, but for those who don’t, finding an individual health plan can be a challenge. High medical expenses is the primary cause of bankruptcy, and since accidents and injuries can happen at any time, it’s important to get coverage now rather than wait.
In comparing health insurance rates, you’re likely to find a lot of terms like “deductibles” and “copays.” It’s important to understand what these mean as you decide among the best health insurance companies in Maryland, so you can be sure to get a good policy and not pay too much for coverage.
Deductible: This is the amount of money you’ll need to pay toward your medical bills each year before the insurance company begins to pay. Different plans have different deductibles and some have no deductible at all.
Copay: The copayment, or copay, is a flat fee that you pay each time you go to the doctor or get a prescription filled. It’s usually a small amount of money. Your copay does not go toward meeting your deductible.
Coinsurance: This is the percentage of medical bills that is shared between you and your insurance company. For example, a common type of coinsurance is 80-20, where your insurer pays 80% of a covered expense and you pay 20%. Coinsurance goes into effect after you pay your deductible.
Premium: This is a monthly fee that is paid in order to keep your insurance policy active.
Average Cost of Health Insurance in Maryland
The average cost for mid-range health insurance in Maryland is $475 per month. Different individual and family health insurance plans may have discounts to help make staying healthy even easier, like gym membership discounts.
There is a key difference between health insurance and discount health plans. Discount plans are not the same as health insurance. They advertise savings on things like dental, vision, hearing, prescriptions and even hospital visits.
The amount the discount plans could save you varies and depends on many factors, including where you live, the service or product you need and much more. You’ll also need to contact your doctors and local hospitals to find out if they are participating providers in these discount card programs. Many are not, and the coverage they provide is not nearly as extensive as what you will find in an actual health insurance plan.
Types of Health Coverage
There are a variety of different health coverage plans available, each one paying a specific portion of the individual’s health care costs. Details may vary widely from plan to plan, with some of them featuring high deductibles but 100% coverage after the deductible is met, or others with low deductibles but higher copays or coinsurance.
Health Maintenance Organization (HMO): An HMO works by providing healthcare services through a predetermined network of providers and facilities. With this type of health insurance plan, you don’t have as much freedom to choose your health care providers, however, you also have less paperwork to deal with compared to other types of plans.
Generally speaking, you’ll have a primary doctor who is in charge of your care, and you’ll need a referral from that doctor in order to see a specialist. Both your doctor and the specialist you’re referred to must be in your HMO network for the care to be covered by the insurance program.
Preferred Provider Organization (PPO): With a PPO, you have greater freedom to choose your health care providers and you don’t need a referral in order to see a specialist. The tradeoff for this ease of use is that you may have more paperwork involved (especially if you see out-of-network providers) and you may pay more if you see out-of-network doctors versus those who are in your PPO network.
If you do choose to see an out-of-network doctor, you’ll need to file a claim yourself to get your PPO to pay you back some portion of the funds you spent.
Point of Service (POS) plan: This plan combines HMO and PPO features. You’ll have more freedom than you would with an HMO and some paperwork to deal with, especially if you see out-of-network providers. As with an HMO, you’ll also have a primary care doctor that supervises your care and can refer you to specialists.
Like with a PPO, you can see out-of-network doctors but you’ll pay more. Also like a PPO, if you choose to see an out-of-network doctor, you’ll need to pay your medical bill on your own and submit a claim to you POS plan to get reimbursed.
What Does Health Insurance Cover?
Health insurance plans typically cover illnesses and injuries as well as preventive services like shots or health screenings. Preventive services often have no cost associated with them. What’s covered and isn’t covered will depend primarily on your plan, but generally speaking, health insurance companies offer the following benefits:
Ambulance services: If you need an ambulance to take you to the emergency room but you aren’t admitted to the hospital as a result
Emergency services: Emergency room care that necessitates an urgent response
Hospitalization: When you are admitted to the hospital for illness or injury, including surgery
Maternity and newborn care: Includes care before and after your baby is born
Prescription drugs: Medications that are necessary to help treat illnesses or injury
Rehabilitative services: Devices and services used to help recover from injuries, chronic conditions and disabilities and build or recover physical strength or mental acuity
Laboratory services: Additional diagnostic services that help to identify illnesses or conditions
Mental health care: Counseling, behavioral treatments, drug addiction recovery and other types of mental health and wellness care
Preventive services and wellness checks: May include screenings and injections as well as the management of chronic diseases
Pediatric care: Care to ensure the health and wellness of children
What Does Maryland Health Insurance Not Cover?
Although health insurance covers a variety of costs associated with injuries, illnesses, preventive care and other treatments, there are a few things that insurance companies typically do not cover:
Elective or cosmetic procedures: Certain procedures that a patient chooses to have done, rather than having their doctor formally diagnose them or refer them to a specialist
Beauty treatments: Any type of treatment designed to increase attractiveness or body shape
Off-label drug use: Prescription drugs to treat conditions, illnesses or other issues other than those for which they were prescribed
New or untested technologies: Any brand new technology that has not been formally tested or approved for use in a healthcare setting
Choosing Health Insurance in Maryland
Buying Maryland health insurance doesn’t have to be complicated. By getting a free online quote and comparing plans among the top insurance companies profiled here, you’ll be well on your way to ensuring that you and your family are protected against the high medical costs of injuries and illnesses. In addition, you may benefit from additional services that reward you for getting and staying healthy.
There’s no better time than now to get a free quote for all your health insurance needs.
Frequently Asked Questions
Does health insurance cover routine care?
Health insurance covers routine care, medications, procedures, etc. However, you should check your policy to learn the coverage level for each service.
Will health insurance premiums rise every year?
Health insurance premiums tend to rise every year with inflation, but employers often defray those costs with contributions to the plan.