Maryland Health Insurance

Navigate the Complexities of Health Insurance in Maryland

Despite all the talk about health insurance in the state and national debate, the topic remains confusing, complex and frustrating for many consumers. How much should you pay for health care insurance? What types of coverage options are best for you and your family? What does the Affordable Care Act mean for Maryland residents?

Before you search for health insurance quotes, there are several factors to consider.

How Maryland Fares on Healthcare Insurance

According to media reports and census data:

  • In 2007, more than 10 percent of Maryland residents reported they were unable to see a doctor when needed due to cost.
  • From 2003 to 2009, the cost of a family health insurance policy increased 50 percent in the state, with the average annual premium approaching $14,000. Single policy holders saw their rates increase by 42 percent over the same period.
  • Of the Maryland residents who do have health insurance, 57 percent are covered through their employment. Public programs such as Medicaid and Medicare insure 25 percent of the population and 5 percent of Maryland residents purchase individual private polices.
  • This leaves 13 percent of Maryland’s population, or 771,500 people, uninsured.

What Does Health Insurance Cover?

Health insurance can cover a number of things, from regular checkups and doctor appointments, to major surgery. The types of services that are covered significantly vary between different Maryland insurance providers and plan types. The first thing to do is identify your health care needs before buying a specific health insurance plan.

Doctor office visits are one of the most common things that health insurance covers. Other common services that are covered include hospital room and board, emergency room visits, and inpatient substance abuse treatment.

Be sure that you know what your policy covers, who is covered, and who pays for the service. Some health insurance policies, like HMOs (health maintenance organizations), will only cover procedures performed by certain professionals in a network. A PPO (preferred provider organization) will allow you to choose your provider and then pay based on that provider’s preferred status.

How Does Health Insurance Work in Maryland?

Most health insurance plans offered by Maryland providers are employer-provided. That means the employer helps pay some of the premium costs in most cases. For self-employed or those who purchase health care on the newly formed exchange, however, the entire cost of the premium is paid for by the policy holder.

Along with the monthly premiums, health insurance in Maryland usually involves these types of out-of-pocket expenses for the policy holder:

  • Co-payments: This cost applies every time you schedule a service such as a checkup, blood test or any other trip to the doctor. The most common co-pays are around $25.
  • Deductibles: A deductible is the amount of money that you are required to pay before your insurance begins to cover services. Some plans offer low deductibles with higher premiums, while others offer high deductibles with lower premiums. It's important to choose a deductible that you can comfortably afford to pay.
  • Coinsurance: Some policies may have coinsurance, which requires you to pay a certain percentage of services rendered. Your coinsurance may be an amount you pay in addition to your co-pay and may apply towards your deductible.

Choosing the best plan really depends on your personal circumstances. It's a good decision to speak with an experienced insurance agent who can help you identify your health insurance needs and explain the complexities of the various plans offered by Maryland health insurance companies.

Why is Healthcare Insurance Important?

Starting in 2014, the Affordable Care Act requires all U.S. citizens, including Maryland residents, to purchase health insurance or pay a fine. This fine is set at $95 per individual, or 5 percent of gross income, whichever is higher.

Not only is carrying health insurance now mandated by law, but lack of proper health insurance coverage is the leading cause of bankruptcy in Maryland and the nation. One severe injury or illness can wipe out an entire household's finances.

The medical community also stipulates that people and families with health insurance have better health outcomes, as they are able to seek medical treatment in a timely manner, rather that wait it out or end up in emergency care.

What Will My Maryland Health Insurance Quote Look Like?

The quotes you receive from Maryland health insurance companies can vary considerably depending on several factors. Quotes are determined by the plan you choose, whether you have insurance through an employer or private insurer, and how much of the insurance you cover.

On average, individual policies can be quoted at anywhere from $100 to $200 per month, while family policy premiums can see quotes from $350 to $600 per month. With some plans, you will pay these premiums entirely out of pocket and for others, the majority of premiums are covered by an employer. You can adjust your premium based on your coverage amounts, as well as your deductible amount.

In general, plans with lower premium quotes usually mean higher out-of-pocket expenses. It's important to determine which type of plan suits your needs best. Speaking with a qualified insurance agent can help you identify which plans are best for you and your family.

Is Help Available for Affordable Health Care?

Maryland has several state programs that assist residents in paying for health care insurance. It's a good idea to find out if you qualify for any of these programs.

Maryland is also one of the first states to have an operational health care exchange, created as part of the Affordable Care Act. Qualified individuals and families may be able to secure lower premium rates by signing up for plans available on this exchange.

With either of these assistance programs, applicants must meet income qualifications. To find out if you are eligible, speak to a knowledgeable insurance agent.

Where Can I Find Health Insurance in MD?

If health insurance is still a confusing and frustrating topic for you, you're not alone. Most Maryland residents find it difficult to understand the medical jargon and insurance-speak that permeates the discussion. The good news is you don't have to go it alone.

Knowledgeable, independent insurance agents on the Trusted Choice network are always available to answer your questions, suggest coverage options, and even assist you in filing a claim. These agents have years of experience working with Maryland insurance companies and are up-to-date with all the new health care laws. They can find you a number of quotes with varying coverage options from a variety of companies, ensuring the quotes you see offer the best policies at the most affordable rates. Contact a Trusted Choice member agent near you to find out how you can purchase the perfect health insurance policy that meets your needs and budget.

Now, who's ready to get their insurance problems solved?