Maryland Health Insurance Guide

From Chesapeake Bay shores to vibrant city life in Baltimore, Maryland remains a desirable place to live — and understanding your health insurance options here is key to protecting your health and finances. As of 2025, the uninsured rate in Maryland reflects ongoing efforts to expand access and maintain steady enrollment. If you’re currently without coverage, here’s what you need to know about getting insured in Maryland.

Health Insurance Options in Maryland

Maryland offers a range of health insurance options tailored to residents’ needs, depending on age, income, employment, and family size. Here are the most common coverage types available:

Employer-Sponsored Insurance

Many Maryland residents receive health insurance through their employer. If your workplace offers coverage, this is usually the most cost-effective and convenient option.

ACA Marketplace Plans

The Affordable Care Act (ACA) allows individuals and families to buy health insurance through federal or state Marketplaces. These plans offer essential health benefits, free preventive care, and protection for preexisting conditions.

If you don’t have employer coverage, you may qualify for subsidies to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.

Starting this year, the Centers for Medicare & Medicaid Services (CMS) is requiring income verification to confirm eligibility for premium subsidies. As part of this effort, CMS will reduce the ACA subsidies by $5 per month for individuals who are automatically re-enrolled in fully subsidized plans without verified eligibility.

ACA Plan Types

ACA marketplace plans are available in four tiers: Bronze, Silver, Gold, and Platinum, each with distinct coverage levels. Plans also vary by provider networks and out-of-pocket expenses, so compare carefully to find what fits your needs.

Marketplace Plans:

• Bronze: Low monthly premiums, higher out-of-pocket costs; ideal for minimal healthcare usage.
• Silver: Moderate costs; eligible for cost-sharing reductions (CSRs).
• Gold: Higher monthly premiums with lower out-of-pocket costs; best for frequent healthcare users.
• Platinum (if available): Highest premiums, lowest out-of-pocket costs.

Metal Tier Breakdown:

Medicaid

Maryland Medicaid provides free or low-cost coverage for eligible low-income residents. Medicaid plan benefits typically include preventive care, hospital visits, mental health services, prescriptions, and more.

Short-Term Plans

Short-term medical (STM) plans offer temporary health coverage and can be a practical solution for individuals who are between jobs, recently lost employer coverage, waiting for ACA or Medicare eligibility, or need affordable protection during a coverage gap. These plans are available in Maryland and follow federal rules, but are subject to state restrictions. Maryland limits STM plans to a maximum duration of three months, and they are non-renewable. These plans are not regulated by the ACA and can deny coverage based on pre-existing conditions. They also typically do not include comprehensive benefits like maternity, mental health, or preventive care.

STM Plan Enrollment

Unlike ACA-compliant plans, you can enroll in short-term health plans year-round.

Quick Coverage Start: Many short-term plans can begin as soon as the next day after your application is approved.

STM Plan Enrollment

Unlike ACA-compliant plans, you can enroll in short-term health plans year-round.

Quick Coverage Start: Many short-term plans can begin as soon as the next day after your application is approved.

Children’s Health Insurance Program (CHIP)

Known as the Maryland Children’s Health Program (MCHP), this program helps children and pregnant women in families that earn too much for Medicaid but need affordable insurance.

Student Health Insurance

College students in Maryland have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans—making Maryland student health insurance accessible and flexible for a wide range of needs.

Medicare

Medicare plans are available for residents aged 65+ and younger individuals with qualifying disabilities. Options include:

• Medicare Advantage (Part C): An alternative to Original Medicare offered by private insurers. These plans often include extra benefits and cost protections but typically require using a specific network of providers.
• Prescription Drug Plans (Part D): Provides prescription drug coverage for anyone with Medicare. Offered by private insurers, these plans vary in coverage and can be joined during specific enrollment periods.
• Medicare Supplement (Medigap): Helps cover the out-of-pocket costs that Medicare Part A and Part B don’t pay. Since Original Medicare lacks an out-of-pocket maximum, these plans can limit your expenses for medical services.

COBRA Coverage

If you’ve recently lost job-based insurance, COBRA allows you to continue your employer coverage temporarily—typically at full cost.

Enrollment Periods in Maryland

Open Enrollment for 2026 Coverage:
November 1, 2025 – January 15, 2026
During this window, all eligible residents can apply for, renew, or change their marketplace health plans.

Special Enrollment Period:
Available year-round for those experiencing qualifying life events (QLE), such as:

• Loss of coverage
• Marriage or divorce
• Birth or adoption of a child
• Relocation
• Major change in income

You typically have 60 days from the event to enroll.

Health Insurance Providers in Maryland

As of 2025, these insurers typically offer individual and family plans through the Maryland Health Connection:

• CareFirst Blue Choice
• CareFirst of Maryland
• Group Hospitalization and Medical Services
• Kaiser Foundation Health Plan of the Mid-Atlantic States
• Optimum Choice

Plan availability may vary by county or zip code. Some carriers may also offer standardized plans if your state provides a public option or similar initiative.

Understanding Health Insurance Costs

When selecting a plan, be sure to understand these common cost terms:

• Premium: Monthly payment to maintain your plan.
• Deductible: What you pay before insurance covers services.
• Copayment (Copay): Fixed amount per visit/service.
• Coinsurance: Shared costs with your insurer after the deductible.
• Out-of-Pocket Maximum: Your yearly cost cap for covered services.
• In-Network vs. Out-of-Network: Staying in-network helps you avoid higher charges.

Understanding health insurance doesn’t have to be overwhelming. This glossary offers clear definitions of key terms to help you make confident coverage decisions.

Bottom Line

Health insurance in Maryland comes with many choices—whether from your employer, through the ACA marketplace, or public programs like Medicaid and Medicare. By staying informed and comparing plans during the right enrollment periods, you can secure affordable, reliable coverage that supports your well-being and budget.

Need help choosing a plan? Use our ACA Subsidy Calculator to see if you are eligible for ACA plan financial aid or speak with a licensed insurance agent about all your options.