- Maryland runs its own state-based marketplace, Maryland Health Connection, rather than using HealthCare.gov — it is where residents shop for ACA plans, apply for financial help, and enroll in Medicaid.
- Maryland fully expanded Medicaid, so adults with income up to about 138% of the federal poverty level can qualify for free or very low-cost coverage year-round.
- A state reinsurance program (a Section 1332 waiver) has held down individual-market premiums, and Maryland also runs a state subsidy that lowers premiums for eligible young adults.
- The enhanced federal premium tax credits that lowered net premiums in recent years were scheduled to expire after plan year 2025 — whether Congress extended them changes what you pay in 2026, so verify the current subsidy rules before you enroll.
- Maryland's Easy Enrollment program lets you check a box on your state tax return to be connected with affordable coverage or Medicaid.
- This article is general education, not insurance advice; premium and income figures are approximate — confirm current amounts and dates at Maryland Health Connection.
Health insurance Maryland residents need is available through the state’s own marketplace, Maryland Health Connection, as well as through employer plans, Medicaid, and Medicare. Understanding your health insurance Maryland options is the first step toward finding affordable coverage that fits your healthcare needs and budget.
Maryland operates one of the most successful state-based health insurance marketplaces in the country, with competitive premiums and strong insurer participation. Unlike states that use the federal HealthCare.gov platform, Maryland runs its own exchange, sets its own enrollment dates, and layers state programs on top of the federal ACA rules. The state has also fully expanded Medicaid under the ACA, providing coverage to hundreds of thousands of low-income residents. Whether you are a Baltimore renter, a Montgomery County professional, or a small business owner on the Eastern Shore, this policy guide covers what you need to know.
Maryland Health Connection: The State Marketplace
Maryland Health Connection (MHC) is the state’s official health insurance marketplace where individuals and families can shop for ACA-compliant plans, apply for financial assistance, and enroll in coverage. Because it is state-based, all applications, subsidy determinations, and Medicaid eligibility run through MHC rather than the federal site.
Key features of Maryland Health Connection:
- Website: MarylandHealthConnection.gov
- Plan options: Qualified health plans across Bronze, Silver, Gold, and Platinum tiers, plus Catastrophic plans for eligible individuals under 30
- Participating insurers (verify current for your plan year): CareFirst BlueCross BlueShield, Kaiser Permanente, and other carriers depending on the region
- Financial assistance: Premium tax credits and cost-sharing reductions available based on income, plus Maryland’s own state programs described below
- Open enrollment period: Maryland sets its own dates, which have generally run from November 1 into mid-January for coverage starting the following year. Dates can change year to year, so check open enrollment and MarylandHealthConnection.gov for the current deadlines
- Year-round enrollment: Available for Medicaid and for anyone who qualifies for a special enrollment period after a life event such as losing coverage, moving, marrying, or having a child
Maryland has implemented several innovative programs through its marketplace, including a state reinsurance program that has helped stabilize premiums and keep costs lower than they would otherwise be.
Average Health Insurance Costs in Maryland
Health insurance Maryland premiums vary by age, location, plan tier, and tobacco use. The figures below are approximate and illustrative — real quotes depend on your ZIP code, the plan year, and the carriers competing in your area, so confirm current pricing at Maryland Health Connection. As a rough guide, monthly costs for a 40-year-old individual before any subsidies have looked something like this:
| Plan Tier | Approx. Monthly Premium (before subsidies) | Approx. Annual Deductible |
|---|---|---|
| Catastrophic | $230 – $300 | ~$9,000+ |
| Bronze | $280 – $400 | $6,000 – $8,000 |
| Silver | $380 – $550 | $3,500 – $5,500 |
| Gold | $480 – $650 | $1,000 – $2,000 |
| Platinum | $600 – $800 | $0 – $250 |
Maryland’s state reinsurance program, established under a Section 1332 waiver, covers a share of insurers’ high-cost claims and has reduced individual-market premiums meaningfully compared with what they would be without it (estimates have commonly cited reductions in the range of 20 to 30 percent). This helps make health insurance Maryland plans more affordable than in many neighboring states. With premium tax credits, many Maryland marketplace enrollees pay far less than the sticker prices above, and some lower-income individuals qualify for very low or $0-premium Bronze plans — though the exact amount you pay depends on the subsidy rules in effect for your plan year (see the next section).
2026 Enrollment and the Enhanced Subsidy Question
One issue matters more than any single premium figure for 2026: the future of the enhanced (expanded) federal premium tax credits. These enhanced credits, first enacted in 2021 and later extended, sharply lowered net premiums for marketplace enrollees and removed the old “subsidy cliff” for people above 400% of the federal poverty level. They were scheduled to expire after plan year 2025 unless Congress extended them. Whether that extension happened directly changes what Maryland enrollees pay in 2026 — if the enhanced credits lapsed, many enrollees would see higher net premiums even though base rates are held down by the reinsurance program. Because this is a moving policy target, verify the current subsidy rules and your own estimated cost at Maryland Health Connection before you enroll rather than assuming last year’s net premium still applies.
Even in the least favorable scenario, Maryland’s reinsurance program and state subsidies continue to operate, and Medicaid eligibility is unaffected — so run your numbers through MHC to see the actual price with whatever help is available to you.
Medicaid in Maryland
Maryland fully expanded Medicaid under the ACA, providing coverage to a broad population of low-income residents through the Maryland Medical Assistance Program.
- Adult expansion eligibility: Adults aged 19 to 64 with household incomes up to about 138% of the federal poverty level (roughly $21,000 for an individual, adjusted each year — verify the current figure)
- Children: Covered through Medicaid or the Maryland Children’s Health Program (MCHP), with higher income limits than for adults
- Pregnant women: Eligible at higher income levels than the adult expansion group
- Enrollment: Year-round through Maryland Health Connection or local departments of social services
- Managed care: Most Medicaid beneficiaries are enrolled in managed care organizations (MCOs) such as Aetna Better Health, CareFirst Community Health Plan, Maryland Physicians Care, MedStar Family Choice, Priority Partners, and UnitedHealthcare
More than a million Marylanders are enrolled in Medicaid, making it one of the largest sources of health coverage in the state. Beneficiaries receive comprehensive coverage with minimal or no cost-sharing. Exact income thresholds are updated annually with the federal poverty guidelines, so confirm the current limits when you apply.
Health Insurance Costs by Region in Maryland
Maryland’s marketplace divides the state into rating areas that affect pricing. Premiums can vary by region due to differences in provider costs, competition, and population health:
- Baltimore City and Baltimore County: Generally moderate premiums with strong Kaiser Permanente and CareFirst competition
- Montgomery and Prince George’s Counties (DC suburbs): Multiple carrier options and competitive pricing; Kaiser Permanente has a strong presence in these areas
- Western Maryland: Fewer insurer options and potentially higher premiums due to limited provider networks
- Eastern Shore: Similar to Western Maryland, with fewer carriers and higher costs in some counties
- Southern Maryland: Moderate pricing with access to both DC-area and Baltimore-area provider networks
Choosing the Right Plan in Maryland
When shopping for health insurance Maryland plans, consider these factors to find the best fit:
- Provider network: Make sure your preferred doctors and hospitals are in the plan’s network. CareFirst has a broad statewide network, while Kaiser Permanente uses an integrated model with its own facilities
- Plan type: Maryland offers HMO and PPO options. HMOs are usually more affordable but require referrals and in-network care; PPOs offer more flexibility at a higher cost
- Prescription drug coverage: Check each plan’s formulary to ensure your medications are covered at a reasonable tier
- Total cost of care: Compare premiums, deductibles, copays, and out-of-pocket maximums together, not just monthly premiums. Maryland Health Connection provides a total-cost estimator tool to help
Maryland-Specific Health Insurance Programs and Protections
Maryland has enacted several state-level protections and programs that benefit consumers:
- State reinsurance program: Reduces individual-market premiums by covering a portion of high-cost claims, helping keep Maryland’s rates below what they would otherwise be
- State young-adult subsidy: Maryland runs a state-funded subsidy that further lowers marketplace premiums for eligible younger adults, on top of any federal premium tax credit — check MHC for the current age range and income rules
- Surprise-billing protections: Maryland law, alongside the federal No Surprises Act, protects patients from balance billing for emergency care and for many out-of-network providers encountered at in-network facilities. The Maryland Insurance Administration handles related consumer complaints
- Reporting on the state tax return: Maryland does not impose a financial penalty for lacking coverage, but it uses a health-coverage question on the state tax return
- Easy Enrollment Health Insurance Program: Maryland’s program lets residents check a box on their state tax return to share income information with Maryland Health Connection, which then reaches out about Medicaid eligibility or affordable coverage options
- Small business options: A SHOP marketplace and related programs provide coverage avenues for small employers
How to Enroll in Health Insurance in Maryland
Follow these steps to get health insurance Maryland coverage:
- Visit MarylandHealthConnection.gov: Create an account and complete an application
- Provide income and household information: This determines your eligibility for Medicaid, premium tax credits, cost-sharing reductions, and state subsidies
- Compare available plans: Review options side by side, including premiums, networks, and out-of-pocket costs, using the total-cost estimator
- Select a plan and enroll: Choose the plan that best fits your needs and submit your enrollment before the deadline
- Pay your first premium: Coverage typically begins on the first of the month after you enroll and pay, depending on timing
Free assistance is available through Maryland Health Connection’s call center, in-person navigators, and certified enrollment brokers located throughout the state. If you are not sure whether you qualify for Medicaid or a subsidy, an application through MHC will tell you.
Frequently Asked Questions
Is health insurance expensive in Maryland?
Maryland’s individual-market premiums are moderate compared with many other states, thanks in large part to the state reinsurance program. Before subsidies, a Silver plan for a 40-year-old has commonly run in the several-hundred-dollars-a-month range, but most enrollees pay less after premium tax credits and any state subsidy. Maryland’s fully expanded Medicaid program also provides free or very low-cost coverage to eligible low-income residents. Confirm current pricing at Maryland Health Connection.
Can I get free health insurance in Maryland?
Potentially, yes. Medicaid provides free or very low-cost coverage to eligible residents up to about 138% of the federal poverty level. In addition, some lower-income marketplace enrollees may qualify for $0-premium Bronze plans through premium tax credits, depending on the subsidy rules in effect. The Maryland Children’s Health Program covers children at higher income levels.
What happens if I miss open enrollment in Maryland?
If you miss open enrollment, you can generally only enroll in a marketplace plan during a special enrollment period triggered by a qualifying life event. Medicaid enrollment is available year-round regardless of open-enrollment dates. You can also use Maryland’s Easy Enrollment program through your state tax return to be contacted about coverage options.
Does Maryland require health insurance?
Maryland does not impose a financial penalty for lacking health insurance, but it does use a health-coverage question on the state tax return (which also powers the Easy Enrollment program). Going uninsured means you are responsible for the full cost of any medical care you receive, which can be financially devastating in a serious illness or injury.
Does Maryland use HealthCare.gov?
No. Maryland runs its own state-based marketplace, Maryland Health Connection (MarylandHealthConnection.gov). You apply, compare plans, and enroll there rather than on the federal HealthCare.gov site.
Final Takeaway
Health insurance Maryland residents can access includes competitive marketplace plans through Maryland Health Connection, comprehensive Medicaid coverage, and state programs like the reinsurance waiver, the young-adult subsidy, and Easy Enrollment. Premiums are moderate by national standards, and most marketplace enrollees receive help that makes coverage more affordable — though the future of the enhanced federal premium tax credits directly affects 2026 costs, so verify the current rules. Shop during open enrollment, compare HMO and PPO options, and take advantage of free enrollment assistance to find the right plan. For more on healthcare policy topics, visit our policy guide.
This article is general education, not insurance advice or a quote. Maryland runs its own state-based marketplace (Maryland Health Connection), fully expanded Medicaid, and layers on a state reinsurance program and a young-adult subsidy. The enhanced federal premium tax credits were scheduled to expire after plan year 2025, which changes 2026 net premiums, so verify the current subsidy rules, income limits, enrollment dates, and prices at MarylandHealthConnection.gov before you rely on any figure here.
Sources
- Maryland Health Connection (MarylandHealthConnection.gov) — state-based marketplace, metal tiers, financial help, the Easy Enrollment program, and enrollment dates
- Maryland Insurance Administration (MIA) — balance-billing/surprise-billing protections and individual-market rate regulation
- KFF (Kaiser Family Foundation) — Maryland Medicaid expansion, the Section 1332 state reinsurance waiver, the state young-adult subsidy, and the status of the enhanced ACA premium tax credits scheduled to expire after 2025 (verify current status)