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. 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 everything 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.
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 (2026): 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
- Open enrollment period: Typically November 1 through December 15 for January 1 coverage, with extended enrollment through January 15 in some years. Check open enrollment for current dates
- Year-round enrollment: Available for Medicaid and qualifying special enrollment periods
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. Here are approximate monthly costs for a 40-year-old individual before subsidies in 2026:
| Plan Tier | Average Monthly Premium | Average Annual Deductible |
|---|---|---|
| Catastrophic | $230 – $300 | $9,200 |
| 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, has reduced individual market premiums by an estimated 20 to 30 percent compared to what they would be without the program. This makes health insurance Maryland plans more affordable than in many neighboring states.
With premium tax credits, the majority of Maryland marketplace enrollees pay less than $150 per month. Some lower-income individuals qualify for $0 premium Bronze plans.
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 138% of the federal poverty level (approximately $20,783 for an individual in 2026)
- Children: Covered through Medicaid or the Maryland Children’s Health Program (MCHP) with income limits up to 322% of FPL for children under 19
- Pregnant women: Eligible with incomes up to 264% of FPL
- 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) including Aetna Better Health, CareFirst Community Health Plan, Maryland Physicians Care, MedStar Family Choice, Priority Partners, and UnitedHealthcare
Over 1.5 million Marylanders are enrolled in Medicaid, making it the largest source of health coverage in the state. Beneficiaries receive comprehensive coverage with minimal or no cost-sharing.
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 the broadest network statewide, while Kaiser Permanente uses an integrated model with its own facilities
- Plan type: Maryland offers HMO and PPO options. HMOs are 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
Maryland-Specific Health Insurance Programs and Protections
Maryland has enacted several state-level protections and programs that benefit consumers:
- State reinsurance program: Reduces premiums on the individual market by covering a portion of high-cost claims. This program has saved consumers an estimated 20 to 30 percent on premiums since its inception
- Surprise billing protections: Maryland law protects patients from balance billing when they receive emergency care or inadvertently see out-of-network providers at in-network facilities
- State individual mandate: Maryland does not impose a state-level individual mandate, though there is a reporting requirement for tax purposes
- Easy Enrollment Health Insurance Program: Maryland’s innovative program allows residents to check a box on their state tax return to share income information with Maryland Health Connection, enabling direct outreach about affordable coverage options
- Small business options: The Maryland Health Insurance Plan (MHIP) and SHOP marketplace provide options 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, and cost-sharing reductions
- Compare available plans: Review plan options side by side, including premiums, networks, and out-of-pocket costs
- Select a plan and enroll: Choose the plan that best fits your needs and submit your enrollment
- Pay your first premium: Coverage typically begins on the first of the month following enrollment
Free assistance is available through Maryland Health Connection’s call center, in-person navigators, and certified enrollment brokers located throughout the state.
Frequently Asked Questions
Is health insurance expensive in Maryland?
Maryland’s individual market premiums are moderate compared to other states, thanks in large part to the state reinsurance program. Before subsidies, a Silver plan for a 40-year-old averages $380 to $550 per month. With premium tax credits, most enrollees pay significantly less. Maryland’s fully expanded Medicaid program also provides free coverage to eligible low-income residents.
Can I get free health insurance in Maryland?
Yes. Medicaid provides free health coverage to individuals with incomes up to 138% of the federal poverty level. Additionally, marketplace enrollees with lower incomes may qualify for $0 premium Bronze plans through premium tax credits. 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 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. However, the state does have a tax reporting requirement related to health coverage. Going uninsured means you are responsible for the full cost of any medical care you receive, which can be financially devastating in the event of a serious illness or injury.
Final Takeaway
Health insurance Maryland residents can access includes competitive marketplace plans through Maryland Health Connection, comprehensive Medicaid coverage, and innovative state programs like the reinsurance waiver and Easy Enrollment. Premiums are moderate by national standards, and the majority of marketplace enrollees receive subsidies that make coverage affordable. 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.