Opções de seguro de saúde em Maryland
Are you uninsured? There are a number of circumstances that may qualify you for free health insurance or a low-cost plan.
Learn about Medicaid, private health insurance (discounts available), Medicare, and dental insurance.
211 can answer health insurance questions. Dial 211 or search the database for local health insurance resources, such as a navigator who can provide free guidance for your situation.
Maryland Medicaid
Low-income families, children, pregnant women, and aged, blind, or disabled adults may qualify for Medicaid. Income qualifications change every year.
Children up to age 19 may qualify for additional benefits from the Maryland Children's Health Program.
Individuals who receive other types of public assistance are automatically offered Medicaid. These include:
- Supplemental Security Income
- Auxílio Temporário em Dinheiro
- Foster Care
If you are not a U.S. citizen, Medicaid may be available during pregnancy and for four months after birth. It may also be available if you meet other requirements, like the 5-year rule.
Você pode ter seguro de saúde privado e ser elegível para o Medicaid.
Managed Care Organizations (MCO)
Most individuals enrolled in Medicaid receive care through a Managed Care Organization (MCO).
O MCO cobre despesas de saúde como:
- consultas médicas
- cuidados durante a gravidez
- medicamentos prescritos
- serviços hospitalares e de emergência
Private Health Insurance
If you don’t qualify for Medicaid or children’s health insurance, individuals and families can apply for private health insurance. Financial help may be available.
While many states use the federal marketplace, Maryland has its own one-stop insurance marketplace, Maryland Health Connection, that handles private insurance, Medicaid, and the Maryland Children's Health Program enrollments.
What do they cover?
These plans cover preventive care and other essential health care, such as:
- Doctor visits
- Emergency care
- Hospitalizações
- Lab tests
- Maternity and newborn care
- Mental and behavioral health care
- Cuidados pediátricos
- Prescrições
- Preventive and wellness management
- Rehabilitation
- Substance use disorder treatment
The private plans may have a deductible, coinsurance, and copayment.
Do I qualify for financial help for a private plan?
While financial help is available, the discount may be less than years past. The federal savings program is no longer in place for the Maryland marketplace insurance. Instead, Maryland is providing financial help through Maryland Premium Assistance.
You will no longer be eligible for financial help if your income is below 100% of the federal poverty level and you are not eligible for Medicaid due to your immigration status.
In those situations, the plans are still available, but at full cost.
You can get an estimate for how much these plans may cost.
How do I get help with Insurance enrollment?
If you have questions about Medicare or private insurance enrollment, free help is available in counties throughout Maryland. Navigators can answer questions in-person. They'll help you find the most savings and apply for insurance.
You can also talk to an insurance broker if you are purchasing a private policy.
How do I apply?
You can find a plan through Maryland Health Connection. Make sure you understand the costs and the coverage. Check to make sure your doctors are included in the plan you choose.
And if you need help, use the free counseling support.
Applying for Health Insurance and Medicaid
Whether you apply for Medicaid or a private health insurance plan in Maryland, all applications go through Maryland Health Connection. It's a one-stop shop.
Open Enrollment
Uninsured Marylanders can apply for coverage during open enrollment, which starts in November. Coverage starts on January 1 of the following year.
Às vezes há períodos especiais de inscrição that allow you to apply for coverage at any time of year. In addition, you can enroll during a qualifying life event.
Special enrollment periods include:
- Tornar-se inelegível para Medicaid ou MCHP
- Casar ou divorciar
- Ter um filho, adotar um filho ou colocar um filho para adoção ou em um orfanato
- Mudança para Maryland e algumas mudanças dentro do estado
- O período de cobertura COBRA termina
- Mudança de cidadania ou status de imigração
- Prisão ou libertação
- Mudança de status como índio americano/nativo do Alasca
- Ficar grávida (Nota: você tem 90 dias para se inscrever a partir do momento em que a gravidez é confirmada.)
- Ganhar ou perder um dependente
- Certain losses of other health coverage, like insurance through your job
- Enrolled in your parents’ plan, and you turn 26 years old
COBRA
If you left a job and had medical coverage through your employer, you may be able to temporarily keep your coverage after leaving your job.
O Consolidated Omnibus Budget Reconciliation Act (COBRA) fornece cobertura por um período limitado se você aplicar dentro de 60 dias do seu último dia de trabalho. No entanto, as taxas podem aumentar em relação ao que você pagou enquanto estava empregado.
Benefícios do Medicare
If you are 65 years old or older, have a certain disability and are under age 65, or have End-Stage Renal Disease (ESRD), you may be eligible for Medicare.
A inscrição aberta acontece em dias específicos no outono de cada ano.
Durante a inscrição aberta do Medicare, você tem a oportunidade de revisar seu plano, comprar uma nova cobertura e garantir que seus benefícios sejam os melhores para o próximo ano.
Learn more about Medicare options and costs.
SHIP Can Help You Find the best plan
If you need help finding the best program for your needs, contact a State Health Insurance Assistance Program (SHIP) counselor.
They can help you understand costs and coverage, compare options, enroll or change plans, and correct billing issues.
Conselheiros treinados e voluntários estão disponíveis para fornecer assistência gratuita nos condados de Maryland e da cidade de Baltimore.
Encontre recursos agora
Encontrar recursos da comunidade para alimentação, saúde, moradia e muito mais em nosso banco de dados. Pesquise por CEP.
Seguro dental
While dental coverage is provided at no cost to children and pregnant women through Medicaid and MCHP, other uninsured individuals may need a separate dental plan from Maryland Health Connection.
Saiba mais sobre as opções de planos odontológicos from Maryland Health Connection. You can apply for benefits during open enrollment.
Free and low-cost dental clinic
If you end up without dental insurance, there are free and low-cost dental clinics throughout Maryland.
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