Are you looking for insurance for an uninsured child or adult? There are a number of circumstances that may qualify you for free health insurance in Maryland or a low-cost plan.
Insurance can be difficult to navigate as coverage, benefits and costs vary depending on the plan.
211 can answer health insurance questions. Dial 211 or search the database for local health insurance resources like a local health insurance navigator who can provide free guidance for your situation.
Health Insurance For Children
Maryland provides free or low-cost health insurance to children up to age 19 and pregnant women of any age who meet income guidelines, under the Maryland Children’s Health Program (MCHP).
Free Health Care For Children
Care is provided by the Managed Care Organizations (MCOs) in the Maryland HealthChoice program.
The MCO provides the following benefits:
- Dental care
- Doctor visits including sick and well-visits
- Hospitalizations
- Lab work and tests
- Mental health support
- Substance use treatment
- Immunizations and flu shots
- Prescription medicine
- Transportation to medical appointments
- Vision
To find the best MCO for your personal situation, compare the Managed Care options available in Maryland and the benefits, doctors and pharmacies available for use. The comparison chart is in English and Spanish.
Who Qualifies For Maryland Children’s Health Program (MCHP)
According to recent guidelines, uninsured children under get 19 living in a household with modified adjusted gross income at or below 211% of the federal poverty level qualify for MCHP.
Children may also qualify for a smaller monthly premium if their household income is at or below 322% of the federal poverty level for their family size. The premium offsets the cost for higher-income children.
Income guidelines can change. View recent income guidelines for Maryland Children’s Health Program and Medicaid.
When Is Enrollment?
Enrollment is open year-round for MCHP and Medicaid, through Maryland Health Connection.
Individuals need to renew their coverage once a year. You will be contacted when it’s time for your renewal.
Maryland Health Connection
Maryland Health Connection is a one-stop enrollment resource for Medicaid and private insurance. You can get an estimate of coverage costs before creating an account and applying for a plan.
Medicaid In Maryland
Medicaid is available to individuals and families with limited income and resources. Learn about Medicaid income qualifications.
What Does Medicaid Cover?
The Managed Care Organization (MCO) provides the following free care through Medicaid:
- Doctor visits, including regular checkups and specialists
- Pregnancy care
- Family planning and birth control
- Prescription drugs
- Hospital and emergency services
- Primary mental health services through your doctor
Are Immigrants Eligible For Medicaid?
Lawfully residing pregnant women and children under age 21 (regardless of type of status) are eligible for Medicaid.
Others are not eligible for Medicaid, under most immigration statuses, until the individual has been lawfully in the U.S. for five years. It’s sometimes referred to as the “five-year bar.
If you’re new to the United States or Maryland, you can connect with immigration resources and essential needs like food, housing and health care through 211. Translation is available in 150 languages.
Medicare
Medicare is a federal insurance program for anyone age 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD).
Open enrollment happens on specified days in the fall each year.
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.
Trained and volunteer counselors are available to provide free assistance in counties throughout Maryland and Baltimore City. Find a counselor near you.
During Medicare open enrollment, you have the opportunity to review your plan, shop for new coverage and ensure your benefits are the best ones for the upcoming year.
Learn more about Medicare options and costs.
Individual Health Insurance
If you don’t qualify for Medicaid or children’s health insurance, individuals and families can apply for health insurance through the marketplace.
Health Insurance Marketplace Open Enrollment
Uninsured Marylanders can apply for coverage during open enrollment in the fall, starting in November. Coverage starts on January 1 of the following year.
Sometimes there are special enrollment periods that allow you to apply for coverage any time of year. In addition, you can enroll during a qualifying life event.
These include:
- Becoming ineligible for Medicaid or MCHP
- Getting married or divorced
- Having a child, adopting a child or placing a child for adoption or in foster care
- Moving to Maryland, and some moves within the state
- COBRA coverage period ends
- Change of citizenship or immigration status
- Incarceration or release
- Change in status as an American Indian/Alaska Native
- Getting pregnant (Note: you have 90 days to enroll from the time the pregnancy is confirmed.)
- Gaining or losing a dependent
- Certain losses of other health coverage like insurance through your job
- Enrolled in your parent’s plan and you turn 26 years old
COBRA
If you leave a job and had medical coverage through your employer, you may be able to temporarily keep your coverage after leaving your job.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) provides coverage for a limited period if you apply within 60 days of your last day of work. However, rates may increase from what you paid while employed.
Dental Insurance
While dental coverage is provided for free for children and pregnant women in Medicaid and MCHP, other uninsured individuals may need a separate dental plan from Maryland Health.
You may also look into free and low-cost dental clinics throughout Maryland.
Learn more about dental plan options from Maryland Health. You can apply for benefits during open enrollment.
Get Help Enrolling For Health Insurance
Navigating insurance coverage can be overwhelming. There are deductibles, in-network and out-of-network providers, co-pays and other terms which impact medical costs.
Dial 211 to speak to an Information and Referral Specialist. They will connect you to the right resource for your situation, including identifying a local health care navigator. They help determine if you qualify for health savings with a private plan or Medicaid.
You can also use an authorized insurance broker to find the best health plan for your needs. There is no cost to the individual.
Health Care Navigators
There are also health insurance navigators in each county that provide free, in-person health insurance help. They can help you figure out if you qualify for a subsidy through a private health plan or if you qualify for free health insurance through Medicaid.
Find a local health care navigator near you.
Your local health department or Department of Social Services may also be a resource for Medicaid questions and pregnant women who need health care coverage. Search for your local DSSS agency in the 211 database.
Insurance Complaints
The Maryland Insurance Administration (MIA) can help you with many insurance issues. They have tools to help you learn about health insurance companies that are licensed to sell in Maryland.
If you are having trouble with a claim, you can ask for help from the Rapid Response Program at 410-468-2340 or 1-800-492-6116 ext. 2340, or file a formal complaint. Get more information from the Maryland Insurance Administration.
To learn about these or other health insurance options, call 211 or search the database.
