Health Insurance (2024)

Maryland's Appeals and Grievance Law

You have the right to appeal denial decisions.
How the Appeals and Grievance Process Works​.​

• ​​​FAQ: Catastrophic Health Plans and Other HealthInsurance

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• Commercial Carrier Process to Request a Referral to a Specialist or Non-Physician Specialist​​

• ​​List - Carriers with Approved Individual Health Benefit Plans in Maryland

• List - Carriers with Approved Small Group Health Benefit Plans in Maryland

• List - Carriers with Approved Individual Short-Term Medical Plans in Maryland

• List - Carriers with Approved Individual Dental Policies

• List - Carriers with Approved Stand-Alone Dental Plans Certified for Sale Outside the Exchange in Maryland

  See Also

  Plan B Morning-After Pill | How Plan B Works & Side EffectsMaryland Is 2022’s 5th Best State for Health Care, According to Study - The MoCo Show6 Reasons Healthcare Is So Expensive in the U.S.California could become first US state to offer universal healthcare to residents

• ​​​​Click HERE for Dental Related Information

• ​​Consumer Advisory:What Consumers Need to Know About Discount Medical and Discount Drug Plans​​
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• ​​Essential Health Benefits-Refer to this chart if you have an individual insurance policy or if you receive your insurance from an employer with 50 or fewer employees.
• Maryland Mandated Benefits-Refer to this chart if you receive your plan through an employer with more than 50 employees or if you are in a grandfathered plan.

• Transparency in Coverage: Did you know you can find out what your health insurance will pay before a procedure?​
• How to purchase health insurance if you are an immigrant without legal immigration status​
• ​​Consumer Guide: Health-Related Resources​
• ​​FAQ: Credit Insurance
• NOTICE: New Federal RegulationsregardingShort Term Limited Duration Insurance

• Essential Health Benefits
  Refer to this chart if you have an individual insurance policy or if you receive your insurance from an employer with 50 or fewer employees.

• Maryland Mandated Benefits
  Refer to this chart if you receive your plan through an employer with more than 50 employees or if you are in a grandfathered plan.

• ClickHEREfor information on Consolidated Omnibus Budget Reconciliation Act (COBRA)

• Information about habilitative services

• Maryland's Senior Health Insurance Assistance Program​
  

  See Also

  Is there still a penalty for being uninsured? | healthinsurance.org

• Consolidated Omnibus Budget Reconciliation Act (COBRA) and Continuation of Coverage Rights​

• Comparing th​e Quality of Maryland Health Benefit Plans​
  Produced annually by the Maryland Health Care Commission, the report provides consumers with information on the performance of Maryland's health benefit plans, including how well they provide important clinical services and how enrollees feel about their plans.

• Maryland Health Care Commission Hospital Guide​
  Visit the Maryland Health Care Commission for a guide to Maryland hospitals.

• HIPAA​
  Title I of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects health insurance coverage for workers and their families when they change or lose their jobs. The HIPAA website contains information for consumers, state regulators, large and small employers, and self-funded nonfederal governmental plans.

• Maryland Life & Health Insurance Guaranty Corporation

• ​Maryland Medical Assistance for Families
  Medical Assistance for Families will provide comprehensive health care to many more parents and other family members caring for children. Eligibility depends on family size and income.

• Employed Individuals with Disabilities Program (EID)
  Extends Medical Assistance health benefits to working Marylanders with disabilities

• ​Information on Evergreen Health Inc. receivership

• ​​​Long-Term Care Insurance

​​​Maryland's official health insurance marketplace is Maryland Health Connection, where Marylanders can compare and enroll in private health plans, Medicaid, or dental coverage. Maryland Health Connection is also the only place to qualify for financial help to make coverage more affordable.

If you have questions about your application, call Maryland Health Connection at 1-855-642-8572 (TTY: 1-855-642-8573) or find free, in-person help near you. You can also download the free Enroll MHC mobile app to shop, enroll, find local help, view notices and upload documents.

• En español: Inscríbase en línea a MarylandHealthConnection.gov/espanol
• How to enroll through Maryland Health Connection
• See if you may qualify for financial help with your insurance
• FAQ from the MD Health Connection
• FAQ General Health Insurance and the ACA
• Appealing a decision made by Maryland Health Connection

• ​​​​Medicare Supplement FAQs
• Carriers with Approved Individual Medicare Supplement Policies in Maryland​
  
• Monthly Premiums for Medicare Supplement Policies
• Other Related Information
• Medicare Supplement in Maryland
  
• View webinarhere
  
• View presentation here
  

• Mental Health Parity: Video​​​​
• MHPAEA Enforcement Actions
• Key Terms
• Frequently Asked Questions
• Consumer Advisory: Getting started with help for mental health problems
  

  Aviso para clientes: cómo empezar a recibir ayuda para los trastornos de salud mental y por consumo de sustancias​

• ​Maryland's Opioid Crisis and how the Maryland Insurance Administration Can Help Presentation​
• Consumer Guide to Understanding Your Health Insurance coverage for Mental Health & Substance Use Conditions
  Guía Del Consumidor Para Comprender La Cobertura Del Seguro De Salud Para La Salud Mental Y Condiciones De ConsumerDe Substancias
  
• Navigating Private Health Insurance Coverage for Mental Health and Substance Use Disorder Emergencies
• Mental Health Parity and Addiction Equity Act Resource GuideandEquitable Insurance Coverage for Mental Health and Drug Treatment, publications of the University of Maryland Carey School of Law
• Federal Information regarding Mental Health Parity
  This provides information from the U.S. Department of Labor regarding certain federal regulation of consumer health plans, including HIPAA and COBRA.​​

​​​Shopping for Health Insurance

• NEW Health Insurance Tips
  Consejos sobre seguros médicos
  건강보험팁
• NEW Before You Buy that "Low Cost" Health Insurance: Know What You're Buying
• Consumer Advisory: Know The Details When You Shop for Health Insurance Coverage
• Need help shopping for coverage? You may find the NAIC's Health Insurance Shopping Tooluseful
• FAQ: Health Insurance Rates and the Review Process
• What to Ask When Shopping for Health Insurance
  Qué preguntar al comprar un sequromédico

Health Insurance Options

• Health Insurance Options
• Consumer Advisory: Is a Short-Term Medical Plan for You?
• Dependent Health Coverage Up to Age 26
• What Consume​rs Need to Know About Discount Medical and Discount Drug Plans​

Understanding Your Health Insurance

• NEW Consumer Guide: Using Your Health Plan
  Guía Del Consumidor Para Utilizar El Plan De Salud
• Consumer Advisory: Request to See an Out-of-Network Provider
  NEW Asesoramiento al consumidor: solicitud para consultar a un proveedor fuera de la red
• Consumer Advisory:Understanding Your Health Insurance Coverage
• A Consumer Guide to Understanding Your Health Insurance Costs
  Guía Del Consumidor Sobre Comprender De Los Costos De Su Seguro De Salud
  건강보험 비용 이해에 대한 소비자 가이드
• Request for confidential communications form
  FORMULARIO DE SOLICITUD DE COMUNICACIÓN CONFIDENCIAL

Habilitative Services

• Parents' Guide to Habilitative Services​
  Guía de los padres a los servicios de habilitación​
  
• Questions to Ask Your Health Insurance Company or HMO About Your Child's Access to Habilitative Services Benefits

Claims

• Your Rights When Your Health Insurer Will Not Pay For Health Care Services
  Sus Derechos Cuando Su Seguro De Salud No Pagará Por Los Servicios De Atención Médica
• Consumer Advisory: Know Before You Go: Understand Your Financial Responsibility Before Seeing A Health Care Professional
• Frequently Asked Questions to Help You Understand Your Health Insurance Coverage and the Claim Process
  ​Preguntas Frecuentes Para Ayudarle A Comprender Su Cobertura De Sequro Médico Y El Proceso De Reclamos
  의료보험 적용과 청구 과정의 이해를 돕는 흔한 질문
• Pre-Authorization Form - Information to Assist with Claims
• NEW Consumer Advisory: Appealing a Denial of Services

Health Care Bills

• Understanding Medical Necessity
  Factures de la Atención Médica:¿Quées una necesidad Médica?
  
• Codes and Claims
• Filing Health Insurance Claims
  Factures de la Atención Médica: Cómo Presentar Reclamaciones del SeguroMédico
  
• How to Appeal A Denied Claim
  Factures de la Atención Médica: Cómo Apelar una Reclamación Denegada​
  
• Explanation ofBenefits

• ​​Affordable Care Act (ACA) Proposed Premium Rates for 2024Public Hearing Notice​:​ July 19, 2023
  View Public Hearing videohere​.
  Comments: Maryland Hospital Association​​

• Frequently Asked Questions: Health Insurance Rates and the Maryland Insurance Administration's Rate Review Process
  

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• ​NEWAppealing ADenial of Services:Video
  Apelación a una denegación de servicios​
  서비스 거부에 대한 이의 제기​
  
• NEWMedical Necessity and Emergency Appeals:Video
  Necesidad Médica y Apelaciones de Em​ergencia
  의료적필요및응급이의제기​​
  
• NEWYour Rights When Your Health Insurer Will Not Pay for Health Care Services:Video
  Sus Derechos Cuando Su Seguro De Salud No Pagará Por Los Servicios De Atención Médica​
  귀하의 건강 보험사가 의료 서비스 비용을 지불하지 않을 때 귀하의 권리
  
• NEW Healthcare Services Denial: Video
  Denegacionesde Servicios de Salud​
  ​의료서비스거부
• NEWUnderstanding Your Health Insurance Costs:Video
  
• ​Mental Health Parity: Video​​
  
• Provider Networks: Video​​​
• ​Health Care Bills: Filing Health Insurance Claims: Video​
  Factures de la Atención Médica: Cómo Presentar Reclamaciones del Seguro Médico: Video
  
• Health Care Bills: What is an Explanation of Benefits? Video
  Facturas De La AtenciónMédica: Que es unaExplicación de Beneficios? Video
  
• Health Care Bills: Codes and Claims:Video​​
  
• Webinar: Annuities 101: Video
• Health Insurance for Young Adults: Video​
  Seguro Médico para Adultos Jóvenes
• Understanding Your Health Insurance Coverage: Video
  
• Understanding Your Rights - Health Insurance Claims Process: Video​
• Living in Baltimore Greater Baltimore Community Housing Resource Board Radio Show Heatlth Insurance and Access Study- Interview
• Understanding Your Health Insurance Coverage: Webinar
• Medicare Supplement Insurance in Maryland: Webinar
• Understanding your Health Insurance Costs and terms used in policy: Video
• Simplifying Disability Insurance: Video
• Understanding Provider Networks: Video
• Understandingthe Explanation of Benefits summary from your provider: Video
• Understanding how to appeal a health care service denial: Video
  Apelar una decisión de servicio médico: Video
  건강보험사의 결정에 항소하기: 동영상
• The LIfe and Health unit is here to help: Video
• The Life and Health Complaints Unit May be Able to Help: Video