A few new Maryland laws go into effect January 1st, 2024, that expand health coverage for consumers enrolled in Medicaid and private health plans. Here’s what you need to know.

Gender Affirming Care

Gender affirming care is now part of Medicaid coverage. Now Medicaid covers medically needed care that upholds the safety, dignity and respect of transgender and gender expansive people. Gender affirming care is for those who need medical care to make their body match their lived gender. Services include:

• Hormone therapy and lab testing
• Voice surgery, therapy and lessons
• Hair removal and transplants
• Fertility preservation services
• Facial surgery
• Top surgery
• Gender affirming surgery
• Preventative care after transition
• Revision or reversal of prior gender-affirming procedures

More info about Medicaid coverage for gender affirming care.

Coverage for biomarker testing

Biomarker testing is now covered in all private health plans. It will be covered in Medicaid beginning July 1, 2025. Biomarker testing is extremely helpful in detecting, treating, managing, and monitoring various cancers. This coverage can still be subject to cost-sharing, but may not be greater than the cost for similar coverages.

More about targeted treatments to improve survivorship.

Cost-sharing eliminated for diagnostic and supplemental breast examinations

Private health plans may no longer impose any cost-sharing for coverage of both diagnostic and supplemental breast examinations, with one exception: insurers may still subject the costs of examinations to deductible requirements for those with a high-deductible health plan.

Coverage for lung cancer screening

Private health plans are now required to cover recommended follow-up imaging for the diagnosis of lung cancer. Coverage can still be subject to cost-sharing but may not be greater than those imposed on breast cancer screening and diagnosis, and coverage can still be subject to deductible requirements for those with high-deductible health plans.

How do I know if I have a high deductible plan?

High deductible plans usually have lower monthly premiums, but you will have to pay more out-of-pocket for health care services before your insurance company starts to pay

To find out if you have a high deductible plan, you can check your plan's Summary of Benefits and Coverage (SBC) or contact your insurance company.