What benefits do health plans cover?

All qualified health plans (QHPs) through Maryland Health Connection (except Catastrophic plans) provide the same core benefits and offer free preventive services.

These essential health benefits are covered:

what do health plans cover

Where to find more details on covered health benefits

For more details on the essential benefits covered by plans through Maryland Health Connection, see a full chart here (PDF) from the Maryland Insurance Administration that describes general categories of benefits.

Plans may offer additional benefits. You should carefully review the Summary of Benefits and Coverage provided for each plan in our online application. This document provides a summary of the specific services covered by the plan and what costs may apply for each.

You can also visit your insurance company’s website or review any information mailed to you for what your plan covers. Call your insurer directly if you have questions.

Plans cover preventive care at no extra cost.

Plans through Maryland Health Connection must cover preventive services for adults, like checkups, shots and screenings, without charging a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. These services are free only when delivered by a doctor or other provider in your plan’s network.

For a total list of what health plans cover for adults, click here.

For women

Plans through Maryland Health Connection cover free screenings for illnesses such as anemia, STD and HIV, UTIs, and gestational diabetes. Health insurance plans also cover preventive services for women who are pregnant or may become pregnant such as contraception, folic acid supplements, breastfeeding support and counseling, and tobacco intervention. For a complete list of services offered to women, click here.

For children

Qualified health plans through Maryland Health Connection, as well as coverage through Medicaid or the Maryland Children’s Health Program (MCHP) must cover preventive services. These services include screenings for autism, developmental issues, hearing, vision, hepatitis or STDs, hypothyroidism for newborns, depression, lead, obesity, PKU, and more. Other services include alcohol and drug use assessments, immunization vaccines, iron supplements, and more. For a full list of preventive care for children, click here.

About Maryland Health Connection

Maryland Health Connection is Maryland’s official health insurance marketplace for individuals and families to compare plans and enroll in health and dental coverage. It’s the only place to get financial help with health insurance. See if you qualify for financial help like tax credits or Medicaid/MCHP to make health insurance more affordable.

Visit MarylandHealthConnection.gov to enroll, or download our free Enroll MHC mobile app for Android and iPhone.

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