July 30, 2025

Big changes are coming in 2026.
We are here to help.

Starting next year, federal rules will change health insurance in Maryland. We are here to help you understand what’s happening and what you can do to stay covered and save money.

4 things to know right now:

1.  Use Your Coverage. Your 2025 Plan Is Still Good!

If you have health insurance through Maryland Health Connection, your current 2025 plan hasn’t changed. Use your benefits through the end of the year.

Now is a great time to:

• Schedule your free annual wellness checkup

• Get care for health needs you’ve been putting off

• Use your plan before any changes happen

2. Plan for higher costs

The extra savings (enhanced premium tax credits) funded by the federal government will probably end this year.

That means costs will go up in 2026.

But don’t worry - we’ll help you:

• Compare plans

• Find one that fits your budget

• Connect with free help

3. Catch Up on Taxes Now

Don’t lose your coverage! Some people could lose their coverage if they did not file their taxes after getting financial help with payments.

 Here’s what you can do:

• File your taxes if you haven’t yet (especially if you received premium tax credits in 2024. File your 2024 return and IRS Form 8962 to stay eligible for savings in 2026)

• Look out for messages from Maryland Health Connection during open enrollment. We’ll let you know when you can explore 2026 plans or if we need documents for your application.

4. Some People May Need to Send In Extra Info

We may need to check your income again during Open Enrollment. If we do, we’ll send you a message.

Be sure to check your online account so you don’t miss anything.

Need Help?

Maryland Health Connection remains committed to helping Marylanders get covered. We’re here to help - and we’ll guide you every step of the way.

Free expert assistance is available, and there are many ways you can get free help:

• Talk to a trained expert in your area, for free!

• Call us at 855-642-8572. Deaf and hard of hearing use Relay.

• If you had help enrolling with a broker, contact your broker for assistance.

Stay Informed. Stay Covered.

We know these changes can be confusing. But you’re not alone. As your trusted local resource, we’ll make sure you have the facts, the tools, and the support to stay covered and stay healthy.

Find an event in your area. You can also sign up for text alerts or email notifications to stay updated with the latest news and updates.

Open enrollment begins November 1, 2025.

Interested in finding a health plan? Congrats! Picking a health plan can be complicated. Before diving in, here are some questions you should consider.

What type of plan is it?

Maryland Health Connection offers private health plans from insurance companies you’ll recognize, like CareFirst and Kaiser Permanente. All plans have been certified by Maryland Health Connection to meet certain standards and offer core health benefits. These health plans cover at least 60 percent of your annual medical costs.

All plans sold through Maryland Health Connection cover the same benefits:

• Doctor visits

• Hospitalization

• Emergency care

• Maternity and newborn care

• Pediatric care, including dental and vision

• Prescription drugs

• Laboratory tests

• Mental health care

• Substance use disorder treatment

and offer free preventative services such as checkups, vaccinations, blood pressure and diabetes screenings, and more. Some plans offer additional benefits.

How much is the premium?

The premium is the monthly amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly or yearly. Depending on the type of plan and the amount of coverage you choose, the cost can vary drastically.

How much is the deductible?

The deductible is the amount you owe for covered health care services before your health insurance or plan begins to pay. Generally, plans with lower monthly premiums have higher deductibles. Plans with higher monthly premiums usually have lower deductibles. With a $1,000 deductible, for example, you pay the first $1,000 of covered services. After you pay your deductible, you usually pay only a copayment or coinsurance for covered services. Your insurance company pays the rest.

Are my preferred doctors and hospitals in my network?

If you have favorite doctors or hospitals, it is always a good idea to call and ask which insurance plans they accept. If they do not take your insurance, they are considered out of network. Some plans cover a percentage toward out-of-network providers, and some do not cover them at all.

Do I qualify for financial help?

This past year, the average Maryland Health Connection customer buying private health insurance saved $388 a month on their monthly premium. That’s money you can save or use to cover other important costs in your life.

Many Marylanders ages 18-37 can get special discounts for 2025 health plans — on top of other savings available through Maryland Health Connection. For example, a 27-year-old living in Baltimore City who makes $50,000 a year will pay a monthly premium of $171 for the lowest cost gold plan. A 27-year-old living in Baltimore City who makes $25,000 a year will pay $0 a month for the lowest cost silver plan.

Use this tool to calculate your income and see if you qualify.

Medicaid and MCHP provide health coverage free or at a low cost to eligible individuals.

Need help or have questions?

Hundreds of trained experts are available throughout Maryland to help you apply and enroll. Find help near you.

Now that you have a health plan through Maryland Health Connection, you may be wondering, “what are my next steps?” To help you understand your benefits, we are breaking down the top 5 questions about your health coverage.

1. Who do I contact for information about my payments?

If you have questions about your bill, contact your insurance company directly:

• Aetna Health: 844-365-7373 (TTY: 711)

• CareFirst BlueCross BlueShield: 855-444-3121

• Delta Dental: 800-471-0275 (PPO) or 800-471-9925 (Alpha DC-USA)

• Dominion Dental: 888-518-5338

• Kaiser Permanente: 866-475-3920

• United Healthcare: 800-691-0021

• Wellpoint: 833-707-0867 (TTY 711)

2. How much do I have to pay for my plan?

In addition to your monthly bill, or premium, you may have to pay out-of-pocket costs when you use certain medical services. Here are some common terms.

• Deductible: The amount you owe for health care services before your health insurance begins to pay.
• Coinsurance: Your share of the costs of a covered health care service. This is calculated as a percent (for example, 20%) of the allowed amount for the service.
• Copayment (copay): A set amount you pay for a covered health care service. For example, your copayment to see your primary care provider when you’re sick may be $15.

3. What is a network and how can I find out if my doctor is in a health plan’s network?

A network is the list of the doctors, health care providers, and hospitals that a health plan has contracted with to provide medical care to its members.

To find a doctor who participates in your health plan or Managed Care Organization, visit our Find a Provider tool.

4. How do I update my information about my household or income?

After you enroll, it’s important to tell Maryland Health Connection right away if you’ve had changes in your household or income to be sure you are receiving the right coverage and financial help. You can update your information by logging into your account and reporting a change. You can also call 855-642-8572 or find free in-person help.

5. What benefits are covered by qualified health plans?

All plans offered through Maryland Health Connection provide the same set of essential health benefits, which include:

• Doctor visits
• Emergency care
• Hospitalization
• Laboratory tests
• Maternity and newborn care
• Mental and behavioral health care (includes counseling and psychotherapy)
• Pediatric care
• Prescriptions
• Preventive and wellness management (wellness visits, shots and screenings)
• Rehabilitative services
• Substance use disorder treatment (includes counseling and psychotherapy)

Mental Health Awareness Month is a time to put self-care first, to build up strength to overcome hard times, and to extend kindness and support to those around us. It's also a month to educate ourselves, to push for change, and to create communities where mental health is considered and valued.

Mental Health by the Numbers

Many people in the U.S. are affected by mental illness each year. It’s important to know how common mental illness is, so we can understand its physical, social and financial impact — and so we can show that no one is alone. These numbers are also powerful tools for raising public awareness, and removing negative thoughts about people with mental illnesses (National Alliance on Mental Illness):

• 1 in 5 U.S. adults experience mental illness each year

• 1 in 20 U.S. adults experience serious mental illness each year

• 1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year

• 50% of all lifetime mental illness begins by age 14, and 75% by age 24

• Suicide is the 2nd leading cause of death among people aged 10-14

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org to reach the 988 Suicide & Crisis Lifeline.

Raising awareness for mental health has never been more important and is necessary for increased understanding, aiding early intervention, having better self-management skills, building up support systems, using our voices for change, and stopping crises.

Check out our events page to find local mental health & wellness events happening this month throughout Maryland.

Health Coverage for Behavioral and Mental Health Services

Behavioral and mental health services are covered by all health plans offered through Maryland Health Connection.

• Behavioral health treatment including psychotherapy and counseling

• Mental and behavioral health inpatient services

• Rehabilitative and habilitative services

• Prescription drugs

• Emergency services

• Plans also cover free preventive services, including depression screenings for adults and behavioral assessments for children.

Compare plans and costs, see what financial help you may qualify for, and enroll. Download the free Enroll MHC mobile app (via Apple or Android) to apply or find help from your phone or tablet.

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.

Good news for young adults in Maryland who need health coverage!

Young adults ages 18-37 are now eligible for additional discounts through the young adult subsidy program. Previously, the state program only provided savings for adults through age 34. The savings are combined with those already available through the marketplace.

Monthly premiums dropped by about $40 on average for more than 33,000 young adults who qualified in 2023, in addition to other savings. The subsidy works on a sliding scale for those with the youngest and lowest income young adults paying the least.

The program's goal is to encourage more young adults in Maryland to enroll in health coverage. Young adult enrollments surpassed 50,000 in 2022 - 7% more than a year earlier.

To find out how much you can save, use the Get an Estimate tool beginning in early October 2023. The amount of financial help you receive will vary based on your income, family size and ZIP code. Examples of discounts for 2024 are:

If you are age 25 in Baltimore City with a lowest cost gold plan and making $27,500, your new monthly payment is $0.
If you are age 28 in Allegany County with a lowest cost gold plan and making $33,000, your new monthly payment is $5.53.
If you are age 30 in Prince George’s County with a lowest cost gold plan and making $38,500, your new monthly payment is $57.14.

Open enrollment begins Nov. 1, 2023 and runs through Jan. 15, 2024.

In the past, eligibility for Medicaid required pregnant individuals to be residing in Maryland lawfully and have certain immigration statuses. 

Thanks to the Healthy Babies Equity Act, effective July 1, 2023, noncitizen pregnant individuals in Maryland of any immigration status will now have access to Medicaid coverage.

The benefit will provide coverage during pregnancy and for four months after the baby is born. Medicaid may help pay for health care you had three months before you applied. 

Medicaid will pay for many different services, not just those related to the pregnancy.

An individual may qualify for this coverage if they meet the following criteria: 

• Noncitizen (e.g., undocumented) who does not qualify for  Medicaid solely due to immigration status;
• Maryland resident; 
• Currently or recently pregnant;
• Income up to 250% federal poverty level (FPL).

The best way to know if you can get Medicaid is to apply. 

Starting July 1, 2023, you can apply:

• Online at MarylandHealthConnection.gov 
• By using the app: Apple or Android​
• By calling 1-855-642-8572, deaf and hard of hearing use Relay.​
• In person at a local health department 
• In person at a local Health and Human Services Office 

For more information, visit:

https://health.maryland.gov/mmcp/medicaid-mch-initiatives/Pages/healthybabies.aspx 

Thanks to a new law this year, many more families can get financial help to purchase a high-quality health plan on Maryland Health Connection.

In the past, your family was not able to get financial help if your job offered health coverage.

Some employers, like small businesses, offer health care. However, it can be too expensive to get coverage through the employer for the entire family. But because your job offered coverage, your family was not eligible for financial help through Maryland Health Connection.

Beginning Jan. 1, 2023, family members will be able to receive financial help even if you have affordable employee-only health coverage. Affordability for family members will now be based on the cost an employee has to pay for family coverage.

In Maryland, 53,000 individuals were affected by what was called the family glitch.

That means that some people who haven’t qualified for financial help in the past can get help to lower the cost of premiums. It’s worth checking this year to see if your family can save more on health insurance. If you have job-based coverage, but haven’t been able to afford health coverage for your family — get an estimate through Maryland Health Connection. See if your family can save on coverage for 2023.

Do I Need Health Insurance?
Can you put a price on good health? A health insurance plan can protect not only your health, but also your financial future. Understanding and paying for health insurance can be a bit scary. Sometimes the young and healthy don’t think that health insurance is necessary and is too expensive. Maryland Health Connection is the only place where you can get help paying for insurance.

Health Insurance is too expensive!
Access to quality primary care is important and can prevent serious health issues. A plan with Maryland Health Connection covers your yearly checkup with your provider. It also covers vaccinations and tests for illnesses like cancer and diabetes. These services are free with your health plan.

Doctors have the right to deny patients that are uninsured even if you are willing to pay out of pocket. Maryland Health Connection is the only place to get financial help to pay for your insurance plan. Without health insurance the average emergency room visit in Maryland is $2200. Protect yourself from unexpected medical costs with health insurance. The average Maryland Health Connection customer saves $300/month.

Health Insurance is too complicated!
Health insurance is important because it can be there for you, for the big things, like a trip to the ER and for the little ones like medications, doctor visits. Every plan covers primary care visits, emergency care, mental health services, and generic prescriptions that allows you to get the care you need. This also means you’ll be paying less out-of-pocket for things.

When it comes to health insurance there are certain terms that can be confusing such as:

Premium - amount that you pay to keep your health insurance active.
Copayment - fixed dollar amount for covered services.
Deductibles - the amount you owe for covered services before your plan begins to pay.

At Maryland Health Connection we can help you through the process of choosing the right health plan to fit your needs. Depending on your health care needs, you might need a plan that has a lower monthly bill or you might want a plan where the monthly bill is higher, but it starts paying for services sooner.

Do some research. Here’s some quick links to help you think about your coverage options:

Choose a plan

Use your coverage

And, best of all, Maryland Health Connection offers free help to understand what will work best for you and your budget.

As you get outdoors and enjoy the hot weather, you may experience seasonal allergies. Don’t let your sneezing, congestion, and watery eyes prevent you from enjoying summer.

1. Talk to a healthcare provider on how to treat your allergies
   If you are experiencing flu symptoms and don't know what to do, the best thing to do is reach out to your doctor. Maryland Health Connection plans cover your health care provider visits, prescriptions, laboratory tests, and more. When meeting with your doctor, discuss possible treatments to help with your seasonal allergies. You can also ask to take an allergy test and see what allergies you might have and what symptoms come with each.
2. Take over-the-counter medication
   Go to your local pharmacy for any over-the-counter medications that can help with your allergies. The most common over-the-counter medications for allergies are Zyrtec, Claritin, Allega, Xyzal, and Benadryl . If you are not sure which medication to get, ask your doctor.
3. Keep your indoor space clean
   Keeping your indoor space clean is key to preventing allergy triggers. Make sure to keep any surface in your house clean using disinfectants. Keep your windows and doors shut to help prevent pollen from getting into your home. When coming back inside your home, try to take a shower to help rinse off the pollen particles off your body and hair. After the shower, wash your clothes to remove outdoor residue.
4. Pay attention to the weather in your area
   Before heading outside it’s always best to check the weather. You want to make sure the pollen counts are low and that it's not dry and windy. These weather conditions can trigger your allergies.