Notice: Marylanders can enroll in 2020 and 2021 health plans through Dec. 15, 2020. The application is available daily 5 a.m.-1 a.m.

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Notice: Marylanders can enroll in 2020 and 2021 health plans through Dec. 15, 2020. The application is available daily 5 a.m.-1 a.m.

Frequently Asked Questions

Frequently Asked Questions

Frequently Asked Questions

Frequently Asked Questions

Frequently Asked Questions

Eligibility


Am I eligible for insurance through Maryland Health Connection?

To be eligible for health insurance through Maryland Health Connection, you must:

  1. Live in Maryland.
  2. Be a U.S. citizen or be lawfully present.
  3. Not be incarcerated, except if you are incarcerated pending disposition.

Am I eligible for Medicaid?

You may be eligible for Medicaid now, even if you weren’t in the past. The best way to know if you’re eligible for Medicaid is to apply. Your child or a member of your household may be eligible for Medicaid even if you’re not.

What is the age limit for keeping my child on my private plan?

A child may stay on a parent’s plan until the end of the year in which the child turns 26. Children can join or remain on a parent's plan even if they are:

  • Married
  • Not living with their parents
  • Attending school
  • Not financially dependent on their parents
  • Eligible to enroll in their employer’s plan

Am I eligible to buy a health plan through Maryland Health Connection if my employer offers insurance?

You can purchase a private health plan through Maryland Health Connection, but you will only be eligible for financial assistance to lower the cost of coverage if your employer coverage is considered to not be affordable or if the coverage offered by your employer doesn’t meet some basic standards, known as providing minimum value.

Employer coverage is considered affordable if the cost you pay annually for employee-only coverage is no greater than 9.78 percent of annual household income.

Employer coverage provides minimum value if it covers 60 percent of health care costs on average. Your employer should be able to tell you if your plan meets this standard.

What is COBRA and can I shop for health coverage on Maryland Health Connection instead?

After a job loss or reduction in hours, your company may offer you coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). This is an opportunity to continue your current health coverage for typically up to 18 months at an increased personal cost, since you will be paying the portion your employer used to pay.

If you already have enrolled in coverage through COBRA, you must either wait for open enrollment in the fall or wait for your COBRA benefits to expire before you can enroll through a special enrollment period with Maryland Health Connection.

If you have not yet enrolled in COBRA, you can estimate the cost and benefits of Maryland Health Connection coverage to compare with that of COBRA. Use our Get an Estimate tool to understand your options before making a decision.

Can I appeal a decision made by Maryland Health Connection?

If you disagree with a decision made by Maryland Health Connection, you may request a case review. Maryland Health Connection will review your information and the decision to make sure it is correct. If the case review shows that the decision is incorrect, Maryland Health Connection will fix it.

If you are still dissatisfied after the case review, you may request a hearing before the Office of Administrative Hearings. If you have any questions about this information, contact the Call Center at 1-855-642-8572. Deaf and hard of hearing use Relay.

More information about appeals.

Enrollment


When can I enroll?

Marylanders can apply during open enrollment, Nov. 1–Dec. 15. Coverage starts Jan. 1.

You can enroll in health coverage any time of year if you qualify for Medicaid, the Maryland Children's Health Program (MCHP) or MCHP Premium.

You can enroll or change plans if you’ve recently experienced a certain life event, such as becoming pregnant or losing other health coverage. Learn more about life events and how you may qualify to enroll.

How do I enroll?

You can apply for coverage and financial help in any of the following ways:
1) Online – Create an account,complete your application, choose a plan and enroll online.
2) In Person – Complete your application in person with free, local help.
3) Phone – Call 1-855-642-8572. Deaf and hard of hearing use Relay service. Help is available in more than 200 languages.
4) Mobile App – Download our free mobile app, Enroll MHC, from the Apple Store (iPhone) or the Google Play Store (Android) to apply from your phone.

What documents do I need to apply?

When you apply for coverage, you’ll need to provide this information about yourself and each member of your household who is enrolling:

  • Birthdates
  • Social Security Numbers (or document numbers for legal immigrants)
  • Citizenship or immigration status
  • Tax returns for previous years
  • Employer and income info (pay stubs, W-2 forms)
  • Policy numbers for any current health insurance and information about employer-sponsored coverage you or someone in your household is eligible for.

When does my coverage begin?

If you apply for a health plan during the open enrollment period Nov. 1 to Dec.15, your coverage starts Jan. 1.

If you are eligible for Medicaid, MCHP, or MCHP Premium, your coverage begins on the first day of the month that you applied. For example, if you apply on Dec. 18 and are found eligible, your coverage will be considered effective as of Dec. 1.
You may also be able to get help with medical bills that you incurred up to 3 months before you applied. Applicants who need retroactive coverage and did not select this option during online enrollment should contact their local health department or department of social services.

If you enroll in or change your plan during a special enrollment period, in most cases, between the 1st and the 15th of the month, your coverage will begin on the 1st of the following month. If you report your new plan selection between the 16th and the last day of a month, your coverage will begin on the 1st of the next following month. For example, if you select your plan July 16, your coverage will begin Sept. 1.

For some life events, your coverage may be available sooner.

Can I purchase a plan directly from the health insurance company?

You can purchase a plan directly from an insurance company, but you will not be eligible for any financial assistance.

Who should be the primary applicant when I apply?

In most cases, when you apply for coverage, the account holder / primary applicant should be the household member you want as the contract holder with your insurance company. Some things to consider:

  • The primary applicant must be at least 18 years old. If you are seeking coverage only for a dependent child under 17, an adult must be listed as primary, even if the adult is not seeking coverage. If you have more than one dependent (for example, you are a single parent seeking coverage for each of your 3 children but not yourself), complete a separate application for each child.
  • If you expect one member of your household to end their coverage within the year (such as becoming eligible for Medicare, or enrolling through an employer), make another adult the primary applicant.
  • If your household has mixed immigration status, make the adult who is a U.S. citizen or lawfully present the primary applicant, even if that person is not seeking coverage.

Financial Help


Do I qualify for financial help?

When you apply through Maryland Health Connection, you’ll find out if you qualify for financial help or for free coverage through Medicaid.

You may qualify for different types of financial help depending on your:

  • income
  • household size
  • age
  • county of residence
Use the Get an Estimate tool and answer a few easy questions to see if you may qualify for financial help.

Do I qualify for Medicaid?

Look up your income and household size to see if you may qualify. If you’re pregnant or have a family with children, you may earn more and still qualify.

What are tax credits (Advance Premium Tax Credits)?

You can use tax credits to help pay your monthly health insurance premiums.

To be eligible for tax credits, you must enroll through Maryland Health Connection and meet certain income requirements.

You are not eligible for tax credits if you are eligible for Medicaid or have access to affordable coverage through your job.

Find out more about tax credits.

What are cost-sharing reductions?

You can use cost-sharing reduction credits to help pay your out-of-pocket costs such as copays or deductibles.

To be eligible for cost-sharing reductions, you must enroll through Maryland Health Connection and select a Silver plan.

Learn more about cost-sharing reductions.

What income should I include on an application for financial help?

When you apply for financial help, you’ll need to estimate your income for the year you want health coverage to see if you qualify for lower costs. You can quickly calculate your income with one of these tools:

Health Plans


What do plans cover?

All plans through Maryland Health Connection must cover preventive services 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. Read more about preventive services for adults, women and children.

Is my doctor in my health insurance plan?

You will pay the lowest costs for services when you see a doctor or provider in your plan’s network.

Call your doctor’s office to ask if he or she accepts your insurance, check with your insurance company, or use the doctor search tool.

Health plans are categorized as Bronze, Silver, Gold, or Catastrophic. What does this mean?

The Platinum, Gold, Silver, and Bronze plan categories cover different percentages of your medical expenses. These major types of coverage are designed to make it easier for you to compare plans. Health insurance plans that cover more of your expenses when you receive health care services – for example, when you visit the doctor or go to the hospital – will typically have a higher monthly premium.
Plan Metal Levels

Can I buy dental insurance?

You can buy a dental-only plan or a health plan that includes dental on Maryland Health Connection during open enrollment Nov. 1–Dec. 15. Certain life events qualify you to enroll in a dental plan outside of open enrollment.

Manage My Account


Who is included in my household?

Generally, your household includes the people you put on your tax form: you, your spouse, and any children or relatives you financially support. Learn more about dependents and who to include.

What documents can I use to verify information in my application?

You may have to provide documentation that can verify your information on your application such as: income, identity, residency, Social Security number, citizenship or immigration status.

If you don’t have the requested information, you may submit a written statement using one of these affidavits for different situations including: If you have no income, or income from self-employment.

Application Affidavits:
Fluctuating Income
Self-employment Income
Social Security Income
Other Income
No Income
Exemption from Obtaining a SSN
Residency
Non-incarceration

How do I reset my password?

Click Forgot Your User ID or Password on the login screen. If you do not have an email address or cell number associated with your account or have forgotten both your user ID and email call us toll-free at 1-855-642-8572. Deaf and hard of hearing use Relay.

How do I cancel my plan?

To cancel your health plan or Medicaid coverage, log into your account at and use the End My Current Coverage link.

Request cancellation by the last day of the month you want your coverage to end.

Get help ending your coverage.

What changes do I need to report?

It’s important to update your information right away if you’ve had changes in your household or income, like pregnancy, marriage or job loss, to be sure you are receiving the right coverage and financial help. See the full list of changes to report.

Medicaid


What is Medicaid and how do I find out if I’m eligible?

Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. You can enroll in Medicaid any time of year.

You may be eligible for Medicaid now, even if you weren’t in the past. The best way to know if you’re eligible for Medicaid is to apply. Your child or a member of your household may be eligible for Medicaid even if you’re not.

If you are eligible for one of these programs, enroll online at MarylandHealthConnection.gov or get help enrolling.

When can I enroll in Medicaid?

Apply for Medicaid at any time.

How do I enroll in or change my Medicaid Managed Care Organization (MCO)?

If you are enrolling in Medicaid for the first time or if the state automatically assigned you to an MCO, you may change your MCO one time within 90 days. You may change MCOs for any reason within the first 90 days of initial enrollment.

If you do not change within 90 days, you must remain with your MCO for 12 months before you can change again. You can change your Medicaid MCO once a year.

You also may change MCOs in select circumstances, such as combining all household members or children into the same MCO, or if you moved and your current MCO does not provide service in the county where you now live.

If I’m enrolled in Medicaid, which plans can I choose?

In Maryland’s HealthChoice program, health care services are provided through managed health care organizations, called MCOs. Use the chart to help pick your MCO.

If you do not pick an MCO within 28 days, you will be automatically assigned to one.

Ask your doctors which MCOs they accept, or use the MCO provider search tool.

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