What has changed this year?
With health care in the headlines, here are the latest developments and what they mean for you and your coverage.
For now, here’s what you need to know:
Open enrollment for 2019 health and dental has ended. You may qualify for a special enrollment period because of a recent major life event or special circumstance, such as having a baby, getting married or losing other health coverage. If you are eligible for Medicaid or Maryland Children’s Health Program (MCHP), you can enroll any time. Beginning Jan. 1, 2020, pregnant women will be eligible for a special enrollment period.
Maryland Health Connection now offers value plans
Value plans are health plans that offer lower deductibles and useful coverage for more health care services before your deductible is met. Value plans are designed to lower your out-of-pocket costs for the health care services the majority of people use most frequently.
Pregnancy will qualify for special enrollment
Beginning Jan. 1, 2020, women who become pregnant are eligible for a special enrollment period. To qualify, they must receive certification of their pregnancy from a health care provider. They then have 90 days to apply for coverage. Coverage will be effective the first of the following month.
Maternity care provides better outcomes for both mother and baby.
Maryland Easy Enrollment Program
Uninsured Marylanders can start the health insurance enrollment process by checking an optional box on their state income tax returns between Jan. 15 and April 15, beginning in 2020 to allow Information from the state tax return to be shared with Maryland Health Connection to see if they qualify for free or low-cost coverage.
The goal of this program is to enroll uninsured Marylanders who may not realize they are eligible for free or low-cost health coverage.
New Email Requirements and Optional Security
As of October 2019, when you log into your account at Maryland Health Connection, we’ll ask you to provide and validate your email address so your account and your application are linked. We’ll send an email with a verification code. Enter the code into the screen in Maryland Health Connection, and you’re all set! If you need help, call 855-642-8572. You also may register and validate your cell number with Maryland Health Connection.
In addition to email requirements, we’ve added an additional security layer. If you opt in, we’ll send you a code by text or email each time you log into your account. This feature may be turned on or off from the Manage Account Settings page.
What will happen to an undocumented family member? Can he or she still get health coverage?
Current law states that legal residents and those with qualifying documentation are able to purchase a plan through Maryland Health Connection. We use the information you provide in your health coverage application only to determine your eligibility for tax credits and health coverage through Maryland Health Connection.
It’s important to know that you can still apply for health coverage through Maryland Health Connection, even if some of your family members do not qualify for coverage because of immigration status. Individuals who are not requesting coverage will not be asked about their immigration status.
Here’s what you should know about immigration status and who can sign up for coverage through Maryland Health Connection:
- In addition to U.S. citizens, people who are living in the United States legally can sign up for coverage through Maryland Health Connection. See our information for immigrant families(PDF) (también disponible en español) for statuses.
- Currently, only certain immigration statuses qualify an individual to receive Medicaid. In addition, under most immigration statuses, you must be lawfully present in the U.S. for five years (“the five-year bar”) before you are eligible for Medicaid. A limited number of groups (including children under 21 and lawfully residing pregnant women) are exempt from the five-year requirement.
- If you are an undocumented immigrant, you may be eligible for coverage of emergency medical services only, including labor and delivery, if you meet all other Medicaid eligibility requirements.
What is the new public charge rule and who does it affect?
The federal Department of Homeland Security (DHS) has issued new rules that allows the government to deny an individual's application for entry into the U.S. or deny an application to change their immigration status if they use public benefits, including Medicaid. Absent a legal challenge, it becomes effective Oct. 15, 2019.
Individuals can be considered a public charge if they currently use public benefits or are likely to use them in the future. The determinations are based on education and income levels, among other factors.
The new rule expands the public benefits that DHS considers in public charge determinations to include medicaid, except for anyone under age 21 and pregnant women.
The rule does NOT apply to people who receive a private health plan through Maryland Health Connection including those who get Advanced Premium Tax Credits (APTC) to help pay for their plan.
Do I still have to pay the penalty?
The short answer is no.
As of 2019, uninsured consumers will not face a fine. However, if you are filing taxes from 2018 and earlier, there could be a penalty.
For 2018, the penalty for being uninsured is 2.5% of your gross household income, or $695 per individual (whichever is higher). The maximum penalty for lack of coverage in 2018 is $2,085, uninsured consumers will not face a fine. You must report your health insurance status when you file your taxes. Learn more at www.IRS.gov.
Some people are exempt from the requirement to have coverage and do not have to pay a fee even if they remain uninsured. For example, you may be exempt if you cannot afford coverage, are facing a hardship, have a religious objection to buying insurance, are an American Indian or Alaska Native, or are incarcerated.
Individuals remain responsible for having insurance or paying the penalty for the 2017 filing season and for 2018. The IRS has announced that it will reject electronic filings of taxes for 2017 that do not claim coverage or an exemption, or include a payment of the penalty. If you’re uninsured only one or two months, you don’t have to pay the fee at all. Learn about the “short gap” exemption.
What is the new rule to expand Health Reimbursement Arrangements (HRAs)?
In June 2019, the Treasury, Labor, and Health & Human Services departments published a rule to expand the uses of health reimbursement arrangements (HRAs).
If your employer offers an HRA, ask them about your eligibility for health coverage through Maryland Health Connection.