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Advance Premium Tax Credit (APTC)

A tax credit that can reduce what you pay for health insurance. When you apply for coverage through Maryland Health Connection, you’ll estimate your household income to find out if you qualify for an advance payment of the premium tax credit that lowers your premium (the amount you pay each …

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Health Savings Account (HSA)-Eligible Plans

Health Savings Account (HSA)-eligible plans are a type of health plan with specific cost-sharing rules on how they cover benefits. For the most part, except for zero-cost preventive care and prescription drugs, HSA-eligible plans have cost-sharing that begins paying for care only after you have met your deductible. Also, all HSA-eligible …

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Integrated Delivery System (IDS)

IDS health insurance plans have many things in common with HMO plans. IDS plans require that you select a primary care provider to coordinate your care, do not cover services from out-of-network providers (unless in emergencies), and require referrals for most specialist visits. IDS plans are unique in that you …

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Exclusive Provider Organization (EPO)

An EPO is a type of health insurance plan where generally services are covered only if you use doctors, specialists or hospitals in the EPO’s network (except in an emergency). Members do not require referrals to see a specialist.

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Point-of-Service (POS)

A Point-of-Service (POS) plan is a type of health insurance plan where you can get medical care from both in-network and out-of-network providers. You’ll pay less if you use in-network doctors, hospitals, and other health care providers. If you have a POS plan, you’ll select a primary doctor from a …

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Preferred Provider Organization (PPO)

A PPO is a type of health insurance plan where you have the choice of getting care from in-network or out-of-network providers. You’ll pay less if you use providers in the plan’s network. If you have a PPO plan, you can visit any primary care doctor or specialist without getting …

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Retroactive Medicaid

Medicaid will pay for unpaid medical expenses for certain medical services that were incurred up to three calendar months prior to the month of the initial application, if the applicant was eligible for Medicaid during this retroactive period and their provider accepts Medicaid as payment for the services they received. …

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Immigration Status

Individuals with eligible immigration status include the following: Lawful Permanent Residents (LPR/"Green Card" Holders); Asylees; Refugees; Cuban/Haitian Entrants; Aliens paroled into the U.S. for at least a year; Aliens granted Withholding of Deportation or Withholding of Removal; Conditional Entrants Granted before April 1, 1980; Battered Spouses, Children, and Parents; Victims …

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Household

Generally, your household includes the people you put on your tax form: you, your spouse, and any children or relatives you financially support. When filling out your application, do include: Yourself; Your spouse; Your children who live with you, even if they make enough money to file a tax return …

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Authorized Representative

An authorized representative is someone who you choose to act on your behalf with the Maryland Health Connection, like a family member or other trusted person. Some authorized representatives may have legal authority to act on your behalf. Caseworkers, Navigators, Brokers, Certified Application Counselors or other Assisters are NOT authorized …

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