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Balance Billing

When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services.

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Appeal

A request for your health insurer or plan to review a decision or a grievance again. Learn more here about Maryland Health Connection's appeals process.

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Annual Limit

A cap on the benefits your insurance company will pay in a year while you’re enrolled in a particular health insurance plan. Caps are sometimes placed on particular services such as prescriptions or hospitalizations. Annual limits may be placed on the dollar amount of covered services or on the number …

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Annual Household Income

The total income for a family in a calendar year. Use our calculator to determine your household income.

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Allowed Amount

Maximum amount on which payment is based for covered health care services. This may be called “eligible expense,” “payment allowance" or "negotiated rate." If your provider charges more than the allowed amount, you may have to pay the difference. (See Balance Billing.)

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Affordable Care Act

The 2010 Patient Protection and Affordable Care Act (ACA) requires states to establish and operate a health insurance exchange by 2014, or to participate in a federal exchange. Maryland opted to create Maryland Health Connection, a marketplace for Marylanders to shop for and enroll in health plans.

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