Use Your Coverage

All health plans offered through Maryland Health Connection provide the same core benefits including:

- Doctor visits
- Hospitalization
- Emergency care
- Maternity and newborn care
- Pediatric care, including dental and vision benefits
- Prescription drugs
- Laboratory tests
- Mental health care

Substance use disorder treatment

Some plans offer more. Visit your insurance company’s website or review any information you receive in the mail for what your plan covers.

Preventive services are free

All plans through Maryland Health Connection cover preventive services. Schedule a regular checkup with your doctor. It’s covered by your plan at no cost, even if you haven’t met your yearly deductible.These services are free only when delivered by a doctor in your plan’s network.

Free preventive services for adults

- Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
- Alcohol misuse screening and counseling
- Aspirin use to prevent cardiovascular disease for men and women of certain ages
- Blood pressure screening for all adults
- Cholesterol screening for adults of certain ages or at higher risk
- Colorectal cancer screening for adults over 50
- Depression screening for adults
- Diabetes Type 2 screening for adults with high blood pressure
- Diet counseling for adults at risk for chronic disease
- HIV screening for ages 15 to 65, and other ages at increased risk
- Immunization vaccines for adults – doses, recommended ages, and recommended populations vary:

Hepatitis A
Hepatitis B
Herpes Zoster
Human Papillomavirus (HPV)
Influenza (flu shot)
Measles, Mumps, Rubella
Meningococcal
Pneumococcal
Tetanus, Diphtheria, Pertussis
Varicella (Chickenpox, Shingles)

Obesity screening and counseling for adults
Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
Syphilis screening for adults at higher risk
Tobacco use screening and cessation interventions

Free preventive services for women

Breast cancer genetic test counseling (BRCA) for women at higher risk
Breast cancer mammography screenings every 1 to 2 years for women over 40
Breast cancer chemoprevention counseling for women at higher risk
Cervical cancer screening for women age 21 and older
Chlamydia infection screening for younger women and other women at higher risk
Domestic and interpersonal violence screening and counseling for women
Gonorrhea screening for women at higher risk
HIV screening and counseling for sexually active women
Human Papillomavirus (HPV) DNA test every 3 years for women with normal cytology results 30 or older
Osteoporosis screening for women over age 60 with risk factors
Rh incompatibility screening follow-up testing for women at higher risk
Sexually transmitted infections counseling for sexually active women
Syphilis screening for women at increased risk
Wellness visits for recommended services for women under 65

Free preventive services for pregnant women or women who may become pregnant

Anemia screening on a routine basis
Breastfeeding comprehensive support and counseling from trained providers and access to breastfeeding supplies for pregnant and nursing women
Contraception – Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider, for women with reproductive capacity (not including antibortifacient drugs, which induce abortions) This does not apply to health plans sponsored by certain exempt “religious employers.” Learn more about contraceptive coverage.
Folic acid supplements for women who may become pregnant
Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
Gonorrhea screening for all women at higher risk
Hepatitis B screening for pregnant women at their first prenatal visit
Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
Syphilis screening
Expanded tobacco intervention and counseling for pregnant tobacco users
Urinary tract or other infection screening

Free preventive services for children

- Alcohol and drug use assessments for adolescents
- Autism screening for children at 18 and 24 months
- Behavioral assessments for children ages 0-11 months, 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years
- Blood pressure screening for children ages 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years
- Cervical dysplasia screening for sexually active females
- Depression screening for adolescents
- Developmental screening for children under age 3
- Dyslipidemia screening for children at higher risk of lipid disorders ages 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years
- Fluoride chemoprevention supplements for children without fluoride in their water source
- Gonorrhea preventive medication for the eyes of newborns
- Hearing screening for newborns
- Height, weight and body mass index (BMI) measurements for children ages 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years
- Hematocrit or hemoglobin screening for all children
- Hemoglobinopathies or sickle cell screening for newborns
- Hepatitis B screening for adolescents at high risk, including adolescents from countries with 2% or more Hepatitis B prevalence, and U.S.-born adolescents not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence, 11-17 years
- HIV screening for adolescents at higher risk
- Hypothyroidism screening for newborns
- Immunization vaccines for children from birth to 18 years — doses, recommended ages, and recommended populations vary:
- Diphtheria, Tetanus, Pertussis (whooping cough)
- Haemophilus Influenzae type b
- Hepatitis A
- Hepatitis B
- Human Papillomavirus
- Inactivated Poliovirus
- Influenza (flu shot)
- Measles
- Meningococcal
- Pneumococcal
- Rotavirus
- Varicella (Chickenpox)
- Iron supplements for children ages 6-12 months at risk for anemia
- Lead screening for children at risk of exposure
- Medical history for all children throughout development, ages 0-11 months, 1-4 years , 5-10 years, 11-14 years, 15-17 years
- Obesity screening and counseling
- Oral health risk assessment for young children ages 0-11 months, 1-4 years, 5-10 years
- Phenylketonuria (PKU) screening for newborns
- Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
- Tuberculin testing for children at higher risk of tuberculosis ages: 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years
- Vision screening for all children

Telehealth coverage
	CareFirst BlueCross BlueShield	Kaiser Permanente	UnitedHealthCare
Is there a free nurse advice line?
	Yes 24-hour nurse advice line (800) 535-9700	Yes 24-hour line staffed by licensed care providers (nurse or doctor) (800) 777-7904	Yes Call member services to be directed. Phone number on the back of your medical card.
What services are covered through telehealth and what is the member cost?
Primary Care and OB/GYN	Video visits are covered. Audio-only visits are covered through 12/31/20. Member cost-sharing is the same as it would be for an in-person visit.	Video and Audio visits are covered. No member cost-sharing, unless enrolled in an HSA qualified plan in which case the deductible applies.	Video visits are covered. Audio-only visits are covered but this may change if federal guidelines related to the public health emergency change. Member cost-sharing is the same as it would be for an in-person visit.
Urgent Care	Video visits are covered. Member cost-sharing is the same as it would be for an in-person visit.	Video and Audio visits are covered. No member cost-sharing, unless enrolled in an HSA qualified plan in which case the deductible applies.	Video visits are covered. Audio-only visits are covered but this may change if federal guidelines related to the public health emergency change. Member cost-sharing is the same as it would be for an in-person visit.
Behavioral Health	Video visits are covered. Audio-only visits are covered through 12/31/20. Member cost-sharing is the same as it would be for an in-person visit.	Video and Audio visits are covered. No member cost-sharing, unless enrolled in an HSA qualified plan in which case the deductible applies.	Video visits are covered. Audio-only visits are covered but this may change if federal guidelines related to the public health emergency change. Member cost-sharing is the same as it would be for an in-person visit.
Medical Specialists	Video visits are covered. Member cost-sharing is the same as it would be for an in-person visit.	No member cost-sharing, unless enrolled in an HSA qualified plan in which case the deductible applies.	Video visits are covered. Audio-only visits are covered but this may change if federal guidelines related to the public health emergency change. Member cost-sharing is the same as it would be for an in-person visit.
Where can I find more information about telehealth coverage?
Where can I find more information about telehealth coverage?	https://member.carefirst.com/members/health-wellness/video-visit.page	https://healthy.kaiserpermanente.org/maryland-virginia-washington-dc/get-care	https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/covid19-telehealth-services/covid19-telehealth-services-telehealth.html

Use Your Coverage

Use Your Coverage

Use Your Coverage

Use Your Coverage

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