Questions to ask before selecting a health plan

Interested in finding a health plan? Congrats! Picking a health plan can be complicated. Before diving in, here are some photo of checklistquestions you should consider.

What type of plan is it?

Maryland Health Connection offers private health plans from insurance companies you’ll recognize, like CareFirst and Kaiser Permanente. All plans have been certified by Maryland Health Connection to meet certain standards and offer core health benefits.These health plans cover at least 60 percent of your annual medical costs.

All plans sold through Maryland Health Connection cover the same benefits:

  • Doctor visits
  • Hospitalization
  • Emergency care
  • Maternity and newborn care
  • Pediatric care, including dental and vision
  • Prescription drugs
  • Laboratory tests
  • Mental health care
  • Substance use disorder treatment

and offer free preventative services such as checkups, vaccinations, blood pressure and diabetes screenings, and more. Some plans offer additional benefits.

How much is the premium?

The premium is the monthly amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly or yearly. Depending on the type of plan and the amount of coverage you choose, the cost can vary drastically.

How much is the deductible?

The deductible is the amount you owe for covered health care services before your health insurance or plan begins to pay. Generally, plans with lower monthly premiums have higher deductibles. Plans with higher monthly premiums usually have lower deductibles. With a $1,000 deductible, for example, you pay the first $1,000 of covered services. After you pay your deductible, you usually pay only a copayment or coinsurance for covered services. Your insurance company pays the rest.

Are my preferred doctors and hospitals in my network?

If you have favorite doctors or hospitals, it is always a good idea to call and ask which insurance plans they accept. If they do not take your insurance, they are considered out of network. Some plans cover a percentage toward out-of-network providers, and some do not cover them at all.

Do I qualify for financial help?

Depending on your income and household size, you may qualify for different types of financial help. If your income is below a certain level — for example, less than $17,620 for a single person or less than $36,167 for a family of four — you may qualify for Medicaid. Last year, 9 in 10 people who enrolled through Maryland Health Connection qualified for free or reduced cost health coverage. Use this tool to calculate your income and see if you qualify.

Medicaid, MCHP, and MCHP Premium provide health coverage free or at a low cost to eligible individuals.

Need help or have questions?

Hundreds of trained experts are available throughout Maryland to help you apply and enroll. Find help near you.