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Top 5 questions about using your health coverage

Now that you have a health plan through Maryland Health Connection, you may be wondering, “what are my next steps?” To help you understand your benefits, we are breaking down the top 5 questions about your health coverage.

1. Who do I contact for information about my payments?

If you have questions about your bill, contact your insurance company directly:

How much do I have to pay for my plan?

In addition to your monthly bill, or premium, you may have to pay out-of-pocket costs when you use certain medical services. Here are some common terms.

  • Deductible: The amount you owe for health care services before your health insurance begins to pay.
  • Coinsurance: Your share of the costs of a covered health care service. This is calculated as a percent (for example, 20%) of the allowed amount for the service.
  • Copayment (copay): A set amount you pay for a covered health care service. For example, your copayment to see your primary care provider when you’re sick may be $15.

What is a network and how can I find out if my doctor is in a health plan’s network?

A network is the list of the doctors, health care providers, and hospitals that a health plan has contracted with to provide medical care to its members.To find a doctor who participates in your health plan or Managed Care Organization, visit our Find a Doctor tool.

How do I update my information about my household or income?

After you enroll, it’s important to tell Maryland Health Connection right away if you’ve had changes in your household or income to be sure you are receiving the right coverage and financial help. You can update your information by logging into your account and reporting a change. You can also call 855-642-8572 or find free in-person help.

What benefits are covered by qualified health plans?

All plans offered through Maryland Health Connection provide the same set of essential health benefits, which include:

  • Doctor visits 
  • Hospital stays
  • Maternity and newborn care 
  • Mental health and substance use disorder treatment (includes counseling and psychotherapy)
  • Prescriptions
  • Emergency visits
  • Rehabilitative services 
  • Laboratory tests
  • Preventive and wellness management
  • Pediatric care