Maryland Health Insurance: Marketplace, State Savings & Private Options

Looking for health insurance in Maryland? We help self-employed workers, 1099 contractors, families, early retirees, and small business owners understand the different coverage options available in the state.

Maryland is different from many states. It operates its own health insurance Marketplace, has state programs designed to help with affordability, and has its own rules for certain types of coverage.

We'll help you compare the choices that fit your situation, including Maryland Health Connection plans and other available private coverage, while looking at your doctors, prescriptions, budget, and how you actually use health care.

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Maryland Health Insurance at a Glance

Topic What Maryland Residents Should Know
Marketplace Maryland Health Connection, not HealthCare.gov
2027 Open Enrollment November 1 through January 15
January 1 Coverage Generally enroll by December 31 through Maryland Health Connection
Financial Help Federal premium tax credits and Maryland-specific affordability programs may apply depending on eligibility
Medicaid & MCHP Eligible residents can apply throughout the year
Private Coverage Non-Marketplace options may also be available depending on the product and your eligibility
Short-Term Plans Maryland limits short-term coverage to three months and does not allow renewal

Maryland Has Its Own Health Insurance Marketplace

Maryland does not use HealthCare.gov for individual Marketplace enrollment. The state's official Marketplace is Maryland Health Connection.

Maryland Health Connection is where eligible residents can shop for ACA-compliant individual and family health insurance, apply for premium tax credits and other financial help, and determine whether they may qualify for Medicaid or the Maryland Children's Health Program.

Marketplace plans are ACA-compliant major medical insurance. That means they cover pre-existing conditions and include the consumer protections required for ACA-compliant individual plans.

Maryland Health Connection is different from HealthCare.gov. If you're moving to Maryland from another state, don't assume the Marketplace process or plan choices will be the same as where you lived before.

Maryland Open Enrollment for 2027 Coverage

Maryland's annual Open Enrollment period runs from November 1 through January 15.

Under Maryland Health Connection's current enrollment schedule:

  • Enroll between November 1 and December 31 for coverage beginning January 1.
  • Enroll between January 1 and January 15 for coverage beginning February 1.

Outside Open Enrollment, you generally need a qualifying Special Enrollment Period to enroll in an individual Marketplace plan.

Maryland Health Insurance Rates Are Changing for 2027

The Maryland Insurance Administration approved 2027 rates for the state's individual Affordable Care Act market.

Across the unsubsidized individual ACA market, the approved average rate increase for 2027 is about 14.6%.

That does not mean your premium will automatically rise 14.6%. Your actual cost can be very different depending on your age, ZIP code, insurance company, plan, household income, and any financial assistance for which you qualify.

The important number is not just the carrier's full premium. If you receive financial assistance, changes in the benchmark plan and subsidy amount can also affect what you actually pay each month.

This is one reason it can be worth reviewing your coverage rather than allowing a plan to renew automatically.

Maryland Has Its Own Health Insurance Assistance Programs

Maryland has taken additional steps beyond federal premium tax credits to help address the cost of individual health insurance.

State law created a State-Based Health Insurance Subsidies Program designed to provide additional assistance during 2026 and 2027, subject to available funding and the eligibility and payment parameters established by the Maryland Health Benefit Exchange.

Maryland also has a separate program designed to provide additional help to eligible young adults.

Don't assume last year's subsidy will be the same this year. State and federal assistance can change. When reviewing 2027 coverage, we'll look at the assistance actually available based on the current rules and your application.

Self-Employed in Maryland? Your Income Estimate Matters

This is especially important for freelancers, independent contractors, consultants, real estate agents, business owners, and other people whose income changes throughout the year.

When you apply for Marketplace financial assistance, Maryland Health Connection asks you to estimate your household income for the year you want coverage.

For self-employment income, the calculation generally looks at your net business income after business expenses, rather than simply the total amount of money your business collects.

Income Higher Than Expected?

If your business has a better year than expected, your final premium tax credit eligibility can change.

Updating your Marketplace application during the year can help keep your financial assistance closer to your actual income.

Income Lower Than Expected?

A meaningful drop in income may change the amount of assistance available to you or potentially affect eligibility for other programs.

Report major income changes rather than waiting until tax time.

Premium tax credits are reconciled when you file your federal tax return. If your actual household income is different from what you estimated, your final tax credit can be different from the amount paid in advance.

Maryland Marketplace Plans vs. Other Private Health Coverage

These options are not interchangeable, and a lower monthly price does not automatically mean one option is better.

Maryland Health Connection Plans

Marketplace Qualified Health Plans are ACA-compliant major medical coverage.

  • Cover pre-existing conditions
  • Include ACA-required essential health benefits
  • Have defined annual out-of-pocket limits
  • May qualify for federal or state financial assistance
  • Do not use medical underwriting to determine eligibility

Other Private Coverage

Some health insurance and health benefit products are sold outside Maryland Health Connection.

  • Some may use medical underwriting
  • Pre-existing-condition rules can differ
  • Benefits and exclusions can differ significantly
  • Provider networks may be structured differently
  • Marketplace premium tax credits generally cannot be used
Compare the whole plan, not just the premium. We look at the deductible, out-of-pocket exposure, prescriptions, provider network, exclusions, pre-existing-condition rules, and the situations you actually want insurance to protect against.

Health Insurance Networks Matter in Maryland

Maryland's individual insurance market includes different types of provider networks. Approved 2027 individual-market filings include HMO, EPO, and PPO products.

The letters matter because they can affect where you receive care, whether you need referrals, and what happens if you use a provider outside the network.

HMO

HMOs generally focus care within a defined network and typically provide little or no routine out-of-network coverage except in situations such as emergencies.

EPO

EPO plans also generally rely on an in-network provider system and usually do not provide broad out-of-network benefits.

PPO

PPO plans can provide more flexibility for using providers, but the exact in-network and out-of-network benefits still depend on the specific policy.

Why This Matters

Someone who receives almost all care near Baltimore may have different network priorities from a consultant who works regularly in D.C., Virginia, Pennsylvania, or another state.

Have doctors you want to keep? Give us their names before choosing coverage. We can help you focus on the network rather than finding out after enrollment that an important provider isn't included.

Work in D.C. or Another State?

Maryland's location creates an issue that doesn't come up everywhere: many residents routinely cross state lines for work and medical care.

Network design deserves extra attention if you:

  • Live in Maryland but work in Washington, D.C.
  • Commute into Northern Virginia
  • Work in Pennsylvania or Delaware
  • Travel frequently for work
  • Split time between Maryland and another state
  • Use specialists or hospitals outside your local area

Don't assume that simply having a Maryland health plan means you have routine in-network access everywhere you travel. Network rules vary by policy.

Can You Enroll Outside Open Enrollment?

Possibly. Maryland Health Connection offers Special Enrollment Periods after a number of qualifying events.

Examples include:

  • Losing qualifying job-based health coverage
  • Getting married or divorced
  • Having or adopting a child
  • Certain moves
  • Gaining or losing a dependent
  • Becoming ineligible for Medicaid or MCHP
  • Reaching the end of a COBRA coverage period
  • Turning 26 while covered under a parent's plan
Maryland also recognizes pregnancy as a Special Enrollment event. Maryland Health Connection currently provides a 90-day enrollment window from the time pregnancy is confirmed.

Most other qualifying events have their own enrollment deadlines, so it's a good idea to act soon after your existing coverage changes.

Maryland's Easy Enrollment Program

Maryland also has a health insurance enrollment path connected to the state income tax return.

When filing a Maryland tax return, an uninsured resident can choose to have certain information sent to Maryland Health Connection to see whether they may qualify for coverage or financial help.

If eligible, Maryland Health Connection sends information about the next steps and may provide a special enrollment opportunity.

This can be useful for someone who missed traditional Open Enrollment and learns during tax season that affordable coverage may be available.

Short-Term Health Insurance Is Very Limited in Maryland

Maryland has stricter rules for short-term, limited-duration insurance than many states.

In Maryland, a short-term medical policy:

  • Can last no more than three months
  • Cannot be renewed or continued after that period
  • Is not required to meet all federal ACA requirements
  • May use medical underwriting
  • May not cover pre-existing conditions
  • May not include benefits such as outpatient prescriptions or maternity
  • May contain dollar limits on covered health benefits
Short-term coverage is generally a gap product, not a long-term replacement for comprehensive insurance. If you need coverage for more than a brief transition, compare the alternatives carefully before using a short-term plan.

Learn more about short-term health insurance →

How We Help Maryland Residents

Self-Employed & 1099 Workers

Consultants, contractors, real estate professionals, government contractors, freelancers, tradespeople, and other people who buy their own insurance.

We can help you think through Marketplace eligibility, income estimates, private options, networks, deductibles, and prescription needs.

Self-employed health insurance →

Individuals & Families

We help families look beyond the monthly premium and compare doctor networks, prescriptions, deductibles, out-of-pocket exposure, and available financial assistance.

Individual & family health insurance →

People Leaving Employer Coverage

If you're losing job-based insurance, you may have several paths to compare, including COBRA, a spouse's employer plan, Maryland Health Connection, or other available coverage.

Compare COBRA alternatives →

Early Retirees

Retiring before age 65 can create a several-year gap before Medicare eligibility. Income planning can also affect Marketplace financial assistance during those years.

Young Adults

Turning 26, starting contract work, or taking a job without benefits can make individual coverage necessary for the first time.

Maryland also has state-specific programs aimed at improving affordability for eligible younger adults.

Small Business Owners

Maryland employers may compare traditional group health insurance, level-funded arrangements, ICHRAs, QSEHRAs, and other benefit strategies depending on company size and eligibility.

Small business health insurance →

Maryland Health Insurance for Small Businesses

Small business owners have different decisions to make than someone buying individual insurance.

Depending on the business, options may include:

  • Traditional fully insured group health plans
  • Level-funded group plans where available
  • Individual Coverage HRAs (ICHRA)
  • Qualified Small Employer HRAs (QSEHRA)
  • Dental, vision, life, and supplemental employee benefits

The right approach can depend on the number of employees, employee ages, where they live, how much the employer wants to contribute, and whether employees already have individual coverage.

We don't assume every small business needs a traditional group plan. We'll help you understand how the different structures work and what responsibilities come with each option.

Serving Clients Across Maryland

We work with Maryland clients by phone and video, so you don't need to live near our office.

Central Maryland
Baltimore, Columbia, Ellicott City, Towson, Glen Burnie and Annapolis
Montgomery County
Rockville, Bethesda, Silver Spring, Gaithersburg and Germantown
Prince George's County
Bowie, College Park, Laurel and Upper Marlboro
Southern Maryland
Waldorf, La Plata and surrounding communities
Western Maryland
Frederick, Hagerstown, Cumberland and surrounding areas
Eastern Shore
Salisbury, Easton, Ocean City and surrounding communities
Your ZIP code matters. Health insurance premiums, carrier availability, provider networks, and plan choices can vary by location. We'll focus on what is actually available where you live.

Common Questions About Maryland Health Insurance

Does Maryland use HealthCare.gov?

No. Maryland operates its own state-based Marketplace called Maryland Health Connection.

When is Maryland Open Enrollment for 2027?

Maryland's Open Enrollment period runs from November 1 through January 15.

Under the current Maryland Health Connection schedule, enrolling by December 31 generally provides a January 1 effective date. Enrollment from January 1 through January 15 generally begins February 1.

Does Maryland offer extra help paying for health insurance?

Maryland has created state-funded affordability programs in addition to federal premium tax credits.

The exact 2027 eligibility and amount of assistance can depend on current Maryland Health Benefit Exchange parameters, funding, household income, family size, ZIP code, and other eligibility rules.

How much are Maryland health insurance rates increasing for 2027?

The Maryland Insurance Administration approved an average 14.6% increase across the unsubsidized individual ACA market for 2027.

That is a statewide market average, not the increase every individual will see. Your actual premium depends on your plan, age, location, and financial assistance.

Are PPO health plans available in Maryland?

Maryland's individual market includes different network structures, including HMO, EPO, and PPO products in approved 2027 filings.

The plans actually available to you depend on your location, eligibility, carrier service area, and whether the specific product is offered through or outside Maryland Health Connection.

How is self-employment income counted for Maryland Health Connection?

Maryland Health Connection asks applicants to estimate annual household income for the coverage year.

For self-employment, this generally includes net income from your business after business expenses rather than simply gross revenue.

Can I get health insurance in Maryland outside Open Enrollment?

Yes, if you qualify for a Special Enrollment Period or another year-round enrollment program.

Medicaid and MCHP accept eligible applicants throughout the year. Certain non-Marketplace products may also have different enrollment rules.

Does pregnancy qualify for Special Enrollment in Maryland?

Yes. Maryland Health Connection currently lists pregnancy as a qualifying event and provides a 90-day enrollment period from the time the pregnancy is confirmed.

How long can a short-term health plan last in Maryland?

Maryland limits short-term, limited-duration health insurance to three months, and the coverage cannot be renewed or continued beyond that period.

Can I keep my doctor?

That depends on the specific insurance plan and provider network.

Before choosing a plan, give us the names of your doctors, hospitals, and specialists so the network can be checked.

Can you help me if your office is in Arizona?

Yes. We are licensed in Maryland and work with Maryland clients remotely by phone and video.

Compare Your Maryland Health Insurance Options for 2027

Maryland has more moving parts than many states. We'll help you understand Marketplace coverage, available financial assistance, private options, provider networks, and the tradeoffs that matter before you choose.

Schedule My Free Consultation Call or text (833) 833-1099

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