Maryland Health Insurance

Maryland residents who wish to purchase a new health insurance policy may find that the state’s lax regulations make for a somewhat treacherous marketplace.  Fortunately, you can drastically improve your chances of finding good health coverage by taking the time to learn about the things you should (or shouldn’t) expect from insurers in this state.  Below is an overview of the important facts you should know about when shopping for health coverage in Maryland.

• One of the most important pieces of protection that Maryland grants to health-insurance consumers is a guaranteed-renewability clause, which must be included in all health coverage sold in this state.  This ensures that, as long as you have paid your premiums as required, you will be able to renew your health insurance policy as many times as you wish.  Your insurer is also forbidden to cancel your existing policy on the grounds that a change in your current state of health makes you a greater risk.
• Maryland also requires insurance companies to extend the individual health insurance of a parent to cover a newborn or newly-adopted child for up to 31 days (assuming that the parent’s health plan includes coverage for dependents).
• Insurance companies in Maryland are allowed to take pre-existing conditions into account when creating a new health insurance policy.  In particular, they are allowed to specifically exclude a health issue that was diagnosed or treated within the previous 7 years from being covered under the new policy.  This exclusion period cannot normally last for more than two years, but under some circumstances the exclusion may be set up as a permanent exemption from covering costs related to that specific health condition.  This makes it especially important to read over any health plan before signing on.
• Unless they are participants in SAAC, health insurance companies in Maryland are free to deny coverage to any new applicant on the basis of health, age, or other major risk factors.  These companies may also use these criteria to determine what a particular health plan will cost on a case-by-case basis.  SAAC-participating insurers, on the other hand, must take all applicants during their annual open-enrollment period.
• Small businesses in Maryland are automatically eligible to purchase group health coverage, provided that they have between 2 and 50 employees.  Health insurance providers are required to sell these companies group insurance comparable to what has been offered to other small businesses in this state.
• The aforementioned group health coverage for small businesses can include a number of conditions which, if not met, could mean the cancellation of the policy.  These conditions can include a minimum level of participation among employees, a minimum employer contribution to each employee’s premiums, and so on. 
• The cost of a small business’s health plan can vary dramatically based on the family status, age, and other risk factors of its participants; insurers cannot, however, take the health of the insured into account when setting prices.  It is also illegal for a company’s health plan to be cancelled on the grounds that one of the insured employees has fallen ill.
• Maryland considers self-employed workers to be “small businesses” when determining eligibility for purchasing group health coverage, even if there are no other employees.  If you are self-employed you automatically have the option of purchasing this form of insurance instead of individual coverage, but remember that the premiums for an individual health plan may be tax-deductible.

The state of Maryland offers precious few regulatory protections to consumers participating in the health-insurance arena, but those that are present can be of great help to those who know what they’re looking for.  As long as you’re willing to carefully examine your options and weigh each offer against those made by other companies, you are much more likely to find the health coverage you’re looking for at an affordable price.

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