Best Health Insurance Rates Maryland – Compare Senior And Marketplace Quotes

Compare the most affordable health insurance quotes in Maryland on our website. We provide the lowest Md rates for individuals, families, small businesses and self-employed persons. Within a few moments, you can view the best offers from the most respected insurers in the state and purchase a policy on or off the Marketplace Exchange. Most plans are issued quickly and easily. The Maryland Health Connection offers plan comparisons but does not underwrite the policies.

Prices have remained low for many years due to increased primary and specialist care availability, enhanced safety regulations for workers, and comprehensive preventive benefits for infants and toddlers. We  show you which plans provide you with the maximum amount of benefits for the least cost. A reinsurance program approved by the federal government has lowered 2019 premiums. The waiver for the program runs until the end of 2020.

NOTE: Medicare’s Open Enrollment for Seniors takes place earlier than for persons under age 65.  It begins on October 15th and ends on December 7th. Maryland Medicare Advantage, Supplement and Part D prescription drug plans are offered. Medicaid registration is available all year. For persons under age 65, the Open enrollment period begins on November 1st and ends on December 15th.

Open Enrollment

During Open Enrollment, you do not have to qualify medically, take or pass a physical, or worry about whether your pre-existing conditions will be covered. If the Open Enrollment deadline has passed, and you did not apply for coverage, you may qualify for a special enrollment period (SEP). The most common SEP situations are losing  group benefits from your employer, divorce, moving to a different state or service area, and having a baby. Although the newborn is eligible for coverage, the delivering mother is not.

If you missed Open Enrollment (which is very common), and you don’t qualify for a special exception, very cheap “short-term” policies may be able to provide gap coverage until the next OE period. Many major carriers offer this type of benefit, and typically, you can keep coverage for 6-12 months without re-applying. Approval is also often instantaneous since underwriting is limited.

But, since “temporary” policies are not in full compliance with the Affordable Care Act, insurers do not have to cover pre-existing conditions, and instant federal tax credits can not be used, regardless of  individual or household income. You also may be subject to the special tax for not complying with the mandatory purchase of healthcare.

Maryland Health Marketplace Open Enrollment

Maryland Health Connection Was Created When The ACA Legislation Passed

 

Maryland Health Benefit Exchange (MHBE)


The MHBE was created as a direct result of the passage of the Patent Protection And Affordable Care Act (Obamacare). Although government administered, it is its own separate entity. The Maryland Health Connection is the “Marketplace” that provides consumers the opportunity to purchase subsidized healthcare plans.

Our website provides current quotes and rates, along with detailed analysis of your options. We also make it VERY easy for you to enroll. Unlike when Exchanges were first launched when the application process took about 90 minutes, now it takes about 10-15 minutes.

All companies that participate on the Exchange must receive prior approval from the state. Also, any time a rate increase is requested, a decision will be made whether to approve the price hike and what percentage of the requested increase. Like other state-based Exchanges (and federally-run also), Catastrophic, Bronze, Silver, Gold and Platinum tier policies are offered.

All but the “catastrophic” contracts allow you to qualify for federal subsidies. Since catastrophic-tier plans are typically inexpensive (but not always the lowest cost plans), a low household income will not result in an Obamacare instant tax credit. Also, unless you are under the age of 30, you must meet “financial hardship” guidelines. Otherwise, a Bronze-tier policy will likely be the cheapest option.

CHIP

For children, the CHIP program is currently active and provides a reputable solution for kids in low-income households. Medicaid eligibility is largely determined by household income, and is also available to many low-income family members. Often, a household may have a combination of adults that are receiving federal subsidies to purchase Marketplace plans, while CHIP is covering the children.

There were about 750,000 residents without coverage before the first year of Open Enrollment five years ago. At that time, it represented about 13% of the state’;s population. However, by 2016, only about 8% of the population was uninsured. The significant reduction was a result of a combination of factors including the implementation of the ACA legislation, and higher Medicaid enrollment.

Who Are The Available Companies?

CareFirst Blue Cross Blue Shield is a non-profit company that offers many competitively-priced plans in the state. The list of providing and participating physicians and hospitals is large and extends to other areas of the country. Policies are also offered through CareFirst of Maryland (see below), and Group Hospitalization and Medical Services Inc. As the largest healthcare carrier in the Middle Atlantic region, more than three million members are provided service, along with an additional 600,000 members of the FEP (Federal Employees Health Program).

CareFirst BlueChoice offers HMO and POS plan options and is part of the BCBS family of companies. Policies are issued through CareFirst Blue Choice and CareFirst Of Maryland.

Lowest Health Insurance Quotes Md

Affordable Maryland Health Insurance Is Available

 

Kaiser Permanente  allows you to coordinate benefits with a primary care physician (PCP), and is the nation’s largest non-profit healthcare plan. Kaiser Foundation hospitals form the backbone of the major medical care.

 

Note: Cigna and Evergreen Health (currently in receivership) exited the market and no longer offer private plans in Maryland. However, their market share was very low and prices of the participating carriers were not impacted.

 

 

Current Available Plans For Individuals And Families

 

Catastrophic  (Must be under age 30 or prove “financial hardship”

CareFirst BlueChoice HMO Young Adult $7,900 – $7,900 deductible with 0% coinsurance. First three primary care physician (pcp) office visits not subject to deductible.

Kaiser KP MD Catastrophic 7900/0/Dental  – $7,900 deductible with 0% coinsurance. First three pcp office visits not subject to deductible.

 

Bronze

Kaiser KP MD Bronze 6200/20%/HSA/Dental – HSA-eligible plan with $6,200 deductible and $6,550 maximum out-of-pocket expenses and 20% coinsurance. $20 generic drug copay after deductible. 50% coinsurance applies to other drugs.

Kaiser KP MD Bronze 6000/50/Dental – $50 pcp office visit copay for the first two visits, although specialist visits must meet deductible and coinsurance. Deductible is $6,000 with 40% coinsurance and maximum out-of-pocket expenses of $7,900.

CareFirst BlueChoice HMO Bronze 7900  – Deductible of $7,900 and maximum out-of-pocket expenses of $7,900 with 0% coinsurance.

CareFirst BlueChoice PPO Bronze 7900  – Deductible of $7,900 and maximum out-of-pocket expenses of $7,900 with 0% coinsurance.

 

Silver

Kaiser KP MD Silver 6000/35/Dental – $35 and $55 office visit copays with $55 Urgent Care copay.  Deductible is $6,000 with 35% coinsurance and $7,900 maximum out-of-pocket expenses.  Generic and preferred brand drug copays are $20 and $60.  Other drugs are subject to coinsurance and deductible.

Kaiser KP MD Silver 3200/20%/HSA/Dental – HSA-eligible plan with $3,200 deductible and $6,000 maximum out-of-pocket expenses and 20% coinsurance. $15 generic drug and $55 preferred brand drug copays after the deductible.

Kaiser KP MD Silver 2500/30/Dental – $30 and $50 office visit copays with $50 Urgent Care copay.  Deductible is $3,000 with 35% coinsurance and $7,750 maximum out-of-pocket expenses. X-rays and diagnostic imaging are subject to a $50 copay, while outpatient lab services are subject to a $30 copay.  Generic and preferred brand drug copays are $15 and $55.  Other drugs are subject to coinsurance and deductible.

CareFirst BlueChoice HMO HSA Silver $3,000 VisionPlus – HSA-eligible plan with $3,000 deductible and $6,650 maximum out-of-pocket expenses. Office visit copays of $30 and $40 are subject to the deductible.

CareFirst BlueChoice PPO HSA Silver $3,000 VisionPlus – HSA-eligible plan with $3,000 deductible and $6,550 maximum out-of-pocket expenses. Office visit copays of $30 and $40 are subject to the deductible.

 

Gold

Kaiser KP MD Gold 1500/20/Dental – $20 and $40 office visit copays with $40 Urgent Care copay.  Deductible is $1,500 with 30% coinsurance and $6,850 maximum out-of-pocket expenses. X-rays and diagnostictests are subject to a $40 copay, while outpatient lab services are subject to a $20 copay.   Preferred generic drug copay is $10. Other drugs are subject to coinsurance and/or deductible.

Kaiser KP MD Gold 1000/20/Dental – $20 and $40 office visit copays with $40 Urgent Care copay.  Deductible is $1,000 with 30% coinsurance and $6,850 maximum out-of-pocket expenses. X-rays and diagnostic tests are subject to a $40 copay, while outpatient lab services are subject to a $20 copay.   Preferred generic drug copay is $15 and preferred brand drug copay is $30. Other drugs are subject to coinsurance and deductible.

Kaiser KP MD Gold 0/20/Dental – $20 and $40 office visit copays with $40 Urgent Care copay.  Deductible is $0 with 30% coinsurance and $6,850 maximum out-of-pocket expenses. X-rays and diagnostic tests are subject to a $40 copay, while outpatient lab services are subject to a $20 copay.  Imaging has a $500 copay. Preferred generic drug copay is $10 and preferred brand drug copay is $30. Other drugs are subject to coinsurance and deductible.

CareFirst BlueChoice Healthy Blue HMO Gold $1,750 – $0 and $30 office visit copays with $50 Urgent Care copay.  Deductible is $1,750 with $6,650 maximum out-of-pocket expenses.  X-rays  are subject to a $65 copay, while outpatient lab services are subject to a $15 copay. Preferred generic dug copay is $0. Other prescription drugs must meet deductible.

CareFirst BlueChoice Healthy Blue PPO Gold $1,750 – $0 and $30 office visit copays with $50 Urgent Care copay.  Deductible is $1,750 with $6,650 maximum out-of-pocket expenses.  X-rays  are subject to a $65 copay, while outpatient lab services are subject to a $15 copay. Preferred generic dug copay is $0. Other prescription drugs must meet deductible. More expensive than previous plan since it is a PPO.

 

Platinum

Kaiser KP MD Platinum 0/5 – $5 and $15 office visit copays with $15 Urgent Care copay.  Deductible is $0 with 30% coinsurance and $4,000 maximum out-of-pocket expenses. X-rays and diagnostic imaging are subject to a $5 copay, while outpatient lab services are subject to a $5 copay.   Preferred generic drug copay is $5 and preferred brand drug copay is $30. The non-preferred brand drug copay is $50.

 

Sample Monthly Rates (Under Age-65)

 

40-Year-Old Residing In Baltimore With Household Income Of $30,000

$83 – Kaiser KP MD Bronze 6200/20%/HSA/Dental

$98 – CareFirst BlueChoice HMO Bronze 7900

$109 – Kaiser KP MD Bronze 6000/50/Dental

$189 – Kaiser KP MD Silver 6000/35/Dental

$193 – Kaiser KP MD Gold 1500/20/Dental

$198 – Kaiser KP MD Gold 1000/20/Dental

 

40-Year-Old Married Couple Residing In Baltimore With Household Income Of $30,000

$165 – Kaiser KP MD Bronze 6200/20%/HSA/Dental

$195 – CareFirst BlueChoice HMO Bronze 7900

$216 – Kaiser KP MD Bronze 6000/50/Dental

$376 – Kaiser KP MD Silver 6000/35/Dental

$384 – Kaiser KP MD Gold 1500/20/Dental

$395 – Kaiser KP MD Gold 1000/20/Dental

 

50-Year-Old Married Couple With One Child Residing In Columbia With Household Income Of $70,000

$410 – Kaiser KP MD Bronze 6200/20%/HSA/Dental

$461 – CareFirst BlueChoice HMO Bronze 7900

$498 – Kaiser KP MD Bronze 6000/50/Dental

$769 – Kaiser KP MD Silver 6000/35/Dental

$782 – Kaiser KP MD Gold 1500/20/Dental

$801 – Kaiser KP MD Gold 1000/20/Dental

 

55-Year-Old Residing In Germantown With Household Income Of $40,000

$125 – Kaiser KP MD Bronze 6200/20%/HSA/Dental

$151 – CareFirst BlueChoice HMO Bronze 7900

$170 – Kaiser KP MD Bronze 6000/50/Dental

$309 – Kaiser KP MD Silver 6000/35/Dental

$316 – Kaiser KP MD Gold 1500/20/Dental

$326 – Kaiser KP MD Gold 1000/20/Dental

 

Maryland Senior Medigap Coverage

 

Medicare Supplement plans are issued by many carriers, and are approved by the DOI. Since original Medicare doesn’t cover 100% of all medical expenses, many copays, deductibles, coinsurance, and other items can be paid for with supplementary plans. Polices are standardized (11 available options), although carriers are not required to offer all plans. However, participating companies must offer Plan A, and either Plan C or F. Listed below are estimated monthly rates from selected companies for several plans. Attained Age, and preferred non-tobacco ratings were used.

 

Plan A Female Age 65

$96 – United American

$110 – Transamerica

$121 – Thrivent

$124 – GPM Health

$126 – State Farm

$127 – Assured Life

$132 – Cigna

$132 – USAA

$137 – Greek Catholic Union

$140 – Equitable National Life

$141 – Reserve National

$145 – Everence

$147 – First Health

$153 – Aetna

$157 – Philadelphia American Life

$163 – Massachusetts Mutual

$164 – Liberty Bankers Life

$166 – Humana Dental

$167 – Pan American Life

$168 – Puritan Life

$169 – Shenandoah Life

$172 – American Retirement Life

$187 – Americo

$195 – Gerber

$231 – Mutual Of Omaha

$256 – Colonial Penn

 

Plan C Female Age 65

$126 – Greek Catholic Union

$127 – Cigna

$129 – Transamerica

$132 – Manhattan Life

$133 – Individual Assurance

$133 – AARP-UnitedHealthcare

$138 – Continental Life

$149 – Mutual Of Omaha

$156 – American Retirement Life

$160 – Central States

$162 – Gerber

$165 – United American

 

Plan F (HD) Female Age 65

$30 – United American

$32 – Standard Life And Accident

$32 – Globe

$33 – Liberty National

$36 – FirstCare

$42 – Colonial Penn

$42 – Guarantee Trust Life

$43 – Physicians Mutual

$44 – Philadelphia American

$46 – Cigna

$49 – Unified Life

$54 – Bankers Fidelity

$57 – Mutual Of Omaha

$59 – Humana

$62 – Reserve National

$68 – Continental Life

 

Plan F (HD) Male Age 65

$32 – Globe

$32 – Standard Life And Accident

$34 – United American

$38 – FirstCare

$38 – Liberty National

$39 – Physicians Mutual

$35 – United American

$46 – Colonial Penn

$47 – Guarantee Trust

$49 – Philadelphia American

$53 – Cigna

$54 – Bankers Fidelity

$56 – Unified Life

$57 – Mutual Of Omaha

$63 – Humana

$71 – Reserve National

$79 – Continental Life

 

Plan F Female Age 65

$153 – Cigna

$155 – AARP-UnitedHealthcare

$160 – Greek Catholic Union

$162 – Manhattan Life

$171 – Transamerica

$176 – United American

$177 – Individual Assurance

$184 – Oxford Life

$187 – American Retirement Life

$188 – Central States

$191 – Humana

$196 – Continental Life

$198 – Medico

$212 – Mutual Of Omaha

$240 – Gerber

 

Plan F Male Age 65

$162 – Physicians Mutual

$164 – FirstCare

$165 – Thrivent

$165 – USAA

$174 – Globe

$174 – Cigna

$178 – Greek Catholic Union

$179 – Puritan Life

$179 – Unified Life

$181 – Manhattan Life

$183 – Guarantee Trust

$183 – Liberty Bankers

$187 – Massachusetts Mutual

$189 – American National

$189 – Transamerica

$189 – Medico

$192 – Humana

$194 – State Farm

$202 – Oxford Life

$202 – United American

$204 – Americo

$212 – Mutual Of Omaha

$216 – Central States

$226 – Continental Life

$231 – Colonial Penn

$231 – Everence

$235 – Aetna

$246 – UnitedHealthcare

$276 – Gerber

$283 – Government Personnel

 

Plan N Male Age 65

$103 – FirstCare

$105 – Everence

$115 – Humana

$116 – USAA

$116 – United American

$118 – Colonial Penn

$120 – Greek Catholic Union

$121 – Puritan Life

$123 – Cigna

$123 – Manhattan Life

$125 – Liberty Bankers

$127 – Continental Life

$127 – Central States

$128 – Americo Financial

$134 – Medico

$138 – Oxford Life

$138 – Transamerica

$145 – Reserve National

$150 – Standard Life And Accident

$152 – Aetna

$173 – UnitedHealthcare

 

Maryland Medicare Advantage Plans (Rates, copays, deductibles, and availability vary by county)

 

Kaiser Permanente Medicare Plus Basic  – $10 monthly premium.  $0 deductible and maximum out-of-pocket expenses of $6,700. Inpatient hospital copay is $1,340 per visit and outpatient hospital copay is $400. Office visit copays are $35 and $50, and ER and Urgent Care copays are $90 and $65. $0 copay for diagnostic tests and procedures, $0 copay for lab services, 20% coinsurance for diagnostic radiology services, and $40 copay for outpatient x-rays. Skilled nursing copay is $0 for first 20 days, and $167.50 for days 21-100. Occupational, speech, and language therapy copays are $40. The ambulance charge is $375. Foot exams and treatment are subject to a $50 copay, and hearing exams are subject to a $50 copay. Prescription drug coverage is not included. Dental benefits are also not included.

 

Kaiser Permanente Medicare Advantage Standard MD  – $28 monthly premium.  $0 deductible and maximum out-of-pocket expenses of $6,700. Inpatient hospital copay is $250 for the first 5 days and outpatient hospital copay is $250. Office visit copays are $10 and $40, and ER and Urgent Care copays are $90 and $40. $0 copay for diagnostic tests and procedures, $0 copay for lab services, $150 copay for diagnostic radiology services, and $10 copay for outpatient x-rays. Skilled nursing copay is $0 for first 20 days, and $160 for days 21-100. Occupational, speech, and language therapy copays are $40. The ambulance charge is $275. Foot exams and treatment are subject to a $40 copay, and hearing exams are subject to a $40 copay. Dental benefits are included, although copays are high. Comprehensive dental, eyewear and hearing aids coverage is available for an additional $23 per month.

Prescription drug copays are $5 (Tier 1), $15 (Tier 2), $45 (Tier 3), $100 (Tier 4), and 33% (Tier 5).  90-day prescription drug copays are copays are $15 (Tier 1), $45 (Tier 2), $135 (Tier 3), $300 (Tier 4), and 33% (Tier 5).

 

Cigna HealthSpring PreventiveCare  – $27 monthly premium.  $310 deductible (except Tiers 1 and 2) and maximum out-of-pocket expenses of $6,700. Inpatient hospital copay is $1,860 per visit and outpatient hospital coinsurance is 0%-30%. Office visit copays are $10 and $50, and ER and Urgent Care copays are $90 and $50. 0%-30% coinsurance for diagnostic tests and procedures, $0 copay for lab services, 0%-20% coinsurance for diagnostic radiology services, and 20% coinsurance for outpatient x-rays. Skilled nursing copay is $0 for first 20 days, and $172 for days 21-100. Occupational, speech, and language therapy copays are $40. The ambulance charge is $200. Foot exams and treatment are subject to a $45 copay, and hearing exams are subject to a $10-$30 copay.

Prescription drug copays are $4 (Tier 1), $15 (Tier 2), $42 (Tier 3), $95 (Tier 4), and 26% (Tier 5).  90-day prescription drug copays are copays are $8 (Tier 1), $30 (Tier 2), $126 (Tier 3), $285 (Tier 4), and NA (Tier 5).

 

Cigna HealthSpring Preferred  – $48 monthly premium.  $280 deductible (except Tiers 1 and 2) and maximum out-of-pocket expenses of $6,700. Inpatient hospital copay is $370 for the first 5 days and outpatient hospital copay is $0-$300. Office visit copays are $5 and $50, and ER and Urgent Care copays are $90 and $50. $0-$400 coinsurance for diagnostic tests and procedures, $0 copay for lab services, 0%-20% coinsurance for diagnostic radiology services, and 20% coinsurance for outpatient x-rays. Skilled nursing copay is $0 for first 20 days, and $172 for days 21-100. Occupational, speech, and language therapy copays are $40. The ambulance charge is $200. Foot exams and treatment are subject to a $40 copay, and hearing exams are subject to a $5-$35 copay.

Prescription drug copays are $4 (Tier 1), $15 (Tier 2), $42 (Tier 3), $95 (Tier 4), and 27% (Tier 5).  90-day prescription drug copays are copays are $8 (Tier 1), $30 (Tier 2), $126 (Tier 3), $285 (Tier 4), and NA (Tier 5).

 

MedStar Medicare Choice  – $27 monthly premium.  $405 deductible (except Tiers 1,2, and 6) and maximum out-of-pocket expenses of $6,700. Inpatient hospital copay is $350 for the first 5 days,  and outpatient hospital coinsurance is $0-$300 per visit. Office visit copays are $5 and $50, and ER and Urgent Care copays are $80 and $50. 20% coinsurance for diagnostic tests and procedures, $0 copay for lab services, $200 copay for for diagnostic radiology services, and $20 copay for outpatient x-rays. Skilled nursing copay is $0 for first 20 days, and $167.50 for days 21-100. Occupational, speech, and language therapy copays are $40. The ambulance charge is $250. Hearing exams are subject to a $50 copay. Routine vision exams have a $0 copay and dental oral exams are subject to a $45 copay.

Prescription drug copays are $4 (Tier 1), $15 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 25% (Tier 5).  90-day prescription drug copays are copays are $12 (Tier 1), $45 (Tier 2), $141 (Tier 3), $300 (Tier 4), and NA (Tier 5).

 

University Of Maryland Health Advantage Complete  – $41 monthly premium.  $0 deductible and maximum out-of-pocket expenses of $6,700. Inpatient hospital copay is $275 for the first 7 days,  and outpatient hospital coinsurance is $250 per visit. Office visit copays are $10 and $45, and ER and Urgent Care copays are $80 and $50. 20% coinsurance for diagnostic tests and procedures, $0 copay for lab services, 20% coinsurance for for diagnostic radiology services, and $25 copay for outpatient x-rays. Skilled nursing copay is $0 for first 20 days, and $150 for days 21-100. Occupational, speech, and language therapy copays are $40. The ambulance charge is $275. Hearing exams are subject to a 20% coinsurance. Routine vision exams have a $0 copay and dental oral exams are subject to a $45 copay.

Prescription drug copays are $4 (Tier 1), $15 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5).  90-day prescription drug copays are copays are $12 (Tier 1), $45 (Tier 2), $141 (Tier 3), $300 (Tier 4), and 33% (Tier 5).

 

Johns Hopkins Advantage MD  – $47 monthly premium.  $0 deductible and maximum out-of-pocket expenses of $6,700. Inpatient hospital copay is $285 for the first 7 days,  and outpatient hospital coinsurance is $395 per visit. Office visit copays are $10 and $50, and ER and Urgent Care copays are $80 and $50. 20% coinsurance for diagnostic tests and procedures, $0 copay for lab services, $250 copay for for diagnostic radiology services, and $30 copay for outpatient x-rays. Skilled nursing copay is $0 for first 20 days, and $160 for days 21-100. Occupational, speech, and language therapy copays are $40. The ambulance charge is $300. Hearing exams are subject to a $50 copay. Routine vision exams have a $0 copay and dental oral exams are subject to a $15 copay.

Prescription drug copays are $7 (Tier 1), $15 (Tier 2), $45 (Tier 3), $95 (Tier 4), and 33% (Tier 5).  90-day prescription drug copays are copays are $14 (Tier 1), $30 (Tier 2), $135 (Tier 3), $285 (Tier 4), and n/a (Tier 5).

 

Johns Hopkins Advantage MD Plus  – $78 monthly premium.  $0 deductible and maximum out-of-pocket expenses of $5,900. Inpatient hospital copay is $255 for the first 7 days,  and outpatient hospital coinsurance is $275 per visit. Office visit copays are $5 and $40, and ER and Urgent Care copays are $80 and $40. 20% coinsurance for diagnostic tests and procedures, $0 copay for lab services, $250 copay for for diagnostic radiology services, and $20 copay for outpatient x-rays. Skilled nursing copay is $0 for first 20 days, and $150 for days 21-100. Occupational, speech, and language therapy copays are $30. The ambulance charge is $300. Hearing exams are subject to a $40 copay. Routine vision exams have a $0 copay and dental oral exams are subject to a $10 copay.

Prescription drug copays are $4 (Tier 1), $12 (Tier 2), $42 (Tier 3), $92 (Tier 4), and 33% (Tier 5).  90-day prescription drug copays are copays are $8 (Tier 1), $24 (Tier 2), $126 (Tier 3), $276 (Tier 4), and n/a (Tier 5).

 

Maryland Medicare Stand-Alone Part D Prescription Drug Plans – Monthly Cost And Benefits

 

EnvisionRxPlus – $16.50 per month with $365 deductible. 2,963 Formulary drugs available. 30-day preferred pharmacy copays are $1 (Tier 1), $6 (Tier 2), $32 (Tier 3), 35% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $2 (Tier 1), $18 (Tier 2), $96 (Tier 3), 35% (Tier 4), and n/a (Tier 5).

Aetna Medicare Rx Select– $17.20 per month with $390 deductible. 3,737 Formulary drugs available. 30-day preferred pharmacy copays are $0 (Tier 1), $2 (Tier 2), $47 (Tier 3), 40% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $0 (Tier 1), $6 (Tier 2), $141 (Tier 3), 40% (Tier 4), and n/a (Tier 5).

Aetna Medicare Rx Saver– $28.20 per month with $310 deductible. 3,283 Formulary drugs available. 30-day preferred pharmacy copays are $1 (Tier 1), $2 (Tier 2), $30 (Tier 3), 35% (Tier 4), and 27% (Tier 5). 90-day preferred pharmacy copays are $3 (Tier 1), $6 (Tier 2), $90 (Tier 3), 35% (Tier 4), and n/a (Tier 5).

Humana Walmart Rx Plan– $20.40 per month with $405 deductible. 3,300 Formulary drugs available. 30-day preferred pharmacy copays are $1 (Tier 1), $4 (Tier 2), 23% (Tier 3), 35% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $3 (Tier 1), $12 (Tier 2), 23% (Tier 3), 35% (Tier 4), and n/a (Tier 5).

Express Scrips Medicare Saver– $24.00 per month with $415 deductible. 2,806 Formulary drugs available. 30-day preferred pharmacy copays are $1 (Tier 1), $4 (Tier 2), 18% (Tier 3), 33% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $3 (Tier 1), $12 (Tier 2), 18% (Tier 3), n/a (Tier 4), and n/a (Tier 5).

Express Scrips Medicare Value– $25.50 per month with $405 deductible. 3,117 Formulary drugs available. 30-day preferred pharmacy copays are $1 (Tier 1), $4 (Tier 2), 18% (Tier 3), 44% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $3 (Tier 1), $12 (Tier 2), 18% (Tier 3), n/a (Tier 4), and n/a (Tier 5).

Symphonix Value Rx– $25.50 per month with $405 deductible. 3,259 Formulary drugs available. 30-day preferred pharmacy copays are $1 (Tier 1), $3 (Tier 2), $35 (Tier 3), 25% (Tier 4), and 35% (Tier 5). 90-day preferred pharmacy copays are $3 (Tier 1), $9 (Tier 2), $105 (Tier 3), 25% (Tier 4), and 25% (Tier 5).

AARP MedicareRx Walgreens $28.00 per month with $415 deductible. 2,884 Formulary drugs available. 30-day preferred pharmacy copays are $0 (Tier 1), $5 (Tier 2), $30 (Tier 3), 32% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $0 (Tier 1), $15 (Tier 2), $90 (Tier 3), 32% (Tier 4), and 25% (Tier 5).

AARP MedicareRx Saver Plus $28.90 per month with $405 deductible. 3,168 Formulary drugs available. 30-day preferred pharmacy copays are $1 (Tier 1), $5 (Tier 2), $34 (Tier 3), 41% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $3 (Tier 1), $15 (Tier 2), $102 (Tier 3), 32% (Tier 4), and 25% (Tier 5).

SilverScript Choice $29.50 per month with $0 deductible. 3,187 Formulary drugs available. 30-day preferred pharmacy copays are $9 (Tier 1), $19 (Tier 2), $46 (Tier 3), 49% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy copays are $22.50(Tier 1), $47.50 (Tier 2), $115 (Tier 3), 49% (Tier 4), and n/a (Tier 5).

WellCare Value Script $14.00 per month with $415 deductible. 3,327 Formulary drugs available. 30-day preferred pharmacy copays are $0 (Tier 1), $8 (Tier 2), $40 (Tier 3), 46% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $0(Tier 1), $24 (Tier 2), $120 (Tier 3), 46% (Tier 4), and n/a (Tier 5).

Cigna-HealthSpring Rx Secure-Essential $21.80 per month with $415 deductible. 3,154 Formulary drugs available. 30-day preferred pharmacy copays are $1 (Tier 1), $3 (Tier 2), 20% (Tier 3), 50% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $3(Tier 1), $9 (Tier 2), 20% (Tier 3), 50% (Tier 4), and n/a (Tier 5).

Mutual Of Omaha Rx Value $28.40 per month with $415 deductible. 2,806 Formulary drugs available. 30-day preferred pharmacy copays are $1 (Tier 1), $4 (Tier 2), 15% (Tier 3), 35% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy copays are $3(Tier 1), $12 (Tier 2), 15% (Tier 3), 50% (Tier 4), and n/a (Tier 5).

Impact On Businesses

 

Small and large business owners may find some attractive options although some company some owners may choose to pay a penalty that costs far less than providing benefits to employees. The employees would then be able to buy policies through the regular Exchange.  The “SHOP” Marketplace is exclusively set up for small business owners and is available all year. Residents over the age of 65 may be eligible for Medicare and possibly a MediGap plan.

A call center and “navigators” may provide some assistance in the application process. However, utilizing more experienced and unbiased brokers (there are no fees) may be the best way to ensure you’re receiving the maximum amount of federal tax subsidy and that you are being made aware of the best plans, both inside and outside of the Exchange.

After you request a quote on our website, we’ll begin researching your best Maryland healthcare options. we truly do the shopping, so you save.

PAST UPDATES:

The Maryland Health Insurance Exchange is in the process of being rebuilt. Last year, consumers experienced numerous problems and delays during the enrollment process. However, Governor O’Malley is confident the improvements will be completed by the time Open Enrollment begins in November at a cost in excess of $35 million.

By September, enough positive change and progress will have to  be recognized by the federal government, who is overseeing the changes. One possible result is that reduced access to all features by the beginning of enrollment may occur.

More than $28 million dollars may have to be returned to the Department of Health and Human Services because of mistakes in Medicaid funding allocation in 2013 and 2014.  However, Maryland’s Exchange Director Carolyn Quattrocki said that the state was in full compliance with Centers for Medicare and Medicaid Services (CMS) guidelines and she disagrees with the findings.

States that created their own Marketplaces are entitled to federal funds based on the number of persons that enroll in either an Exchange plan or Medicaid coverage. Part of the problem could be the closure of the MD Exchange in 2013 due to several glitches and software  issues.

Maryland carriers have submitted their projected 2016 rates to the Department of Insurance. Listed below are the requested increases that would impact plans issued January 1st, 2016 or later.

32.6% – CareFirst Blue Preferred Multi-State Plan

30.1% –  CareFirst BlueChoice Individual

21.9% – CareFirst BlueChoice Plus Individual

10.2% – Aetna HMO Off-Exchange Small Group

10.1% – Aetna PPO Small Group