Maryland Health Insurance

While health insurance can often be an overwhelming topic to try to research on your own, The Simple Dollar has created this guide to help you. This is a compilation of important facts and figures you can use when comparing health insurance coverage and rates in Maryland.

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Stats in Your State

Looking at the following charts, you will gain a better understanding of how health insurance premiums in Maryland stack up to figures for other states in the Mid-Atlantic, as well as the national average. And while you may be shopping around for private coverage or have a plan through your employer, many Maryland residents also take advantage of state-funded programs for assistance. Still, others remain uninsured because they are unable to find an affordable coverage option.

Chip Medicaid

For those who cannot afford to participate in an employer-offered family health insurance plan or do not have access to one, CHIP or Medicaid may be an option to help protect children and provide them with routine medical care. In 2010, more than 550,000 children were enrolled in CHIP and Medicaid in Maryland.

Individual Health Insurance Premiums

In 2011, the average single premium per enrolled employee for employer-based health insurance was $5,225 in Maryland, with the employer contributing $3,988 and the employee $1,237. This total was very close to the national average of $5,222.

Family Health Insurance Premiums

As for the average cost for a family health insurance premium in 2011, Maryland came in at $15,315, with the employer paying an average of $10,951 and the employee $4,364. The average for the U.S. that year was $15,022, with the employer contribution at around $11,060 and the employee $3,962.

SAHIE Health Insurance Uninsured

In 2010, statistics from the U.S. Census Bureau’s Small Area Health Estimates (SAHIE) program found there were approximately 630,000 individuals without health insurance in Maryland. This was equivalent to 12.7% of state residents.

Rules in Your State

Like most states, the majority of individuals in Maryland have health insurance coverage through a private provider. Some also take advantage of state-funded programs for more affordable options, when employer-offered programs are not available or premiums are too high.

Review your policy:

  • Read your Summary of Benefits to gain a better understanding of what is covered and what is not.
  • Learn what is defined as “medically necessary” under your plan.
  • Find out whether or not you need pre-approval or a referral for certain types of care.
  • Learn about the steps you can take if a claim is denied.

As a consumer, it is important to understand your rights when it comes to insurance. If you believe you have a violation to report, the Maryland Insurance Administration may be able to help. Below are just a few examples of potential violations.

It can be considered a violation if an insurance company or agent:

  • Denies or delays payment of all or some of your claim improperly.
  • Improperly raises your premiums or terminates your policy.
  • Does not pay or authorize the payment for services deemed medically necessary.
  • Makes false statements in selling you a policy or processing a claim.
  • Overcharges you for services or premium finance charges.

Representatives & Resources in Your State

If you believe your rights were violated or you have further questions about health insurance regulations in your state, the following are excellent resources. These include the Maryland Insurance Administration, Maryland Children's Health Program (MCHP), and the Maryland Department of Health and Mental Hygiene.

Maryland Insurance Administration
200 St. Paul Place
Suite 2700
Baltimore, MD 21202
Get Directions
410-468-200
Toll Free: 1-800-492-6116
File a complaint with the Maryland Insurance Administration here.

Maryland Department of Health and Mental Hygiene
201 West Preston Street
Baltimore, MD 21201
Get Directions
410-767-6500
1-877-463-3464

Maryland Children’s Health Program (MCHP)
Hotline: (800) 456-8900