How Health Insurance Works in Maryland’s State Marketplace

Health insurance helps protect your health and your money. But trying to figure it all out on your own can feel confusing and stressful. If you’re looking for help understanding how health insurance works in Maryland, this guide is for you.

We’ll walk you through how Maryland’s official insurance marketplace—Maryland Health Connection—works, who can use it, when to apply, how to get help paying, and how to choose the right plan for your needs.

Need one-on-one help? EIMA Health offers free guidance. Call us at (972) 728‑0386 or visit eimahealth.com/contact-us to schedule your appointment today.

Key Takeaways

1. Maryland Health Connection is the state’s official ACA health insurance marketplace for people who don’t have job-based insurance, Medicare, or Medicaid.
   
2. Most Maryland residents qualify for financial help, including premium tax credits and cost-sharing reductions, especially if their income falls between 100% and 400% of the Federal Poverty Level.
   
3. Open Enrollment typically runs from November 1 to January 15, but you may qualify for a Special Enrollment Period if you’ve had a major life event like losing Medicaid, moving, or having a baby.
   
4. Health plans are grouped by metal levels (Bronze, Silver, Gold, and Catastrophic), each offering different monthly premiums and out-of-pocket costs.
   
5. Choosing a plan should involve looking at more than just monthly costs—including deductibles, copays, network providers, and total yearly expenses.
   
6. Common mistakes to avoid include waiting too long to enroll, picking plans only by price, and not checking if your doctors are covered.
   
7. If you recently lost Medicaid, you may still qualify for low-cost or no-cost Marketplace coverage, but you must enroll within 60 days.
   
8. EIMA Health offers free, one-on-one help with enrollment, plan comparisons, and post-enrollment support—without pressure or hidden fees.
   
9. Many EIMA Health clients pay under $10/month for their plans thanks to expert help finding all available discounts.
   
10. Getting the right coverage doesn’t have to be stressful—EIMA Health can guide you through every step to make sure you’re covered and confident.

What Is Maryland Health Connection?

Maryland Health Connection is the state’s official website where you can apply for health insurance. It’s part of the Affordable Care Act (ACA) and helps people who don’t get health insurance through work, Medicaid, or Medicare.

You can use Maryland Health Connection to:

• Shop for health plans
  
• Compare costs and coverage
  
• See if you qualify for financial help
  
• Enroll in or renew your insurance
  

Plans listed on the site are from private insurance companies, but they are approved by the state. Every plan includes basic benefits like:

• Doctor visits
  
• Hospital care
  
• Emergency room visits
  
• Prescription drugs
  
• Pregnancy and childbirth care
  
• Mental health services
  

What Are the Plan Levels?

Health plans are grouped by “metal” levels:

• Bronze: Lower monthly cost, higher out-of-pocket costs when you get care
  
• Silver: Medium monthly cost; may come with lower out-of-pocket costs if you qualify
  
• Gold: Higher monthly cost, but less to pay when you need care
  
• Catastrophic: For people under 30 or with a hardship exemption; lowest monthly cost, highest costs when sick
  

Each level works differently depending on your income, budget, and health needs.

Who Can Enroll?

You can apply for a plan through Maryland Health Connection if:

• You live in Maryland
  
• You are a U.S. citizen or legal immigrant
  
• You are not currently incarcerated
  
• You don’t have access to affordable health insurance through a job or public program
  

Many people qualify for savings based on their income. Even if you earn more than you think is allowed, you may still be eligible for help.

Example: A 28-year-old gig worker in Baltimore earning $30,000/year could qualify for a Silver plan with a low premium and reduced out-of-pocket costs.

Not sure if you qualify? EIMA Health can check for you and explain your options clearly.

When Can You Enroll?

There are two main times to apply:

1. Open Enrollment

This happens once a year, usually from November 1 through January 15. During this time, you can sign up for a new plan, renew your current one, or switch to a different plan.

2. Special Enrollment Period (SEP)

You may qualify for a SEP if you’ve had a life change, such as:

• Losing job-based insurance or Medicaid
  
• Moving to Maryland
  
• Getting married or divorced
  
• Having a baby or adopting a child
  
• Turning 26 and aging off a parent’s plan
  

You typically have 60 days from the date of the event to enroll.

Note: Medicaid and the Maryland Children’s Health Program (MCHP) accept applications year-round.

What Kind of Financial Help Can You Get?

Health insurance can be expensive, but most people qualify for savings through Maryland Health Connection.

1. Premium Tax Credits

These reduce how much you pay each month for your plan. The amount depends on your income and family size.

2. Cost-Sharing Reductions

These lower the amount you pay when you go to the doctor or fill a prescription. You must choose a Silver plan to get this help.

Example: A family of four earning $42,000 a year could get a Silver plan with very low monthly costs and small fees for doctor visits and prescriptions.

At EIMA Health, most of our clients pay under $10 a month after applying their discounts. We help you get every dollar you qualify for.

How to Choose the Right Health Plan

Choosing the best plan isn’t just about the monthly premium. It’s also about what you’ll pay when you need care. Here’s what to look at:

• Deductible: How much you pay before your plan starts covering costs
  
• Copay: A flat fee for doctor visits or prescriptions
  
• Coinsurance: A percentage you pay after your deductible is met
  
• Out-of-Pocket Maximum: The most you’ll pay in a year
  
• Provider Network: The list of doctors and hospitals that accept your plan
  

Plan Comparison Table

Tip: Always check if your doctor or medications are covered by the plan. EIMA Health can help confirm that for you.

Common Mistakes to Avoid

When signing up for health insurance, many people make these errors:

• Waiting until the last minute
  
• Choosing based only on the lowest premium
  
• Not checking if their doctor is covered
  
• Skipping dental and vision plans if needed
  
• Thinking they won’t qualify for help
  

We see these mistakes often—but they’re easy to avoid with the right help.

What Happens After You Enroll?

Once you choose a plan:

1. You’ll get a letter confirming your enrollment and a health insurance card.
   
2. You need to pay your first premium before your coverage begins.
   
3. If anything changes—like your income, household size, or address—update your account.
   

EIMA Health offers support all year. We help with billing questions, doctor changes, renewals, and more.

What If You Lost Medicaid?

Many people in Maryland are losing Medicaid because of changes after the pandemic. If this happens to you, don’t panic—there are other options.

You may qualify for a Special Enrollment Period and get a plan through the Marketplace with help paying for it. But you only have 60 days to enroll after losing Medicaid.

Example: A single mother in Montgomery County lost Medicaid coverage. EIMA Health helped her apply for a Marketplace plan that covered her children and cost $0 per month.

Why Choose EIMA Health?

EIMA Health is not a call center. We’re a real team of licensed agents who take time to help you understand your options. Here’s what makes us different:

• No cost to you
  
• Clear and honest support
  
• One-on-one attention
  
• Help after enrollment—every step of the way
  

We listen, explain things in plain language, and never pressure you to choose a plan that doesn’t work for you.

We Help Maryland Residents Like You

Even though our office is based in Dallas, EIMA Health is licensed in Maryland and other states. We proudly support:

• Individuals who lost Medicaid
  
• Gig workers, freelancers, and part-time employees
  
• Parents looking for family coverage
  
• Seniors approaching Medicare age
  
• People who are new to buying insurance
  

Many of our clients are families earning between $15,000 and $50,000 a year. We help them find affordable plans, often for less than $10/month.

Conclusion

Health insurance can feel confusing, but it doesn’t have to be. If you live in Maryland and don’t get health coverage through work, you can shop for affordable plans through Maryland Health Connection. Many people qualify for financial help, and most plans include the care you need—from doctor visits to prescriptions.

But understanding deadlines, benefits, and provider networks takes time. That’s where EIMA Health comes in.

We’ll walk you through every step, answer your questions, and make sure you get the best plan for your life and budget. And we do it all for free.

👉 Call (972) 728‑0386 or visit eimahealth.com/contact-us to schedule your free appointment.

Let us help you get covered, stay covered, and feel confident in your care.

Frequently Asked Questions (FAQs)

This article has been a collaboration between EIMA Health and OpenAI’s ChatGPT. Created on Sep 9, 2025, it combines AI-generated draft material with EIMA Health’s expert revision and oversight, ensuring accuracy and relevance while addressing any AI limitations.

Emily Ima Founder

Hi, I’m Emily Ima, founder of EIMA Health and a proud Dallas resident. I started this agency with one mission: to make health insurance simple, affordable, and accessible, especially for families and individuals who feel overlooked or overwhelmed by the system. Living with Sickle Cell, I understand firsthand how frustrating and confusing healthcare can be. That’s why I take a personal, compassionate approach with every client whether it’s walking you through your ACA Marketplace options, helping you transition from Medicaid, or finding the best Medicare plan for your needs. You’re never just a number here. I take the time to listen, explain, and advocate for what’s best for you and your family. I serve clients across the country but have a special place in my heart for the Dallas community. When I’m not working, you can usually find me cheering on my daughter Emma at volleyball games, walking the trails with my family and our Goldendoodle Teddy, or exploring new recipes and restaurants around town, from southern food and Italian to Nigerian dishes and some good ole’ Texas BBQ. I’m a proud alumna of both Midwestern State University and the University of Texas at Dallas Go Mustangs and Comets! If you’re looking for someone who genuinely cares and will take the time to help you understand your health insurance options, you’re in the right place. Let’s get you covered with peace of mind.

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Sickle Cell Warrior Health Insurance Advocate Medicaid & Medicare Dallas ACA (Marketplace)