Medicare Maryland provides health care insurance to people over age 65 and to adults with chronic illnesses or disabilities. If you’re approaching age 65 and getting ready to retire, or you just want to reevaluate your current Medicare coverage, read on to learn about Medicare plans and coverage in your state.
Medicare Maryland is a federal health insurance program that provides coverage to people ages 65 and over, as well as individuals with certain disabilities, across the state. You can use Medicare as your only health insurance or use Medicare as a supplemental plan for additional coverage.
These are the available types of Medicare plans in Maryland:
- inpatient and outpatient hospital care
- short-term skilled nursing care
- in-home health care
- lab tests
- doctor’s appointments
- medical equipment such as wheelchairs
- basic preventive services
Prescription drug coverage (Part D)
You can add Part D (prescription drug coverage) to your original Medicare coverage to offset medication costs.
Each plan has formulary, which is a list of drugs that are covered. Before choosing a prescription drug plan, make sure your medications are included on that list.
Medicare Advantage plans, also known as Part C, cover the same services as original Medicare and Part D, all under one premium. Some plans will also include coverage for other health services such as hearing tests, vision services, and dental needs.
Advantage plans may also provide coverage for additional healthcare services, such as fitness classes or wellness programs.
There are hundreds of Medicare Advantage plans in Maryland, each with a unique set of coverage options, drug plans, and premiums.
These are the carriers of Medicare Advantage plans in Maryland.
- Kaiser Permanente
- Hopkins Health Advantage
- Sierra Health and Life
- Bravo Health Mid-Atlantic
- University of Maryland Health Advantage
- Optimum Choice
- Highmark Senior Health
- Provider Partners Health Plans
- ISNP Ventures
- Port Holdings
- The Johns Hopkins Health System Corporation
These carriers provide a variety of Medicare Advantage plans in Maryland, with a range of different premiums.
When researching plans, consider covered services and costs and weigh each plan carefully to see if it matches your healthcare needs.
Not all plans are available in every county, so make sure you’re searching for plans offered in your region.
Medicare plans in Maryland are available to people over age 65, as well as to adults with certain disabilities or chronic diseases.
You’ll be able to enroll for Medicare plans in Maryland if you meet the eligibility criteria:
- You’re years old or over.
- You’re a U.S. citizen or permanent resident.
- You qualify for Social Security benefits.
You may also be eligible if you’re living with certain disabilities or a chronic health condition such as end stage renal disease (ESRD), chronic lung disorders, cardiovascular disorders, or cancer.
If you qualify for Social Security benefits or Railroad Retirement benefits, you’ll likely be automatically enrolled in Medicare Maryland when you meet the eligibility criteria.
If you’re not automatically enrolled in original Medicare, your first opportunity to enroll in Medicare is during the initial enrollment period. This starts 3 months prior to your 65th birthday, giving you time to find out more about Medicare and enroll in a plan. If you enroll in the 3 months before your birthday, you’ll start receiving coverage as soon as you turn 65 years old.
The initial enrollment period will extend an additional 3 months after your birthday. If you enroll during your birthday month or in the 3 months following your birthday, benefits will begin a couple of months after you enroll.
Medicare Advantage plans in Maryland change every year, so you may want to reevaluate your coverage once per year. You’ll have two opportunities per year to switch between plans and find the coverage that’s best suited to your needs.
During both the Medicare open enrollment period from January 1 to March 31, and the Medicare annual enrollment period from October 15 to December 7, you can switch between Medicare Advantage plans in Maryland or add a Part D plan to your coverage.
Has your employment status recently changed? If you are no longer receiving employee benefits, or have recently been diagnosed with a chronic illness, you can ask for a special enrollment period to enroll in Medicare Maryland and receive coverage right away.
With so many Medicare plans in Maryland, it’s important to do your research in order to find the right plan for your healthcare needs. The following tips can help you narrow your choices:
1. Calculate your current healthcare costs
Include all current health insurance premiums, out-of-pocket expenses, and the services you accessed that were outside of your coverage. Look for a plan that will cover all these expenses, or as many of them as possible, to lower your out-of-pocket costs and make it easier for you to access quality care.
2. Call your doctor’s office
Did you know that private health insurance providers only work with network-approved doctors? If you’re considering a Medicare Advantage plan, ask your doctor what plans they accept, and make sure your consultations and appointments will be covered by your new plan.
3. Read reviews of the plans you’re considering
You can access the Medicare star ratings to find out what other people think of each plan. The plans are rated on a scale from 1 to 5, with 5 being the highest score. Plans with a high score are known to deliver excellent care as well as great support to plan members.
Access these resources if you have questions about Medicare plans in Maryland or need help enrolling in Medicare.
- Medicare (800-633-4227). You can contact Medicare directly to get more answers, compare plans, and find out more about Medicare coverage.
- Maryland Health Care Commission (410-764-3460). Find out more about federal and private Medicare plans and get advice on planning for long-term care or home care options.
- Maryland Department of Aging (800-243-3425). The Maryland Department of Aging can provide information on health insurance, the SHIP program for counseling and assistance, community wellness connections, and senior center services.
Take some time to evaluate your current healthcare needs and then look for Medicare Advantage plans in Maryland that will allow you to access appropriate healthcare to maintain your quality of life.
- Call Medicare or a Maryland SHIP counselor to get more advice about Medicare, and learn how to compare plans.
- Make a list of all your medications and make sure your prescription costs will be covered by the plan you choose.
- Visit the carriers’ websites to read more about each plan, then fill out a form online, or call the carrier directly, to start the application process.
If you’re qualifying for Medicare for the first time, or need to increase your coverage with a drug plan or an Advantage plan, make sure to take the time thoroughly research plans in order to find one that gives you the right coverage for your healthcare needs.