Maryland Health Insurance

Maryland has fewer health insurance regulations than most states. Still, it's important to familiarize yourself with them, so you're more confident and wise in your purchase.

This guide:

  • Describes Maryland health insurance policy regulations.

  • Lists rules Maryland health insurance companies must follow.

Health insurance policies are regulated by each state's own health insurance laws. Maryland health insurance companies and policyholders alike must abide by established insurance laws.

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Maryland health insurance policy provisions

Some of the most important Maryland health insurance laws are the ones that influence the health insurance policy specifically. For instance, Maryland health insurance policies must contain a guaranteed renewability provision. This provision states that your health insurance is always renewable as long as you have paid your premiums on time.

Maryland health insurance policies can include a pre-existing condition exclusion period, but it can't extend more than 2 years. Health Maintenance Organizations (HMOs) are prohibited from imposing any exclusion period.

According to Maryland health insurance laws, the definition of a pre-existing condition varies from state to state but in Maryland they are defined as conditions you were treated for or diagnosed with in the past 7 years.

Maryland health insurance policies can, however, include elimination riders. These riders can be attached to health insurance policies to permanently exclude coverage for a pre-existing medical condition. You are then responsible for covering the cost of medical treatment for that condition.

If you are switching Maryland health insurance companies, the new health insurance company is permitted to impose a new exclusion period, within Maryland insurance regulations.

Finally, Maryland health insurance policies that cover dependents automatically cover newborns and adopted children for 31 days. Also, dependents with handicaps that are over the legal age limit for coverage under a parent's individual health plan, are allowed to be covered under a parent's policy.

Regulating Maryland health insurance companies

In Maryland, health insurance companies have few rules to abide by when deciding whether or not to offer a health insurance policy to an individual and what to charge for the policy.

Maryland health insurance laws allow insurance companies to use different factors when determining the cost and availability of your Maryland health insurance policy.

In other words, Maryland health insurance companies can use your health and age to decide whether or not they want to offer you a health insurance policy. Also, these same factors can be used to determine what your Maryland health insurance policy will cost.

Although it is illegal for a Maryland health insurance company to deny you continued coverage on the basis on health or age, your premiums can significantly increase due to these factors.

In conclusion, any Maryland health insurance company is free to refuse you coverage and charge you what they want. However, Maryland health insurance companies that participate in SAAC follow different rules. SAAC insurance companies must offer a Maryland health insurance policy to anyone during the yearly open enrollment period.

Temporary Maryland health insurance

If you have a break in your Maryland health insurance coverage, it is strongly advised that your purchase a temporary health insurance policy. The best option for temporary Maryland health insurance is a conversion policy.

Conversion policies are available to qualifying individuals. You qualify if you either: left a fully insured group policy or lost insurance through the death of a spouse or because of divorce.

If you purchase a conversion policy, no new pre-existing condition exclusion period is required. Also, your Maryland health insurance conversion plan can not be canceled because you fall ill. Sometimes the benefits you receive under a conversion policy will be different than your former Maryland health insurance policy's and your premiums may be substantially higher, but it offers adequate coverage when you need it.

If you do not qualify for a conversion policy, temporary Maryland health insurance is still available from some companies.

More MD health insurance help

If you want more help getting the a good health insurance policy, read our guide to health insurance.
Also see the guide to Maryland small business health insurance.

To find out more about MD health insurance laws and regulations, visit the official website of the Maryland Insurance Administration.