Maryland

Maryland’s Marketplace is state-run and residents should use the Maryland Health Connection site to enroll in Marketplace plans. Open enrollment runs from November 1, 2023 until January 15, 2024.

Under federal law, individuals may enroll in the Marketplace outside of the open enrollment period if they experience certain qualifying events, such as the loss of employer-based insurance, marriage, or having a baby (see a more complete list here). Maryland offers additional special enrollment periods (SEPs), including when the following occurs:

• Having a household income at or below 150 percent of the federal poverty level ($21,870 for an individual, $45,000 for a family of four) and being eligible for Marketplace subsidies.
• Losing Medicaid between March 31, 2023 and July 31, 2024—the Marketplace offers an extended SEP for these individuals, allowing them to apply for Marketplace coverage at any point within this period and giving them 60 days once they submit an application to select a plan.
• Indicating on a tax return or when filing for unemployment insurance that you would like to receive information about how to enroll in health insurance and qualifying for Marketplace coverage. More information about the tax filing program is available here.
• Becoming pregnant.

Restrictions may apply, including those outlined in this FAQ. Some SEPs may only be available to individuals who have current Marketplace coverage, and some SEPs may only be accessible through the Marketplace call center. The list of SEPs on our website is not an exhaustive one. If you recently experienced a change in circumstances that you think may qualify you for a SEP, check with the Marketplace, Maryland Health Connection to determine your enrollment options.

• Under federal law, short-term plans are not required to cover services for pre-existing conditions and typically provide far fewer benefits and cost-sharing protections compared to health plans available through the Marketplace. Federal rules allow these plans to last up to 12 months and be marketed as a substitute for Affordable Care Act coverage. However, states may modify these federal standards to make them more strict and also require short-term plans to follow additional consumer protections.
• Maryland allows short-term plans that last up to 3 months. These products can be sold during the open enrollment period.

Maryland does not require individuals to pay a penalty if they fail to maintain minimum essential coverage.

Under the Affordable Care Act, individuals may qualify for premium tax credits and plans with reduced cost-sharing based on their income and other factors. Maryland provides additional financial assistance to certain populations:

• Maryland will provide additional premium subsidies for certain young adults who enroll through the Marketplace. In 2024, the young adult premium subsidies are available to Marketplace enrollees ages 18-37 (as of the effective date of coverage) with annual household incomes between 138 and 400 percent of the federal poverty level (between $20,120 and $58,320 for an individual and between $41,400 and $120,000 for a family of four in Plan Year 2024) who are eligible to receive federal premium subsidies. The exchange may impose a cap on the number of eligible enrollees and other restrictions based on availability of state funds.

Under the Affordable Care Act, individual and group health plans that offer dependent benefits must allow parents to keep their children up to age 26 on their plan. Maryland law is consistent with this requirement.

The Affordable Care Act gives states the option to expand Medicaid to adults with household incomes at or below 138 percent of the federal poverty level. Maryland has taken advantage of this option so that adults with household incomes at or below 138 percent of the federal poverty level ($20,120 for an individual, $41,400 for a family of four annually) are eligible for Medicaid.

• In Maryland, children under age 19 are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) with household incomes at or below 322 percent of the federal poverty level ($96,600 for a family of four annually).
• Pregnant people are eligible for Medicaid with household incomes at or below 264 percent of the federal poverty level ($79,200 for a family of four annually).
• Consumers can learn about what coverage options they are eligible for, including Medicaid, through Maryland's state-based marketplace Maryland Health Connection.

• Generally, lawfully residing immigrants are eligible for Medicaid after a 5-year waiting period with some exceptions.
• In Maryland, lawfully residing children and pregnant people are exempt from the 5-year waiting period.

Federal law gives states the opportunity to optionally extend Medicaid eligibility for postpartum individuals up to 12 months. Maryland has implemented this coverage expansion.