Need some help with Medicare? If you’re beginning your search for Maryland Medicare coverage, you’ve come to the right place. We’ve pulled together a wealth of information to help you make the most informed decision possible. From the basics to comparison-shopping for a plan, we’ve got you covered.
The Best Medicare in Maryland:
- Best Medicare in Maryland: Kaiser Permanente
- Cheapest Medicare in Maryland: Johns Hopkins Healthcare
- Most Flexible Medicare: UnitedHealthcare
- Best for an All-in-One Medical Team: Cigna
- Best for Medical Savings Account: Lasso Healthcare
What is Medicare?
Medicare is a federal health insurance program covering:
- Enrollees or a spouse 65 or older and worked for 40 quarters for a Medicare-covered employer
- Some younger people who are disabled and have received Social Security Disability Insurance (SSDI) or Railroad Retirement disability payments for 24 months
- Those with end-stage renal disease or kidney failure necessitating a transplant or dialysis
- Those with Lou Gehrig’s disease who received an initial month of SSDI payments
You must be a U.S. citizen or legal resident for 5 years or more. To learn more about qualifying, call Social Security Administration at 800-772-1213 or go online. To figure out your eligibility or calculate your premium, see this calculator.
What are Medicare Plans and Who is Eligible?
Part A: Medicare Part A covers home health services, hospice care, skilled nursing facility care, inpatient hospital care and inpatient care in a skilled nursing facility but not long-term or custodial care.
Part B: This voluntary component requires paying a monthly premium. Medicare Part B covers medical insurance, including preventive services, medical equipment, outpatient care and ambulance services. It also applies to part-time services such as rehabilitation and home health support as ordered by your physician.
Part C: Also called a Medicare Advantage plan, Part C is private insurance approved by Medicare. These provide both Part A and Part B coverage and may offer extra services including dental, vision and hearing. You are eligible if you are enrolled in both Medicare Part A and B — also known as Original Medicare. If you live in a Medicare Advantage service area that is accepting new applicants, you’re eligible. (In certain circumstances, you are not eligible if you have end-stage renal disease.)
Part D: The prescription portion of Medicare, Medicare Part D plans have a list of covered drugs, with both brand names and generics. While all Medicare Part D plans must cover at least 2 drugs per category, individual plans can choose which drugs they offer. Your specific medication may not be available, but a similar drug should be. If you’re eligible for Original Medicare, you’re eligible for Medicare Part D.
Legalities of Medicare in Maryland
Medicare in Maryland is administered by the federal government. With more than 1 million Medicare enrollees in Maryland, the program is robust. As of last year, there were just under 50 insurers who offered medical supplement insurance. Maryland law mandates access to Medigap Plans A and C if you are younger than 65. While only 11% of Maryland’s Medicare enrollees opt for a Medicare Advantage plan, more than 50% have opted for standalone Part D prescription coverage.
If you’re on Medicare in Maryland, you can legally switch from Original to Medicare Advantage — or the opposite — from October 15 through December 7, the annual open enrollment time. Those who are currently enrolled in Medicare Advantage plans are able to swap to another Medicare Advantage choice or go back to Original Medicare. This Medicare Advantage open enrollment period runs from January 1 to March 31.
As for Medigap — the supplemental insurance plan — Maryland insurers must guarantee both Plan A and Plan C, if the insurer offers this plan, to those who are under age 65 and have applied for the plan within a half year of enrolling in Medicare Part B. While federal rules also hold that Medicare enrollees have 6 months after turning 65 and enroll in Original Medicare to get guaranteed-issue Medigap, access is not as certain to those eligible for Medicare because of a disability.
Here are a few bits of critical information regarding Medigap:
- You must first have Medicare Part A and B (Original Medicare).
- Only 1 person is covered by a Medigap policy.
- Medigap differs from Medicare Advantage — the former supplements Original Medicare, while the latter gives you Medicare benefits.
- Your monthly Medigap premium is in addition to your monthly Part B premium.
- So long as you pay the premium, your Medigap policy cannot be cancelled even if you develop health issues.
- Medigap policies sold after January 1, 2006, do not include prescription drug coverage (Part D). This must be procured separately.
- You can purchase Medigap from any insurer licensed to sell it.
- An insurer may not legally sell you a Medigap policy if you already have a Medicare Advantage Plan — the only exception is if you’re switching back to Original Medicare.
Remember that Medigap doesn’t cover everything: Long-term care, hearing aids, vision or dental care, private-duty nursing and eyeglasses are excluded.
Types of Medicare Advantage Plans
Interested in Medicare Advantage plans? Start your research here. We’ve collected some essential basic information that you’ll need.
HMO: Under HMO plans, your medical care comes from network providers with a few exceptions: out-of-area urgent care, out-of-area dialysis and emergency care. HMO plans usually cover prescription drugs, but double-check before you make a final decision. In most cases, if you get medical services outside of your network, you’ll be responsible for the entire cost.
PPO: PPO plans come courtesy of private insurers. They have their own network physicians, care providers and hospitals, but you can use out-of-network providers as long as you are prepared to pay more. Prescriptions are typically covered by PPOs, but make sure you confirm this before making a permanent commitment.
How to Sign Up for Medicare in Maryland
If you’re looking for help getting started with enrolling in Medicare in Maryland, keep in mind that the State Health Insurance Assistance Program is available in all 23 counties and Baltimore City, in-person and by phone. They can help with issues including:
- Medicare Part A
- Medicare Part B
- Medicare Part C
- Medicare Part D
- Fraud and abuse
- Volunteer opportunities
- Financial assistance for low-income enrollees
- Billing issues, denials, appeals and grievances
- Free community presentations
You can sign up for Medicare online. If you’re only seeking Original Medicare, this should take about 10 minutes with no documentation or signatures required. Social Security works in tandem with the Centers for Medicare and Medicaid services to enroll participants.
Here is your checklist of documents and other information you’ll want to gather before beginning to enroll:
- Date and place of birth
- Medicaid number
- Current health and insurance
- Marriage and divorce information, if applicable
- Child-related information, if applicable
- Military service information, if applicable
- Employer details for current year and prior 2 years
- Self-employment details for current year and prior 2 years
- Direct deposit information
Already enrolled in Medicare Part A and want to sign up for Medicare Part B? Complete this form and return it to your local Social Security office by mail or in person.
You are eligible to apply online for Medicare if you are:
- At least 64 years and 9 months of age
- Don’t want to start receiving Social Security benefits currently and are not receiving Social security retirement, disability or survivors’ benefits
It’s best to sign up for Medicare 3 months before you turn 65 years of age. You can enroll in Medicare Part A as well as Part B, but if you don’t want Part B because there is a premium, you can specify that on the application. You may also apply by phone at 855-971-2115 or at your local Social Security office.
Once your application is received, it will be reviewed and processed. You will receive a decision letter in the mail.
Average Cost of Medicare Advantage Plans in Maryland
Now it’s time to start comparison-shopping for the right plan to meet your individual needs. We’ve pulled together some data to get you started.
Plan Name | Company | Plan Type | Health & Drug Costs |
|---|---|---|---|
| Kaiser Permanente Medicare Advantage Value HMO | Kaiser Permanente | Medicare Advantage with drug coverage monthly premium | $144.60 monthly Standard Part B premium |
| Johns Hopkins Advantage MD HMO | Johns Hopkins Healthcare | Medicare Advantage with drug coverage monthly premium | $144.60 monthly Standard Part B premium |
| Lasso Healthcare MSA | Lasso Healthcare | Medicare Advantage without drug coverage monthly premium | $144.60 monthly Standard Part B premium |
| Cigna-Healthspring Preferred HMO | Cigna | Medicare Advantage with drug coverage monthly premium | $59.00 monthly plus $144.60 monthly Standard Part B premium |
| Erickson Advantage Liberty Without Drugs HMO | UnitedHealthcare | Medicare Advantage without drug coverage monthly premium | $144.60 monthly Standard Part B premium |
Best Medicare Insurance Providers in Maryland
- Access to Kaiser medical specialists
1. Best Overall in Maryland: Kaiser Permanente
Kaiser’s reach and extensive network offer Medicare enrollees in Maryland an impressive array of choice. Plans range from budget-conscious to premium service and can be customized to your individual needs.
Drug coverage is also available with many plans. Most plans also provide fitness services with no cost for gym memberships, exercise facilities and home fitness programs.
2. Most Affordable in Maryland: Johns Hopkins Healthcare
Johns Hopkins offers affordable all-in-one healthcare coverage through its Medicare Advantage plan. With wide-ranging health benefits and built-in prescription drug coverage including dental, vision and hearing services, you get what you need when you need it.
You’ll also get it at easy-to-manage costs including $0 prescription drug deductibles, $0 copays for preventive care, and full coverage for Medicare Part A and B deductibles. The Hopkins network also includes many of the region’s major medical providers, connecting you to quality care when you need it most.
- Same day coverage available
3. Best for Flexibility: UnitedHealthcare
UnitedHealthcare provides affordable, accessible Medicare Advantage plans, with a website that offers a wide range of information to help you make the right choice for your situation. Plans are easily customizable and simple to tailor to your needs.
Reviews herald UnitedHealthcare professionals as caring and well-informed. Moreover, Golden Rule Insurance Company, which has been folded into UnitedHealthcare, has provided Medicare policies for 3 decades.
- Easy access to benefits
4. Best for an All-in-One Medical Team: Cigna
With Cigna’s Medical Advantage plan, your doctors and specialists work hand-in-hand with case managers and pharmacists to provide the best in quality healthcare.
What’s more, this all-in-one plan rolls all of Medicare’s benefits into a single offering, streamlining the process. Also included are health coaching and fitness programs, often at no cost to you. Low monthly premiums make these plans particularly attractive.
- Best for MSA
5. Best for Medical Savings Account: Lasso Healthcare
With a Medicare Medical Savings Account from Lasso Healthcare, you get a high-deductible plan plus an initial deposit into your medical savings account. That funded account can then be used to cover healthcare expenses.
Once you reach the deductible, the plan pays for Medicare services. You can also earn up to $250 in gift cards associated with the plan.
What Else Should I Know?
Comparison-shopping is the best way to find the right Medicare plan for your needs. Remember to read all the associated literature that goes with any option before you settle on a decision. The investment of time is well worth it.
Frequently Asked Questions
1) Q: What are the different parts of Medicare?
A: Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
2) Q: Is Medicare free?
A: Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.
3) Q: Do I need to sign up for Medicare?
A: If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.