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Types of Maryland & Pennsylvania health insurance plans

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Individual and family health insurance plans

Individual and family health insurance helps pay for the cost of health care, including medical emergencies, routine doctor's appointments, preventative care, and inpatient/outpatient treatment. With a family insurance plan, you, your spouse or partner, and your eligible children under 26 years old are usually covered. You typically pay a monthly premium, plus a deductible or copayment.

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Medicare plans

Our health insurance vendors offer Medicare health insurance plans that provide additional coverage for prescription drugs (stand-alone Medicare Part D prescription drug plans) and out-of-pocket expenses (Medigap) that typically aren't covered by Medicare. You can also enroll in a Medicare Advantage plan.

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Short-term health insurance

One of the most popular plans are short-term health insurance provides coverage for a fixed period of time (one month to three years).These plans are typically 80% cheaper than most medical health insurance plans, but may have limited benefits.

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Dental insurance

Plans vary per carrier, but normally cover preventive and basic care (e.g., oral exams, cleanings, fillings, and X-rays).

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Vision insurance

You can also find vision insurance plans. Eye care may not be covered by your health plan and vision insurance can lower your out-of-pocket costs for routine exams, plus eyeglasses and/or contact lenses.

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How does health insurance work?

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Health insurance works by splitting the cost of health care between you and your insurer. This cost sharing continues until you hit your maximum out-of-pocket limit for the year, after which your insurance covers 100% of your medical costs. Once your policy renews, your out-of-pocket limit resets and you resume splitting costs with your insurer.

But before you reach your maximum limit, you still need to pay for some of your medical care. These are the main costs you can expect to pay with a health insurance plan:
 

• Deductible: This is the amount you must pay out of pocket before your insurance pays for anything. Deductible amounts can range from $500 to over $5,000, depending on the plan type.
   

• Copays: These are set payments you make for medical services, such as doctor appointments. Copays generally apply even after hitting your deductible.
   

• Coinsurance: Coinsurance is the percentage of your medical bills you're responsible for after paying your deductible, but before meeting your out-of-pocket limit.
   

Important note: Your monthly health insurance premium doesn't count toward your out-of-pocket limit. However, any deductible, copay, or coinsurance you pay in a given year does count toward your maximum annual limit.

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What does health insurance cover?

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Health insurance typically covers a wide range of medical services, including doctor and hospital visits, emergency care, and more. By law, there are 10 essential health benefits that all major medical health insurance plans must cover:
 

• Outpatient care: Procedures that don't require you to stay in the hospital overnight.

• Preventive care: Includes vaccinations, checkups, and other routine care.

• Laboratory services: Includes blood work, CT scans, and other diagnostic services.

• Prescription drugs: Exactly which types and brands of drugs are covered varies by insurer.

• Emergency services: Includes emergency room visits and ambulance rides.

• Hospitalizations: Includes surgery and other procedures that require an overnight stay.

• Mental health care: Includes seeing a psychologist and treatment for substance use.

• Rehabilitation: Includes physical therapy after an injury.

• Maternity and newborn care: Includes doctor visits and treatment for pregnant woman and newborns.

• Pediatric services: Includes medical, dental, and vision coverage for children under age 19.​