Durable medical equipment – equipment for small group plans.Durable medical equipment – hair prosthesis – for individual and large group plans.Diabetes care management – equipment, supplies and self-management training – for individual, small and large group plans.Congenital anomaly – cleft lip/palate – for individual, small and large group plans.Clinical trials – for individual, small and large group plans.Chiropractic care – for small group plans.Blood services and products – for small group plans.
Bariatric surgery – for morbid obesity – for individual, small and large group plans.Maryland currently mandates that the following benefits, which exceed ACA requirements, must be provided or offered by specified private providers authorized to sell health insurance within the state: *Lifetime dollar limits on these essential health benefits have been eliminated. Pediatric service, including oral and vision care*.Preventive and wellness and chronic disease management for adults and children, including 100% coverage for some services*.Rehabilitative and habilitative services and devices.Mental health and substance use disorder services including behavioral health treatment*.Plans offered by private insurers may offer additional benefits and individual states may require additional benefits, but all qualifying plans must offer these 10 standardized essential benefits: Under the Employer Shared Responsibility provision of ACA, beginning in 2015, all employers with 50 or more FTEs must offer employees at least one plan that is ACA-compliant or face fines of $2,000 per employee. Beginning in 2016, SHOP will be open to employers with up to 100 FTEs. However, you may qualify for tax credits worth up to 50% of your premium costs if you use the state exchange. If you own a small business in Maryland (50 or fewer full-time-equivalent employees – FTEs), you can purchase qualifying coverage for your employees through Maryland Health Connection for Small Business, the state’s SHOP (Small Business Health Option Program) exchange, or through a private broker or insurance agent. You can apply online at, by calling 85 or in person. However, if you have access to affordable, qualifying coverage from another source such as an employer or government program, you may not qualify for financial assistance from Maryland Health Connection. You are not covered for fewer than three months during the calendar yearĪbout Maryland Health Connection– The State Healthcare ExchangeĪny legal Maryland resident, except for legal minors, can buy healthcare coverage through the state exchange.Your income is below 100% of the poverty level.The cost of coverage exceeds 8% of your household income.You may be exempt from the individual mandate and tax penalties if: The penalty increases annually through 2017 and beyond. Beginning in 2014, the penalty for not having qualifying coverage is $95 per adult and $47.50 per child or 1% of your taxable income whichever is higher (up to $285 per family). This is called the “individual mandate.” There is a grace period through March 31, 2014. citizens and legal residents are required by law to have qualifying health care coverage or pay an annual tax penalty for every month they go without insurance. Provisions of the law have continued to be phased in following passage. The Patient Protection and Affordable Care Act (also known as ObamaCare and the Affordable Care Act and referred to in this guide as ACA) became law in 2010. Maryland and the Patient Protection and Affordable Care Act of 2010 You may also be entitled to certain state and federal programs such as Medicaid, CHIP or Medicare. If you are self-employed with no employees, you can also use the state exchange to purchase coverage. You may also purchase individual and family coverage from participating private insurers through Maryland Health Connection, the state-run exchange. Maryland Health Insurance Information, Resources and Access to Online Health Insurance QuotesĪs a Maryland resident you can choose from health insurance plans offered to individuals and groups by private insurance companies.
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