Maryland Health Insurance Coverage...
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• A Summary of your Protections afforded you under Maryland Health Insurance Laws.
     Numerous state and federal laws make it easier for people with pre-existing conditions to get or keep health insurance, or to change from one health plan to another. A federal law, known as the Health Insurance Portability and Accountability Act (HIPAA) sets national standards for all health plans. In addition, states can pass different reforms for the health plans they regulate (fully insured group health plans and individual health plans), so your protections may vary if you leave Maryland. Maryland has expanded protections for certain kinds of health insurance beyond what federal law requires. Neither federal nor state laws protect your access to health insurance in all circumstances.
• In Maryland, as in many other states, your health insurance options are somewhat dependent on your health status
     Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination.
• All health plans in Maryland must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new health plan will begin to pay for care for that condition.
     Generally, if you join a new group health plan your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage. If you are covered under an HMO or a small group health plan, insurers may not impose any such exclusions, unless you enroll late in a small group plan.
• Your health insurance cannot be canceled because you get sick. Most health insurance is guaranteed renewable.
• If you leave your job, you may be able to remain in your old group health plan for a certain length of time.
     This is called COBRA or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage.
• If you are federally eligible, you are guaranteed the right to buy an individual health plan from any insurance company that sells such plans in Maryland.
     Insurance companies must offer you a choice of at least two plans. However, they may charge you higher premiums due to your health status, age, or other factors.
• Health plans that participate in Maryland’s Substantial, Available, and Affordable Coverage (SAAC) program are required to have two annual open enrollment periods for people seeking individual health insurance.
  During this period, if you live in the service area of one of these health plans, you can buy individual health coverage without regard to your health status.
• There is a principle called "Guaranteed Issue".
     If you are a small employer buying a group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group.
• If you are a small employer buying a group health plan, you cannot be charged more due to the health status of those in your group.
     You can, however, be charged higher premiums, within limits, because of age, where your business is located, and family composition. This is called modified community rating.
• If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family.
     The Maryland Medicaid program (called HealthChoice for some people who enroll in it) offers free health coverage for pregnant women, families with children, elderly and disabled individuals with very low incomes. Maryland’s Children’s Health Program is a part of the Medicaid program that provides health insurance to some low income children and pregnant women.

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