Medicare in Maryland - Compare Plan Options
Medicare in Maryland is a federal program that offers medical insurance to residents at least 65 years old or with a qualifying disability. Over one million people in Maryland benefit from this program.
Medicare Plans in Maryland
There are a variety of Medicare plans in Maryland that offer different levels of coverage tailored to your medical needs and lifestyle. If you have multiple health conditions or a disability, relying solely on Original Medicare may leave you with significant out-of-pocket expenses. Medicare Advantage can be a suitable alternative for comprehensive coverage. However, if you seek maximum coverage, a Medigap plan can help fill the remaining gaps left by Medicare.
Here are the five types of Medicare plans in Maryland:
Original Medicare (Parts A & B)
Original Medicare is the foundation of the Medicare program in Maryland, providing both Part A (hospital insurance) and Part B (medical insurance). Part A is typically available without a premium to individuals who have contributed to Medicare through ten years of work and tax payments. Part B requires a monthly premium that varies based on income. While Original Medicare offers comprehensive coverage for a wide range of healthcare services, it’s important to note that it does not include everything, such as prescription drug coverage.
Medicare Advantage (Part C)
In Maryland, Medicare-approved private insurers offer Medicare Advantage (MA) plans that provide comprehensive benefits beyond Original Medicare. These plans may include prescription drugs, vision, dental, and hearing coverage. Additionally, MA plans often have lower out-of-pocket costs compared to Original Medicare. With many Medicare Advantage options available in Maryland, exploring and selecting the plan that best aligns with your needs is important.
Medicare Supplement Insurance (Medigap)
Private insurers in Maryland offer Medigap plans that help bridge the gaps in coverage left by Original Medicare. These plans, ranging from A to N, are standardized by the government to ensure consistent benefits, with Medigap Plan G being the most popular choice.
In addition to your Original Medicare premium, Medigap plans require a monthly premium. These policies help cover expenses such as deductibles, co-payments, and coinsurances. You can compare Medigap quotes to see the average cost.
Medicare Prescription Drug Plans (Part D)
Prescription drug coverage is not included in Original Medicare in Maryland. You can get it through a standalone Medicare prescription drug plan offered by Medicare-approved private insurers. Choosing a plan that covers your medications is essential, as each plan has a formulary – a list of covered prescription drugs. Also, note that formulary changes may happen annually.
Special Needs Plans (SNPs)
Individuals with specific chronic conditions or needing specialized care, including those eligible for Medicare and Medicaid, can find value in Medicare Advantage plans known as Special Needs Plans (SNPs). In Maryland, three types of SNPs are available: Chronic Condition SNPs, Dual Eligible SNPs, and Institutional SNPs. It’s important to note that the availability of SNPs may vary across different areas of Maryland, and eligibility criteria for SNP plans may differ for each individual.
Medicare Eligibility in Maryland
Medicare benefits in Maryland are available for individuals aged 65 and older and those with disabilities who are younger. People diagnosed with End-Stage Renal Disease (ESRD) are also eligible for these benefits.
To be eligible for Medicare in Maryland, you must meet national standards established by the Social Security Administration (SSA). If you are a U.S. citizen or permanent resident and have worked in jobs subject to Medicare taxes for a minimum of ten years, you will become eligible for Medicare when you turn 65. However, it is important to note that before you apply for Medicare benefits, you must have lived in the United States continuously for at least five years.
Individuals younger than 65 may be eligible if they have received Social Security disability benefits for at least 24 months or have ESRD. Individuals with ESRD must also meet residency requirements to be eligible.
In addition to meeting specific eligibility requirements, applicants must apply for Medicare coverage before their 65th birthday or within three months after their disability begins to avoid late enrollment penalties. Applicants can use the Social Security website or visit a local office for assistance and advice.
How Do I Apply for Medicare in Maryland?
Applying for Medicare in Maryland is an easy process. You can apply online or by phone.
If you apply online, you must visit the Social Security Administration website and complete an application. The website includes a helpful tutorial that walks you through the process step-by-step. Once your application has been submitted, completing the process typically takes less than 10 minutes.
If you prefer to apply over the phone, call 1-800-772-1213 (TTY users should call 1-800-325-0778).
Conclusion
As you can see, each plan type has unique features and benefits. Choosing the right Medicare plan in Maryland can seem daunting at first, but don’t let that scare you off. Take some time to research, ask questions, and decide which plan best fits your specific healthcare needs and budget.
Article Sources: Medicare Health Plans | Medigap | Prescription Drug Coverage | Medicare Advantage
Maryland Medicare Resources
- Maryland Association of Area Agencies on Aging
- Maryland Insurance Administration
- Maryland Department of Human Services
- Baltimore County Area Agency on Aging
