Medicare Advantage Plans in Maryland

Medicare-approved private companies offer Medicare Advantage plans in Maryland. They follow the rules set by Medicare and are viewed as a replacement for Original Medicare.

But, you’re not losing Medicare. Instead, your private insurer will be responsible for your claims, as well as other aspects of its administration. Medicare Advantage members must pay their Medicare Part B premiums to be eligible for an Advantage plan.

The standard monthly Medicare Part B premium for 2022 is $164.90.

The annual Part B deducible for 2023 is $226.

Each year, MA plans become more popular. Their appeal is due to their predictable costs for in-network services and the additional optional coverage benefits available.

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Top-rated Medicare Advantage Plan Providers in Maryland

  • Humana: Humana offers PPO plans in Maryland.
  • Kaiser: Kaiser plans have proven popular with Maryland Medicare beneficiaries, and this company commands almost 40 percent of the total Medicare Part C market. Kaiser cost plans have also earned 5 stars for quality.
  • Cigna: Cigna has enrolled just about 10 percent of the market.

Popular Medicare Advantage plan types in Maryland

Different plans offer different premiums and benefits. You need to find the one that’s best for you.

Best Network Freedom: Medicare Advantage PPO

Preferred Provider Organizations (PPOs) offer a more extensive network and do not require referrals. But, what sets PPO plans apart is that you can still see out-of-network doctors, adding flexibility that is particularly useful for travelers who may need coverage for visits outside of their home area.

PPOs often include prescription drug costs, with premiums ranging from $0 to $100 per month.

Additional Benefits Offered Under Medicare Advantage Plans in Maryland

  • Vision
  • Dental
  • Hearing
  • Gym memberships
  • OTC medications
  • Transportation for medical appointments
  • Delivery of meals

Some Advantage Plans even offer prescription drug benefits and carry the label of Medicare Advantage Prescription Drug (MAPD) plans.

Best for Lowest Out-of-Pocket: Medicare Advantage HMO Plan

HMO premiums are generally $0 per month. But, there are restrictions, such as needing referrals from your primary care doctor to see specialists. Your coverage is also likely limited to in-network providers.

Best for Low Income or Health Conditions: Medicare Advantage D-SNP

Medicare Special Needs Plans (SNPs) limit membership to people with specific characteristics, like chronic health conditions.

Subscribers to SNPs are eligible to retain both Medicare and Medicaid coverage to limit their out pocket costs for copays, premiums, and more.

Eligible SNP Membership Groups

  • People living in certain institutional settings (like a nursing home) or who require nursing care at home
  • People who are eligible for both Medicare and Medicaid
  • People who have specific disabling or chronic conditions (like End-Stage Renal Disease (ESRD), HIV/AIDS, diabetes, chronic heart failure, or dementia)

Maryland Enrollment Facts:

  • As of 2018, there were 131,973 enrolled in Medicare Advantage plans in Maryland.
  • There are 33,394 residents of Maryland enrolled in local HMO plans.
  • There are 41,124 residents of Maryland enrolled in local PPO plans.
  • No one in Maryland is enrolled in a regional PPO plan.
  • Only 12.5% of Medicare beneficiaries in Maryland are enrolled in a Medicare Advantage plan.
  • There are nearly 20 million people currently enrolled in Medicare Advantage plans nationwide.
  • 42% of the total number of Medicare beneficiaries in the United States are enrolled in Medicare Advantage plans.

How much does Medicare Advantage in Maryland cost?

Even within a state, plan availability varies significantly by county. The average cost of a Medicare Advantage in Maryland is $66. To put that in perspective, the lowest average premium is in Nevada ($13), and the highest is in North Dakota ($78).

Maryland’s premiums are double the national average.

Some states do offer $0 per month premiums via an HMO. The number of states offering a PPO with a $0 per month premium is dwindling, as more PPOs are charging premiums. Maryland has, but it’s becoming more common for PPOs to have premiums.

How much do Advantage Plans cost in Maryland?

PPO Plan $0.00 to $66.00

HMO Plan $0.00

When can I enroll in a Medicare Advantage plan?

Medicare supplement insurance does not have a defined enrollment period. But, you are only typically eligible to enroll in a Medicare Advantage plan during three specific periods.

Initial Enrollment Period

If someone is eligible for Medicare Part A coverage for free due to their age, their enrollment eligibility begins three months before the month you turn 65 and ends three months after. Those seven months of enrollment eligibility are collectively called the Initial Enrollment Period (IEP).

Open Enrollment Period (Annual Election Period)

The Open Enrollment Period (OEP) is also called the Annual Election Period (AEP). It runs annually from October 15 to December 7, and beneficiaries can enroll and apply for coverage under a Medicare Advantage plan at this time.

They are also allowed to make certain changes to their coverage:

  • Change from Original Medicare to Medicare Advantage
  • Move from a Medicare Advantage plan back to Original Medicare
  • Change from one Medicare Advantage plan to another available in their area
  • Change from Medicare Advantage plan offering drug coverage to one that doesn’t, or from one that doesn’t to one that does.

Special Enrollment Periods

The Special Enrollment Period allows for enrollment under certain special circumstances.

Some examples of these specific situations include:

  • Relocating out of a Medicare Advantage plan’s service area
  • Becoming eligible for Medicaid
  • Receiving care in institutional settings

5-Star Special Enrollment Period

Switching to a Medicare Advantage plan with the highest possible rating (5-star) from one that doesn’t have as good a rating is always allowed. Please note that this option is only available once per enrollment period (December 8th-November 30th).

Special Enrollment Periods if You Get “Extra Help”

Qualifying for the Extra Help program automatically makes you eligible to enroll in Medicare Advantage plans.

Ready to Learn More?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Give us a call today, or request a quote online to learn more about plan options.

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