Medicare Advantage Plans in Maryland
Key Takeaways
- To get Medicare Advantage (Part C)Medicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). , you must be eligible for Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). .
- The Part B premiumA premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. applies to Medicare Part C plans.
- The number of available Part C plans has increased in Maryland, adding to your options.
- Many Part C plans in Maryland include prescription drug (Part D)Medicare Part D is prescription drug coverage for people enrolled in Medicare. Part D is optional and is offered by private insurance companies. coverage.
- If you have a disability, you may not have to wait until you turn 65 to get Medicare.
Medicare’s alphabet soup can be daunting. If you are dipping a toe into Medicare’s waters for the first time, you may be wondering what type of plan is right for you.
Read on to learn why many people in Maryland have opted to join a Medicare Advantage plan.
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Maryland Medicare Advantage Plan Coverage
Maryland is a small but mighty state, with over a million residents currently enrolled in Medicare.
Suppose you live in Maryland and are eligible for Original Medicare (Parts A and B). In that case, you also are eligible to enroll in Medicare Advantage (Part C) after you have Part A and Part B.
Medicare Advantage is a type of Medicare plan you buy from private companies. These companies are approved by Medicare and required to follow specific rules and guidelines.
By law, Part C plans must cover at least as much as Original Medicare. This ensures you have coverage for inpatient services in facilities such as hospitals. It also assures that you have coverage for outpatient services such as doctor’s visits, preventive care, and durable medical equipment.
The difference? Medicare Advantage plans often offer extra coverage that Original Medicare doesn’t. For example, many Part C plans include prescription drug coverage. When purchased separately, this is known as Medicare Part D. If your Medicare Advantage plan covers prescription drugs, you do not need to buy additional coverage for medications.
Other Part C extras may include:
- Vision care
- Dental care
- Hearing aids
- Health and wellness programs
- Transportation
- Over-the-counter drugs
MD Medicare Advantage Plan Costs
According to the Centers for Medicare & Medicaid Services (CMS), everyone in Maryland has access to a Part C plan with a $0 monthly premiums. As is true throughout the country, not every plan is available everywhere. Your county and ZIP code will determine which plans you can choose.
In 2024, the average Part C premium in Maryland is $35.50. This doesn’t include the monthly Part B premium, which you will typically have to pay in addition to your Part C premium.
For most people in 2025, the monthly Part B premium is $185. Based on the income you reported on your taxes two years ago, you may, in some instances, pay a higher monthly premium amount.
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Medicare Advantage Plan Eligibility and Enrollment in Maryland
If you’re eligible for Original Medicare, you’re eligible for Medicare Advantage in Maryland.
To qualify for Medicare, you must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five years or longer. If you meet this requirement, you may be eligible for Medicare if:
- You are 65 or older
- You have a disability
- You have end-stage renal disease
- You’re already receiving, or are eligible to receive, retirement benefits from either Social Security or the Railroad Retirement Board
- You or your spouse had Medicare-covered government employment
- You receive disability benefits from either Social Security or the Railroad Retirement Board for at least 24 months. An exception is typically made for people living with Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).
- You have ALS. If so, you are entitled to Medicare the first month you receive disability benefits from either SS or RRB.
- You are currently on dialysis or are a kidney transplant patient.
Initial Enrollment Period (IEP): If your eligibility is age-based, you can sign up for Medicare during the seven-month period that starts three months before you turn 65 and ends three months afterward.
For people with disabilities other than ALS, this period starts after 24 months of being eligible for, or having received, disability benefits from either Social Security or the Railroad Retirement Board.
Medicare Open Enrollment Period: You can join, switch, or drop a plan during Open Enrollment, which runs from October 15 to December 7 annually.
Medicare Advantage Open Enrollment Period: If you’re already enrolled in a Medicare Advantage plan, you can switch to a different Part C plan once during Medicare Advantage Open Enrollment.
You can also choose to switch from Part C to Original Medicare and add a Medicare Part D plan once during this timeframe. However, this doesn’t work in reverse. If you have Original Medicare, you can’t switch to a Part C plan during this time.
Medicare Advantage Open Enrollment runs from January 1 to March 31 each year.
Are There Maryland Medicare Advantage Plans With Prescription Drug Coverage?
There are several Medicare Advantage plans throughout the state that include prescription drug coverage.
Some of the plans available have a $0 monthly premium for both health and prescription drug coverage.
Some plans also have a $0 annual drug deductible. Other plans may charge a yearly drug deductible of $400 or more.
Make sure you read through what each plan offers to accurately gauge what you can expect to pay for prescription drugs throughout the year. A GoHealth licensed insurance agent will be happy to help you wade through each plan’s fine print so you get the right one for you.
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
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Sources
- FACT SHEET. CMS.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.