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Medicare in Maryland

October 6, 2016

Health care is a primary concern for retired Americans. Fortunately, the United States government sponsors a health insurance plan, Medicare, for those aged 65 and over. In Maryland, as in all states, Medicare beneficiaries receive coverage for medical insurance and hospital insurance under Original Medicare, Part A and Part B. They can also enroll in private Medicare approved health insurance plans, such as Medicare Advantage (Medicare Part C) or Medicare Part D (prescription drug coverage).

Original Medicare for Maryland beneficiaries

Original Medicare consists of two parts: Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Original Medicare is available to U.S. citizens and legal residents aged 65 and over, and those with qualifying disabilities. In Maryland, as in every state, you’re automatically enrolled in Medicare when you turn 65 if you’re already collecting Social Security benefits (or, typically, if you’re younger than 65 and collecting Social Security or Railroad Retirement Board disability benefits after 25 months).

If you’re not enrolled automatically, you can sign up for Original Medicare during the seven-month Medicare Initial Enrollment Period, which begins three months before the month you turn 65, your birthday month, and ends three months after your birthday month. You can also enroll in Medicare during the annual General Enrollment Period, which runs from January 1 to March 31, but if you miss your Initial Enrollment Period and enroll in Medicare at a later date, you might pay a late-enrollment penalty, which translates into higher monthly premiums.

Medicare beneficiaries in Maryland, like those in other states, can generally enroll in Medicare Part A premium free if they’ve worked at least 10 years while paying Medicare taxes. If you don’t qualify for premium-free Medicare Part A, you may have to pay a premium.

As a Medicare Part A beneficiary, you’re eligible for the following health benefits:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Limited home health services

Original Medicare also includes medical insurance under Medicare Part B. Typically you must pay a monthly premium for Medicare Part B. Under Medicare Part B, Maryland beneficiaries may receive coverage for services and supplies such as, but not limited to:

  • Physician services
  • Medicare –approved clinical research
  • Ambulance services
  • Durable medical equipment
  • Mental health (inpatient, outpatient, and partial hospitalization)
  • Second opinion before surgery
  • Limited outpatient prescription drugs

Medicare private insurance in Maryland

You may choose to receive your Medicare benefits in Maryland through a Medicare Advantage plan (Medicare Part C), which is provided by private insurance companies approved by Medicare. A Medicare Advantage plan in Maryland, as in the rest of the United States, is required by the government to offer at least the same medical and hospitalization coverage as Original Medicare, Part A and Part B (except hospice care, which continues to be covered under Part A). Some Medicare Advantage plans also offer extra coverage not available under Original Medicare, like routine hearing, routine vision, or routine dental benefits. A common type of Medicare Part C plan is a Medicare Advantage Prescription Drug plan, which combines health and prescription drug coverage into a single private plan.

You need to have Medicare Part A and Part B to sign up for a Medicare Advantage or Medicare Advantage Prescription Drug plan. Be aware that if you enroll in a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan, you have to continue paying the Medicare Part B premium. To learn more, read about Medicare Advantage plans in Maryland.

If you have Original Medicare in Maryland (as in other states), you may be able to apply for a Medicare Supplement (Medigap) plan. Medicare Supplement plans are offered by private insurance companies and can help you pay for out-of-pocket costs for services covered by Medicare Part A and Part B. These out-of-pocket expenses may include coinsurance, copayments, and deductibles. Prescription drug coverage for Medicare beneficiaries is available through Medicare Part D. Offered by private insurance companies contracted with Medicare, stand-alone Medicare Prescription Drug Plans can help you pay for prescription medications.  Medicare Part D Prescription Drug Plans are designed to complement Original Medicare and Medicare Advantage plans that do not include prescription drug coverage. Medicare Part D Prescription Drug Plans may have different costs, depending on the extent of the coverage you select, but most plans require payment of a monthly premium, annual deductible, and copayment or coinsurance.

As a Maryland resident, you may have access to various Medicare plans offered by private insurance companies approved by Medicare, depending on the county in which you live. Which type of Medicare insurance do you prefer? You may want to start by considering your personal health and prescription drug needs and then research what types of plans and coverage options are available where you live by entering your zip code (and prescription medications) in the plan finder located on this page.

Maryland resources for Medicare beneficiaries

There are a number of resources designed to help Medicare beneficiaries in Maryland find information. Here are some of the resources that may be helpful to you: