Medicare in Maryland
Find affordable Medicare plans in Maryland
As a Medicare beneficiary living in Maryland, you may have options in how you receive your Medicare benefits, and you may want to consider them carefully before you make a decision.
Original Medicare for Maryland beneficiaries
Original Medicare, administered by the federal government, provides hospital and medical insurance coverage for many people age 65 and older who are United States citizens or legal, permanent residents of at least five continuous years. If you’re under age 65, and you’ve been receiving disability benefits from the Social Security Agency or the Railroad Retirement Board, you generally qualify for Medicare. At any age, you might qualify for Medicare if you have amyotrophic laterals sclerosis (ALS) or end-stage renal disease (kidney failure requiring dialysis and/or a transplant).
Medicare benefits work the same way throughout the country. You will be able to see any provider that is participating in the Medicare program and accepts Medicare assignment—in Maryland and elsewhere.
Original Medicare has two parts, Part A (hospital insurance) and Part B (medical insurance). Most people automatically receive Part A without a monthly premium if they’ve worked 10 years (40 quarters) and paid Medicare taxes. If you don’t qualify for premium-free Part A, you can still enroll and pay a monthly premium. Part B has a premium that most beneficiaries must pay. You can read more details about Medicare Part A and Medicare Part B here.
Original Medicare generally provides some preventive care benefits – including certain cancer screenings – at no cost to beneficiaries when qualified Medicare-assigned health professionals deliver the service. According to a study by the Centers for Medicare & Medicaid Services (CMS), 436,947 people in Maryland with Original Medicare took advantage of at least one preventive service without any out-of-pocket expense from January through July, 2016.
For most covered services, however, you are responsible for certain out-of-pocket costs such as deductibles, copayments and/or coinsurance if you have Medicare Part A and/or Part B. The deductible may change each year. After you have met your deductible, Medicare generally pays 80 percent of the Medicare-approved amount for covered services.
In Maryland, as in the rest of the country, you can sign up for Original Medicare during certain enrollment periods. You can enroll in Medicare through Social Security online, by phone, or in person at a local Social Security office. To find a Maryland office near you, click here. If you worked for a railroad, you can call the Railroad Retirement Board (RRB) to apply for Medicare. The RRB can be reached at 1-877-772-5772; TTY users 1-312-751-4701. RRB representatives are available Monday through Friday, 9AM to 3:30PM.
Medicare plan options in Maryland
As a resident of Maryland, you usually have options as to how you receive your Medicare benefits, including coverage that may go beyond what Original Medicare provides.
Medicare prescription drug coverage in Maryland
Prescription drug coverage is optional; it’s designed to help pay the costs of medication. According to a CMS study, 595,185 Medicare beneficiaries in Maryland received Medicare prescription drug coverage as of January 2017. You may want to explore Medicare Part D prescription drug coverage options that are available in Maryland.
Option #1: Enroll in a stand-alone Medicare Part D Prescription Drug Plan (PDP). If you have Medicare Part A and/or Medicare Part B, you can enroll in any stand-alone Medicare Part D Prescription Drug Plan that’s available where you live.
Option #2: Enroll in any Medicare Advantage Prescription Drug plan if you have both Part A and Part B coverage and you live in the plan’s service area. If you choose this option, you receive your Medicare Part A (hospital insurance), Part B (medical insurance) and Part D (prescription drug coverage) from a single private insurance company contracted with Medicare to provide coverage for these services (except hospice care, which is covered under Part A). Please note that not every Medicare Advantage plan includes prescription drug coverage, although most do.
Medicare Advantage in Maryland
The Medicare Advantage (sometimes referred to as Medicare Part C) program gives you an alternative way to receive your Medicare Part A and Part B benefits –and possible Part D benefits–through Medicare-approved private insurers. The Medicare Advantage program is growing in popularity in Maryland and nationwide. Medicare Advantage plans provide all of the benefits of Original Medicare Part A and Part B (except hospice care, which is still covered by Part A even when you’re in a Medicare Advantage plan). Many plans include extra benefits –such as routine vision and/or dental coverage. Typically Medicare Advantage plans have local networks of participating hospitals, physicians and other health professionals. Deductibles, coinsurance and copayment amounts vary by Medicare Advantage plan, so it is a good idea to compare the Medicare Advantage plans offered where you live. Please note that if you have end-stage renal disease, you might not be eligible for a Medicare Advantage plan.
Medicare Supplement (Medigap) plans in Maryland
If you decide to stay with Original Medicare (Part A and Part B), another option you may have is to sign up for a Medicare Supplement (Medigap) plan to help pay for Original Medicare’s out-of-pocket costs. Different Medicare Supplement plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles. Medicare supplement plans can work alongside your Original Medicare Part A and Part B coverage and your Medicare Part D Prescription Drug Plan coverage.
Maryland resources for Medicare beneficiaries
A number of agencies in Maryland provide additional information and assistance to Medicare beneficiaries. You may find the following resources helpful.
Maryland Department of Aging (MDOA) offers range of services and sources of information for seniors, including information and counseling on long-term care, housing, fraud prevention, community health events for seniors and more.
Senior Health Insurance Assistance Program (SHIP) helps seniors understand their health insurance benefits, bills and rights. The Maryland SHIP program provides trained staff and volunteer counselors in all 24 counties.
Maryland Department of Insurance and Financial Services: Find information on health insurance companies in the state, including insurer ratings and how to file a complaint.
Statistical data from the Centers for Medicare & Medicaid Services, “2017 MA Part D Landscape State-by-State Fact Sheet,“ September 22, 2016 and “Medicare Dashboard,“ Office of Enterprise Data & Analytics (OEDA), April 2017.
Data in this article was checked when the article was written and might not be updated as newer data becomes available.
This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
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