Health insurance in Maryland is sold through Maryland Health Connection, with an estimated 45-70 plans available for 2026. The average Silver-tier premium is $380/mo before subsidies for a 40-year-old non-smoker. Medicaid status: Expanded.
Marketplace
Maryland Health Connection
Maryland Health Connection
Avg Silver Premium
$380/mo
Before tax credits, age 40
Medicaid
Expanded
Affordable Care Act status
| Field | Value | Notes |
|---|---|---|
| Marketplace | Maryland Health Connection | State-run exchange |
| Open Enrollment 2026 | Nov 1, 2025 – Jan 15, 2026 | Special enrollment for QLEs year-round |
| Plans available | 45-70 | Bronze/Silver/Gold/Platinum tiers |
| Medicaid expansion | Expanded | Up to 138% FPL |
Premium and plan counts are estimates for 2026 based on prior-year filings and pending rate approvals. Always verify pricing on the marketplace itself before enrolling.
Maryland experienced a market crisis in 2017–2018 when CareFirst proposed large premium increases due to CSR payment uncertainty. The state responded by implementing a Section 1332 reinsurance waiver that took effect in 2019 and has since produced dramatic premium reductions. Silver premiums that might otherwise top $600/month for a 40-year-old now average $370–$400. The Maryland Health Connection marketplace offers 45–70 plans, with CareFirst BCBS and Kaiser Permanente as the dominant carriers. Network adequacy is generally strong in the Baltimore-Washington corridor, though Western Maryland and the Eastern Shore have fewer options.
Maryland expanded Medicaid in 2014 and operates a robust HealthChoice managed care program. The Maryland Health Connection is a state-based exchange with its own technology platform. Maryland has also pursued state-funded subsidies for certain populations and maintains strong navigator and enrollment assistance programs. The state's proximity to federal workers in the DC metro area creates unique insurance dynamics, with many residents having access to the Federal Employee Health Benefit program as an alternative.
Leading 2026 ACA carriers in Maryland: CareFirst BlueCross BlueShield, Kaiser Permanente Mid-Atlantic, Aetna/CVS. Plan selection and network breadth vary widely by ZIP code — use the marketplace's plan-finder tool with your ZIP and household income for accurate availability.
Maryland's Section 1332 reinsurance waiver has produced some of the largest premium reductions in the country, cutting average benchmarks by roughly 30% from pre-waiver highs.
Maryland expanded Medicaid under the ACA. Adults under 138% of the Federal Poverty Level (FPL) qualify — about $20,800/yr for an individual or $43,000/yr for a family of 4 in 2026.
💡 Maryland Pro Tip
Maryland operates its own state-based exchange called the Maryland Health Connection at marylandhealthconnection.gov.
A 40-year-old non-smoker in Maryland typically pays about $370–$400/month for a Silver plan before subsidies — among the lowest in the nation thanks to the state's reinsurance program.
Yes. Maryland expanded Medicaid in 2014. Adults earning up to 138% FPL are generally eligible for HealthChoice managed care plans.
Marketplace data sourced from state and federal exchange filings for Maryland, April 2026. Premium estimates are 2026-projected.
Jennifer Walsh
Editorial Lead, Health & Medicare
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed April 2026
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