Key Takeaways
- Maryland requires a 6-month open enrollment period for Medicare Supplement starting at age 65
- Maryland provides continuous open enrollment for Medigap - can change plans anytime
- Maryland prohibits pre-existing condition waiting periods during guaranteed issue
- Medicare Supplement plans must be standardized (Plans A through N)
- Community rating is required - premiums cannot vary by age or health
Maryland Medicare Supplement (Medigap) Regulations
Maryland provides strong protections for Medicare beneficiaries purchasing Medicare Supplement (Medigap) insurance, including continuous open enrollment and community rating.
Open Enrollment Period
Maryland provides a 6-month open enrollment period for Medicare Supplement:
When It Begins
The 6-month period starts:
- First day of the month you are 65 or older AND
- Enrolled in Medicare Part B
Protections During Open Enrollment
- Guaranteed issue - Must be accepted regardless of health
- No pre-existing condition exclusions
- Standard rates - Cannot be charged more for health conditions
- Any plan available - Can choose any Medigap plan A through N
Exam Tip: The 6-month open enrollment period is when guaranteed issue is automatically available to all eligible persons.
Continuous Open Enrollment
Maryland provides continuous open enrollment:
- Can change Medigap plans at any time during the year
- No health questions or waiting periods
- More consumer-friendly than most other states
- Guaranteed issue year-round
Comparison to Other States
| Other States | Maryland |
|---|---|
| Limited open enrollment | Continuous open enrollment |
| Health questions after initial period | No health questions anytime |
| Pre-existing waiting possible | No waiting periods |
Guaranteed Issue Rights
Beyond open enrollment, Maryland provides extensive guaranteed issue protections:
Triggering Events
| Event | Guaranteed Issue Right |
|---|---|
| Losing employer coverage | Can purchase Medigap within 63 days |
| Leaving Medicare Advantage | Can return to Medigap within 63 days |
| Medicare Advantage plan leaves area | Can purchase Medigap |
| Medigap insurer becomes insolvent | Can switch to comparable plan |
Standardized Plans
Maryland requires Medigap plans to be standardized:
Available Plans
| Plan | Benefits |
|---|---|
| Plan A | Basic benefits only |
| Plan B | Basic + Part A deductible |
| Plan C | Comprehensive (pre-2020 only) |
| Plan D | Similar to C, no Part B excess |
| Plan F | Most comprehensive (pre-2020 only) |
| Plan G | Like F without Part B deductible |
| Plan K | 50% cost sharing, out-of-pocket max |
| Plan L | 75% cost sharing, out-of-pocket max |
| Plan M | 50% Part A deductible |
| Plan N | Cost sharing, copays for visits |
Note: Plans C and F are only available to those eligible for Medicare before January 1, 2020.
Community Rating
Maryland requires community rating for Medigap:
- Premiums are the same for all ages
- Cannot charge more based on health status
- Cannot charge more based on claims history
- This protects older and sicker individuals
Comparison to Other States
| Other States | Maryland |
|---|---|
| Attained-age rating allowed | Community rating required |
| Premiums increase with age | Same premium for all ages |
| Higher rates for older enrollees | Equal rates regardless of age |
Pre-Existing Condition Rules
Maryland's rules during continuous enrollment:
| Situation | Pre-Existing Waiting Period |
|---|---|
| Open Enrollment | No waiting period |
| Continuous enrollment (anytime) | No waiting period |
| Guaranteed Issue events | No waiting period |
Exam Tip: Maryland is one of few states with continuous open enrollment and community rating for Medigap. This is frequently tested.
Can Maryland residents change their Medigap plan at any time?
What rating method is required for Medigap in Maryland?