What do plans cover?

All qualified health plans sold through Maryland Health Connection (except Catastrophic plans) provide the same core benefits and offer free preventive services.

These essential health benefits below are covered, and some plans offer additional benefits:

  • Doctor visits
  • Hospitalization
  • Emergency care
  • Maternity and newborn care
  • Pediatric care, including dental and vision benefits
  • Prescription drugs
  • Laboratory tests
  • Mental health care
  • Substance abuse treatment

Plans also cover preventive care, for free. Plans through Maryland Health Connection cover preventive services like checkups, shots, and screenings at no extra cost, even if you haven’t met your yearly deductible.

 

For more details on the essential benefits covered by plans through Maryland Health Connection, see a full chart here (PDF) from the Maryland Insurance Administration that describes general categories of benefits. Plans may offer additional benefits.

You should carefully review the Summary of Benefits and Coverage provided for each plan in our online application. This document provides a summary of the specific services covered by the plan and what costs may apply for each.