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Medicare Advantage
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Maryland

Medicare Advantage Plans in Maryland

Find Plans in your area with your ZIP Code

If you don't like the coverage provided by Original Medicare, the alternative is a private health plan through the Medicare Advantage program. In most areas of Maryland there are multiple options to choose from, but options vary between each Maryland County. As a result, you can only choose a plan that's available where you live.

To compare the plans available in your area, you can use our zip code lookup tool above or click on your county below. If you'd like to learn more about how the Medicare Advantage program works in Maryland and how it compares with other options, keep on reading.

Compare the Best Medicare Advantage Plans in Maryland by County

Allegany
Anne Arundel
Baltimore
Baltimore City
Calvert
Caroline
Carroll
Cecil
Charles
Dorchester
Frederick
Garrett
Harford
Howard
Kent
Montgomery
Prince Georges
Queen Annes
Saint Marys
Somerset
Talbot
Washington
Wicomico
Worcester
If you qualify for Medicare but don't know where to begin, we have licensed agents[1] at 1-855-728-0510 (TTY 711) who can answer your questions and help you get enrolled. There's no obligation.

Maryland Medicare Advantage Plans Explained

Unlike Original Medicare, which only covers major medical costs, a Medicare Advantage plan, sometimes called Medicare Part C, can include many extras, including prescription drug coverage, vision, hearing, dental, and fitness, just to name a few. And, good news, they are available in Maryland. But you must have both Medicare Part A and Medicare Part B benefits to join a plan.

Many people love the extra benefits of their Medicare Advantage plan, particularly a prescription drug plan. However, before you jump in with both feet, take the time to understand the trade-offs fully. The extra benefits and perks are nice, but they come at a cost. Specifically, when you become a Medicare Advantage plan member in Maryland you are agreeing to accept the plan's managed care health system. As an MA plan member, you agree to let the insurance plan be a gatekeeper and fully control your access to doctors and other healthcare providers.

Original Medicare vs. Medicare Advantage in Maryland

One way to better understand how different Original Medicare coverage is from Medicare Advantage is to have a look at the pros and cons of each type of health insurance in Maryland. So, let's do that.

The Pros and Cons of Medicare Advantage Plans vs Original Medicare

  1. With Medicare Advantage you must use Maryland healthcare providers within the plan's network. With Original Medicare, you can use the Medicare-approved providers of your choice.
  2. If you travel and have a medical emergency, Medicare Advantage covers you (in the U.S and its territories only). However, if you are a snowbird and winter or summer in another state, a non-emergency doctor outside of your plan's network won't be covered.
  3. All Medicare Advantage plans sold in Maryland protect you with an annual maximum out-of-pocket (MOOP) limit. Once you reach this spending limit the plan pays all additional copays and coinsurance that you'd normally pay out-of-pocket. Original Medicare does not have an out-of-pocket maximum.
  4. Most Medicare Advantage plans come bundled with a Maryland Medicare Part D plan for prescription coverage. With Original Medicare, you must enroll in a stand-alone Part D plan. But, the stand-alone plans offer more choices to get lower-cost prescriptions.
  5. With Original Medicare, your costs (copays, coinsurance, etc.) are predictable, and you can get a Medicare supplement to help pay these costs. In the Medicare Advantage program, each plan can charge what they want for copays and coinsurance, making it very difficult to compare actual costs.
  6. There are eligibility requirements with Medicare Advantage plans. For example, you must have both Medicare Part A and Medicare Part B to join, and you cannot have end-stage renal disease (ESRD) or one of a handful of other diseases.

Maryland Medicare Advantage Plans vs. Medigap

Most Maryland seniors just getting their Medicare benefits want to know which type of plan is better. We commonly see these three questions:

  • Why are Medicare Advantage plans bad?
  • What are the disadvantages of Medicare Advantage plans?
  • Is it better to have Medicare Advantage or Medigap?

Let's take a minute or two to compare and contrast, shall we?

Why Maryland Medicare Advantage Plans are Bad

First things first. Medicare Advantage plans are not bad. More than 26 million people have a Medicare plan. But, it's not for everyone. Before you enroll, learn the disadvantages of Medicare Advantage plans, particularly if you live in Maryland.

MedicareWire advises people who have one or more serious chronic conditions to keep their Original Medicare, particularly if you have specialists treating you and you want to stay with them. Our opinion is that Medicare Advantage is an excellent option for those who qualify for both Medicare and Medicaid (dual eligible), for those with retiree healthcare benefits, and for extremely healthy, active seniors.

Similarly, traditional Medicare, plus Medicare supplement insurance, work best for people with chronic health conditions, as well as those who can afford a higher monthly premium. Most experts agree that this is the best health insurance seniors can get in Maryland.

You can learn more about Medicare supplements in Maryland on our Maryland Medicare supplements page.

What are the Disadvantages of Maryland Medicare Advantage Plans?

We have already highlighted the issue of doctor choice in Medicare Advantage. If this is not an issue for you, then consider the financial differences. These are the same regardless of the type of plan you're evaluating (e.g., HMO, PPO, PFFS, Cost, or HSA).

With Medicare Advantage, you pay a little each month (with some plans, you pay nothing). This is the monthly premium. But you also pay copayments when you use most medical services, and they add up fast. It does not matter if you have a Health Maintenance Organization (HMO) plan or a Preferred Provider Plan (PPO). The majority of your costs are due when you use health services.

However, with Original Medicare and a Medigap plan for supplemental coverage, you pay for most of your costs in advance with a higher premium. You control your costs by choosing a plan that pays the deductible(s) you want to be covered. This makes your health care costs predictable, and for most people on a fixed budget, that's very comforting.

Is it better to have Medicare Advantage in Maryland or Medigap?

  • If you can afford Medigap Plan F, G, or N, keep Original Medicare and add one of these top 3 Medicare supplements. These plans help you manage your out-of-pocket costs the best, giving you peace of mind.
  • If you are a healthy senior and have good health in your family heritage, Medigap Plan N will let you save money by sharing some costs when you see your doctor. The plan benefits are excellent, and you pay just a little to see your doctor (up to $25 per visit).
  • If you are a healthy senior but you cannot afford a Medigap Plan F, G, or N, Medicare Advantage is good. Both Original Medicare and Medicare Advantage cover preventive care at no additional cost to keep you healthy
  • If you are turning age 65, have one or more chronic health conditions that require frequent doctor visits, and do not qualify for both Medicare and Medicaid (dual eligible), the most Medigap coverage you can afford is the best option.
  • If you qualify for both Medicare and Medicaid, Medicare Advantage is your best option regardless of your health condition.
  • If you have special needs (i.e., a full-time nursing home resident, diabetes, etc.) and an appropriate Medicare Advantage Special Needs Plan (SNP) is available, this is your best option.
  • With both Medigap and Medicare Advantage, you must continue to pay your Medicare Part B premium (it typically comes straight out of your Social Security income, unless you're not yet taking it).
  • With Medicare supplement insurance, there are no service area restrictions. With Medicare Advantage, you must receive care within the plan's provider network unless you need emergency care.
  • Medicare Advantage plans have an enrollment period. You get an individual enrollment period when you're first eligible. After that, there's an annual enrollment period to switch plans or go back to Original Medicare. Medigap plans do not have the same restrictions, but you can be turned down if you leave a Medigap plan and later want to come back. Medicare Advantage plans cannot generally turn you down as a Medicare supplement insurance company can.

Find Plans in your area with your ZIP Code

References

medicare.gov ssa.gov cms.gov

This Medicare Advantage state information page was last updated on .