With varying costs and benefits, Medicare Advantage plans can be difficult to compare. Learn about the top plans in Maryland, the coverage they provide, and how to find the right plan for you

How much health insurance coverage do you need? Depending on your health needs, you might need more coverage than Original Medicare (Medicare Part A and Medicare Part B) provides.

If you’re looking for additional benefits, a Medicare Advantage plan might be right for you. Also called Medicare Part C or MA plans, these plans from private insurance companies add additional coverages, such as Medicare Part D drug plan coverage, hearing, vision, dental, and more.

Want to know more about the MA plans available in your county? Try out the Insurify Medicare comparison tool to see options in your service area.

Top Medicare Advantage Insurance Plans in Maryland for 2021

The top MA insurance plans for the state were determined using a number of factors. These include each plan’s Medicare star rating as well as the plans’ costs, including monthly premiums, co-payments, deductibles, and out-of-pocket maximums.

Plan benefits were also considered, such as special needs benefits, Medicare Part D plan drug coverage, long-term care, and nursing home benefits.

#1 Erickson Advantage Freedom H5652-006 Plan

  • Monthly premium: $70
  • Plan deductible: $200
  • Out-of-pocket maximum: $4,300
  • Counties where plan is available: Baltimore, Baltimore City, Montgomery, and Prince George’s

To be eligible for this and other Erickson Advantage plans, keep in mind that you have to be a resident of Erickson Living—a network of senior living communities in the U.S. Erickson Living describes this particular HMO plan as being great if you want “additional certainty around out-of-pocket expenses.”

It offers $0 co-pays for a number of services, including preventive care, primary care, lab services, dental benefits, certain transportation benefits, and vision exams. Coupling that with the reasonable monthly premium and low deductible makes the plan a solid option.

#2 Erickson Advantage Liberty with Drugs H5652-008 Plan

  • Monthly premium: $0
  • Plan deductible: $400
  • Out-of-pocket maximum: $6,700
  • Counties where plan is available: Baltimore, Baltimore City, Montgomery, and Prince George’s

This five-star HMO plan is a great value when considering that it offers the same $0 co-pays as the Freedom plan, in addition to a $0 monthly premium. Of course, it includes Medicare Plan D drug coverage as well. 

The trade-off, though, is that it includes a slightly higher plan deductible and a higher out-of-pocket maximum.

#3 Erickson Advantage Signature H5652-001 Plan

  • Monthly premium: $199
  • Plan deductible: $0
  • Out-of-pocket maximum: $2,600
  • Counties where plan is available: Baltimore, Baltimore City, Montgomery, and Prince George’s

Erickson Living calls this their “most complete plan.” While this five-star plan features the highest monthly premium of any plan on the list, it does include a $0 co-pay for preventive care, in addition to primary care doctor visits (without the doctor limitations of some other Erickson Advantage plans). It also includes a $20 co-pay for specialist visits, where some other Erickson plans include $50 co-pays.

You’ll also find other $0 co-pays similar to the Freedom and Liberty plans. Another standout feature for this plan is the respite care benefit, which covers 20 hours of aid following an inpatient discharge.

#4 Kaiser Permanente Medicare Advantage High MD H2172-002 Plan

  • Monthly premium: $142
  • Plan deductible: $0
  • Out-of-pocket maximum: $5,700
  • Counties where plan is available: Anne Arundel, Baltimore, Baltimore City, Calvert, Carroll, Charles, Frederick, Harford, Howard, Montgomery, and Prince George’s

Like all Kaiser Permanente MA plans, this HMO plan features $0 co-pays for preventive care and care from doctors at Kaiser Permanente, an integrated managed-care consortium. The Kaiser Permanente plans also include Medicare Part D prescription drug coverage.

While this particular five-star plan has the second-highest co-pay on the list, it also includes lower costs, such as just $5 for primary care visits and $30 for specialist care visits. Compared to the other Kaiser Permanente plans on the list, this one also features lower costs for services like urgent care ($30), $200 for the first five days of inpatient hospitalization, and just $100 for outpatient surgery. 

#5 Kaiser Permanente Medicare Advantage Standard MD H2172-004 Plan

  • Monthly premium: $25
  • Plan deductible: $0
  • Out-of-pocket maximum: $6,900
  • Counties where plan is available: Anne Arundel, Baltimore, Baltimore City, Calvert, Carroll, Charles, Frederick, Harford, Howard, Montgomery, and Prince George’s

The standard Kaiser Permanente HMO plan, also a five-star plan, is a great mid-range option. While it features a lower premium, service costs are a bit higher when rendered. Primary care visits are still only $10, with $40 specialist visits and urgent care visits. 

The biggest differences in costs compared to the Kaiser Permanente High plan are those for inpatient hospitalization ($250), outpatient hospitalization ($250), and $100 ($60 higher) for imaging services. 

#6 Kaiser Permanente Medicare Advantage Value Balt MD H2172-006 Plan

  • Monthly premium: $0
  • Plan deductible: $0
  • Out-of-pocket maximum: $7,200
  • Counties where plan is available: Baltimore and Baltimore City

While this five-start HMO plan won’t have you paying a monthly premium, you’ll pay more for health services at the time of the visit. Primary doctor visits are only $10, with a $50 cost for specialist visits. Urgent care costs are a bit higher than the other Kaiser Permanente plans, at $50.

Other higher costs for the value plan include $300 for outpatient surgery and $175 for imagery services. Also, note that this is the only Kaiser Permanente plan on the list that doesn’t include fitness benefits. 

#7 Kaiser Permanente Medicare Advantage Value MD H2172-011 Plan

  • Monthly premium: $0
  • Plan deductible: $0
  • Out-of-pocket maximum: $7,200
  • Counties where plan is available: Anne Arundel, Calvert, Carroll, Charles, Frederick, Harford, Howard, Montgomery, and Prince George’s

The costs and benefits for this five-star HMO plan mirror those in the Value Balt MD plan, but with more Maryland counties in its service area. Consider this plan if you’re looking to pay less regularly each month but more during each instance of care.

#8 HumanaChoice H5216-029 Plan

  • Monthly premium: $69
  • Plan deductible: $265
  • Out-of-pocket maximum: $6,700
  • Counties where plan is available: Allegany, Carroll, Frederick, Garrett, and Washington

The only four-star plan on the list, HumanaChoice’s PPO plan option features a low $15 co-pay for primary care visits and $45 for specialist visits, in addition to no costs for preventive care. Costs for lab services can also reach up to $50.

Emergency care costs are $90 per visit, and urgent care can range between $15 and $45 or 35 percent coinsurance. Like the Kaiser Permanente plans, this one covers nearly a week of inpatient hospital care at $295, as well as outpatient hospital coverage that ranges from $45 to $295.

Other benefits of the plan include coverage for skilled nursing facilities, rehabilitation services, mental health services, and some hearing and dental allowances in addition to drug plan coverage.

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How Much Does Medicare Advantage Cost in Maryland?

What you pay will be different from your neighbor. That’s because what you’ll pay will depend upon a few things:

  • The way you set up your Medicare plan (i.e. which plan options you enroll in)
  • Your location (i.e. the healthcare system available to you)
  • Your plan’s network (i.e. the size of your network and its average costs).

Annually, the average you can expect to spend on Medicare Advantage coverage premiums is around $847.61, in addition to a $295.08 drug plan deductibleAs a Medicare beneficiary with an MA plan, you can expect to spend $70.63 on average per month in premium costs.

But your premium costs and deductibles aren’t the only expense. You will also need to cover copayments for doctor’s visits and coinsurance rates for care you receive. Some plans have low monthly premiums, but higher coinsurance rates or vice-versa. It’s important to take into account the total cost of care, not just your monthly premium. Below is a table comparing total annual costs (minus copayments) of top plans in Maryland.

Which MA plan options fit your budget? Find out today with the Insurify Medicare comparison tool.

Medicare Advantage Plan Types

To understand which plan option is best for you, consider the types of MA plans and how they differ. Each of the top eight plans in Maryland falls into one of the categories below:

  • Health Maintenance Organization (HMO): These plans usually require you to see an in-network provider (unless it’s an emergency), and they will typically provide Medicare prescription drug plan coverage. With an HMO plan, you’ll likely need to select a primary care doctor and get a referral anytime you need to see a specialist.
  • Preferred Provider Organization (PPO): Unlike HMO plans, you aren’t typically required to see an in-network provider, though it’s usually cheaper if you do. They often provide prescription drug plan coverage as well. Unlike an HMO plan, you don’t need a primary care doctor and probably won’t need a referral to see a specialist, either.
  • Private Fee For Service (PFFS): a more expensive option, PFFS works as a “pay as you go” system. The main benefit of a PFFS is the broad range of services and specialists you have access to. Plus, you’re more in control of your care.
  • Special Needs Plan (SNP): SNPs are made for people in special circumstances. People with certain health conditions, like HIV, can find a Special Needs Plan tailored to their care. People living in institutions and people with low income also have access to SNPs. 

If enrollment in an HMO or PPO plan sounds right for you, take a look below at the top MA healthcare plan options in Maryland.

FAQ: Maryland Medicare Advantage

When can I enroll in a Medicare Advantage plan?

The Open Enrollment Period is from October 15 to December 7 each year. During this time, you can add, drop, or change your plan. If you’re already enrolled in a plan, you can switch plans or switch to Original Medicare from January 1 to March 31 each year.

Am I eligible for an MA health plan?

Eligibility is based on a few factors. First, you must live in the service area where the plan is offered. Second, you must have Original Medicare coverage unless you have end-stage renal disease (beginning January 2021).

I already have a Medicare Supplement Insurance (Medigap) plan, but I’d like an MA plan. Can I have both?

You can’t use benefits from a Medicare Supplement plan and an MA plan together. If you sign up for an MA plan, consider dropping the Medigap plan because the MA plan won’t pay for any of your co-payments, deductibles, or premiums as long as you have both.

I’m eligible for Medicaid, too. Can I have an MA plan and Medicaid coverage?

If you meet the requirements for both, then you may be eligible for dual enrollment. To learn more, visit Medicare.gov, where you can find contact information to reach a representative by phone with support for TTY users. 

Conclusion: Take the Guesswork Out of Finding the Right Plan

Now that you know the top plans in your state, you’re one step closer to finding the best MA plan for you. Remember that plan availability varies depending on your county. It’s also important to consider the benefits that are right for your health needs and budget.

Take the next step and compare your MA plan options. Get started today with the Insurify Medicare comparison tool.

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Updated February 25, 2021

Jasmine Fleming is a freelance digital content marketer and strategist. She loves crafting helpful content that readers can use to make important decisions. You can learn more about Jasmine at her website, www.jasminefleming.com.