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Maryland Health Insurance in 2027: Rules and Options

Maryland Health Connection, the state's own exchange, sets its own open enrollment dates; check its site for 2027 deadlines. Maryland offers more state help than most states: its State Reinsurance Program, approved through 2028, helps hold down premiums, and the Maryland Premium Assistance Program adds state help on top of federal tax credits for eligible enrollees based on household income. Maryland's continuation law reaches the small employers that federal COBRA skips, so leaving a small shop usually means you can keep the group plan for up to 18 months if you elect within 45 days. Short-term plans are tightly limited to less than three months with no renewals, which makes them a narrow bridge rather than a long-term option. Because the state subsidy runs through Maryland Health Connection, buying through the exchange matters if you want the full amount of help.

Private health insurance in Maryland

Most people I help in Maryland end up on a private plan, not a Marketplace plan. Private, medically underwritten health insurance is priced on your age, zip code and health instead of your income, so a strong year never raises your premium and there is no tax credit to pay back in April.

Why people leave the Marketplace

Premiums keep climbing. Maryland Marketplace premiums are rising 14.6% on average for 2027.
The subsidy cliff. Above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) you pay full price.
Surprise tax bills. Underestimate your income and you repay the tax credit in April.
Narrow networks. Many plans are local HMOs or EPOs that need referrals and cover little outside the area.
High out-of-pocket costs. 2027 out-of-pocket maximums reach $12,000 per person and $24,000 per family.
One window a year. Outside open enrollment you need a qualifying life event to enroll or switch.

What a private plan does differently

Start any month. If approved, coverage can begin the first of next month, with no wait for open enrollment.
Networks that travel. Many private plans use national PPO networks, which can give you in-network doctors outside Maryland too. Networks vary by plan.
Can cost less than full-price Marketplace plans for some healthy applicants above the subsidy line.
Accident coverage the Marketplace does not offer. A private plan can be paired with accident coverage, a separate policy. What it includes varies by plan.
Approval is based on health. You answer health questions, and acceptance is not guaranteed.

With a significant health condition, or income low enough for a large tax credit, a Marketplace plan can be the better fit, and I will tell you if it is. Either way you see both side by side.

Private plans are not ACA Marketplace plans. Benefits, exclusions and pre-existing condition rules differ by plan and by state, so review the plan details before you enroll.

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Learn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace

Where to enroll

Maryland runs its own exchange, Maryland Health Connection. Maryland Health Connection sets its own open enrollment dates; check its site for 2027 deadlines. Private, medically underwritten plans are sold outside the exchange by licensed agents and can start the first of any month if you are approved.

Leaving a small employer

Maryland requires insured group plans, including those of employers with fewer than 20 workers, to offer up to 18 months of continuation to Maryland residents who leave a job voluntarily or are let go for reasons other than cause after three months of coverage. You have 45 days to elect it and pay the full premium plus up to a 2 percent fee. Losing employer coverage also opens a 60-day Marketplace special enrollment period.

Short-term health plans

Maryland law limits short-term plans to less than three months with no renewals, which is stricter than the federal rule, so the federal enforcement pause does not change anything in Maryland. Short-term plans are medically underwritten, exclude pre-existing conditions and cap benefits, so they fit only a defined gap.

2027 premium changes

Maryland individual-market premiums are set to rise 14.6% on average for 2027, with small-group plans up about 10.2%. The full breakdown is on the Maryland 2027 rate page.

More Maryland guides by job and situation

Maryland questions

Where do Maryland residents buy individual health insurance for 2027?

Maryland runs its own exchange, Maryland Health Connection. Maryland Health Connection sets its own open enrollment dates; check its site for 2027 deadlines.

What happens to my group coverage if I leave a small employer in Maryland?

How long can a short-term health plan last in Maryland?

Maryland law limits short-term plans to less than three months with no renewals, which is stricter than the federal rule, so the federal enforcement pause does not change anything in Maryland.

How much are Maryland premiums rising for 2027?

Individual-market premiums are set to rise 14.6% on average, and small-group plans about 10.2%, based on final rate filings.

Sources: labor.maryland.gov, labor.maryland.gov, insurance.maryland.gov, insurance.maryland.gov. Checked October 21, 2026. More on health insurance in Maryland.

Licensed in Maryland. I compare Marketplace and private plans side by side for your household, no fee.

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