Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Medicare Advantage is an alternative way for seniors who are eligible for Medicare to access health insurance. Also known as Part C, or MA plans, Medicare Advantage plans combine the benefits of Medicare Part A and Medicare Part B into a single plan offered by approved private companies. Except for hospice care, Medicare Advantage plans must provide at least the same level of benefits as Original Medicare. Many insurers offer additional benefits, such as wellness programs, transportation to medical appointments and dental, hearing and vision services.
Most Medicare Advantage plans also include prescription drug benefits. This means seniors with Medicare Advantage don’t need to purchase a supplementary prescription plan. Providers must follow certain rules set out by the Centers for Medicare & Medicaid Services, but they’re allowed to set their own out-of-pocket costs. In addition, each plan has different rules regarding the use of in-network providers and the need for referrals. Almost 1.1 million Marylanders are eligible for Medicare, and 12.5% of these are enrolled in a Medicare Advantage plan. This is significantly lower than the national average of 42%, according to data from 2021.
This guide has an overview of the Medicare Advantage plans available in Maryland. It includes information about what’s covered, who is eligible for Medicare Advantage and how to enroll in a plan.
The Top 10 Medicare Advantage Plans in Maryland
There are several insurance companies that offer Medicare Advantage plans in Maryland. This gives Medicare-eligible people a wide choice when looking for a plan that works for their circumstances. The table below shows the 10 most popular Medicare Advantage providers in the state, based on the number of people enrolled in their plans. We added together the enrollment numbers for all plans to determine each provider’s total enrollment in Maryland. As most companies offer multiple plans, prices are provided as a range rather than an average. This information was accurate as of April 2022. Up-to-date information on plans that are available in each area of Maryland is available on medicare.gov.
Johns Hopkins HealthCare
University of Maryland Health Advantage
CareFirst BlueCross BlueShield Medicare Advantage
CareFirst BlueCross BlueShield
How Medicare Advantage Plans Work in Maryland
Understanding how Medicare Advantage plans work in Maryland can help seniors make the best decision for their individual health care needs. Each insurer offers a variety of plans, including health maintenance organizations (HMOs) and preferred provider organizations (PPOs). These have different requirements regarding referrals, using in-network and out-of-network providers and the need for a primary care provider. Descriptions of the most common types of plans can be found below.
What Medicare Advantage Plans Cover in Maryland
Medicare Advantage plans must provide all the same benefits of Original Medicare, also known as Part A and Part B, except for hospice care. This includes inpatient hospital care, mental health services, preventive screenings and lab tests. Many Medicare Advantage plans offer extra benefits that aren’t included in Original Medicare, such as dental care, hearing and vision services. Most also include prescription drug coverage.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Durable Medical Equipment
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Maryland
To join a Medicare Advantage plan, an applicant must have Medicare Part A and Part B, be a U.S. citizen or be lawfully present in the country and live in the service area of the plan they want to join. Medicare is available to people aged 65 and over, younger people with disabilities and those with end-stage renal disease. As with other types of health insurance, Medicare has specific enrollment periods. It’s important for seniors to know when they can enroll or change Medicare plans to ensure their health needs are covered. The list below has more information about the timing of Medicare enrollment.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
Medicare Advantage Open Enrollment Period
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Maryland
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
Maryland’s Senior Health Insurance Assistance Program is a statewide network of highly trained volunteers who specialize in helping seniors understand, enroll in and navigate Medicare. Seniors can receive one-on-one counseling in person or over the phone to learn about and discuss topics such as Medicare Advantage plans, long-term care insurance, Medigap policies and prescription drug coverage. Counselors can help seniors compare plans, complete applications, better understand their medical bills and recognize and report abuse or fraud.
One of the Maryland Department of Aging’s primary goals is to help seniors and their loved ones easily access and understand the resources and supports available to them throughout the state. The Department promotes seniors’ health and well-being by financing certain supportive services, coordinating programs and partnering with organizations that provide seniors with Medicare information and assistance. These include SHIP, Area Agencies on Aging, the Senior Medicare Patrol program, financial abuse prevention and the Maryland Access Point program.
To reach the Maryland Department of Aging, seniors can call 410-767-1100 or 800-243-3425 or visit the office at 301 West Preston Street, Suite 1007, Baltimore, Maryland 21201.
Senior Medicare Patrol
Maryland’s Senior Medicare Patrol is a program that connects seniors to volunteers who help them become aware of potential Medicare fraud, spot medical billing errors and report concerns and scams. Seniors can receive confidential, one-on-one counseling either over the phone or at an SMP office, with counseling at-home available for some seniors with mobility issues. SMP volunteers are also available to give educational group presentations.
To contact SMP or report potential fraud or concerns, seniors can call the Maryland Department of Aging at 1-800-243-3425. They can also call the SMP program manager, Rebecca Bradley, at 410-767-2077 or email her at [email protected].
The Maryland Insurance Administration helps Maryland insurance consumers by providing detailed information on the many types of insurance programs and options throughout the state. Seniors can contact the administration or visit its website to read consumer publications on understanding their health insurance rights and coverage, view a Medicare supplement webinar and file complaints. Information is also available on annuities, dental plans and life insurance.
To contact the Maryland Insurance Administration, seniors can call toll-free at 1-800-492-6116 or visit the office at 200 St. Paul Place, Suite 2700, Baltimore, MD 21202.
Local Medicare Advantage Resources
Maryland Access Point
Maryland Access Point, or MAP, is a statewide initiative to provide seniors and people with disabilities with access to information, resources and programs regarding long-term care. Spread throughout the state, 20 MAP centers offer Medicare counseling services, legal assistance and one-on-one guidance to help seniors develop a long-term care plan with housing, financial assistance and more. Additionally, The MAP website has an online resources directory seniors can use to find support programs local to their area.
Anne Arundel County Department of Aging and Disabilities
The Anne Arundel County Department Aging and Disabilities offer local seniors a comprehensive list of area resources and programs. Seniors can contact the Department to access services and information on low-cost health care, an aging resource database, adult public guardianship and administrative care coordination. The Department also runs a Legal and Financial Aid program that provides seniors with free assistance with issues regarding Medicare, guardianship, nursing home residence and other health-care-related areas.
Seniors can contact the Anne Arundel County Department Aging and Disabilities office by calling 410-222-4257. They can also visit either of its two locations at 7320 Ritchie Highway, Glen Burnie, MD 21061 and 2666 Riva Road, Annapolis, MD 21401.