The Maryland Insurance Exchange (Marketplace) is called the Maryland Health Connection. The Maryland Health Benefit Exchange is administered by the State of Maryland.
General information about the Maryland Health Benefit Exchange can be found at: http://www.marylandhealthconnection.gov/.
PATIENTS
The Maryland Health Benefit Exchange is essentially a marketplace for individuals and small businesses with up to 100 employees to shop for health insurance if they do not already have insurance coverage from another source. If they have insurance from another source (such as employment, retirement benefits, or spousal benefits), they do not need to obtain it from the Marketplace.
HIV PROVIDERS
Providers must contract with each of the plans in the marketplace individually in order to fully participate in the Maryland Health Benefit Exchange.
This process is similar to enrolling in insurance or managed care organization provider networks. See below the list of insurers participating in the Federally-facilitated Marketplace, and information about contacting them.
As an HIV provider, you may qualify for designation as an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.
Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.
REPORTING PROBLEMS
The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them. If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state office of insurance:
Maryland Insurance Administration
200 St. Paul Place, Suite 2700
Baltimore, MD 21202
800-492-6116
www.mdinsurance.state.md.us/
Complaints: http://www.mdinsurance.state.md.us/sa/consumer/file-a-complaint.html
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE
Below is a list of the Qualified Health Plans that have publically announced that they will offer plans in the Maryland Health Benefit Exchange
This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates.
Aetna
Plan Website: https://www.aetna.com/employers-organizations/small-business-plans-by-state/MD-exchange-2015.html
Provider Enrollment: https://www.aetna.com/health-care-professionals.html#open
Plan types offered: SHOP
CareFirst Blue Cross Blue Shield, Inc.
Plan Website: https://member.carefirst.com/individuals/home.page
Provider Enrollment: https://provider.carefirst.com/wps/portal/Provider/Resources/Credentialing?WCM_GLOBAL_CONTEXT=/wcmwps/wcm/connect/Content-Provider/CareFirst/ProviderPortal/Credentialing/Tab/credProfOverview&WT.z_from=providerQuicklinks
Plan types offered: Individual, SHOP
Cigna
Plan Website: http://www.cigna.com/
Provider Enrollment: http://www.cigna.com/healthcare-professionals/?WT.z_nav=personal%3BTop-Nav%3Bhealth-care-professionals
Plan types offered: Individual
Coventry
Plan Website: http://coventryone.coventryhealthcare.com/maryland/
Provider Enrollment: http://chcdelaware.coventryhealthcare.com/services-and-support/providers/provider-nomination/index.htm
Plan types offered: SHOP
Evergreen Health Cooperative Inc.
Plan Website: http://evergreenmd.org/
Provider Enrollment: http://evergreenmd.org/providers/
Plan types offered: Individual, SHOP
Kaiser Foundation Health Plan of the Mid-Atlantic
Plan Website: https://healthy.kaiserpermanente.org/html/kaiser/index.shtml
Provider Enrollment: http://www.kaiserpermanentejobs.org/default.aspx
Plan types offered: Individual, SHOP
UnitedHealthcare
Plan Website: http://www.uhc.com/health_reform_guide.htm
Provider Enrollment: http://www.uhc.com/physicians/join_our_network.htm
Plan types offered: Individual, SHOP