What are the legal requirements for health insurance?

In Maryland, health insurance must meet certain legal requirements as outlined by state and federal law. In Maryland, all insurance plans must cover certain minimum essential health benefits including doctor visits, hospitalizations, maternity and newborn care, prescription drug coverage, mental health and substance abuse treatment, and preventive and wellness services. The Affordable Care Act (ACA) requires all individuals to have health insurance, or pay a penalty on their federal income taxes. For those who do not have employer-sponsored insurance, they can buy individual health plans on the Maryland Health Connection marketplace. These plans also must meet certain legal requirements, such as providing coverage for essential health benefits (EHBs) and not being more expensive due to age, gender, or health condition. Insurance companies must also abide by Maryland’s rate review system. This system reviews insurance rates to ensure they are justifiable and not overly expensive. The Maryland Insurance Administration also reviews the rate increases to make sure they are reasonable. Individuals who are not eligible for employer-sponsored or individual health insurance can apply for Medicaid. Medicaid is a government insurance program that can provide health coverage for those who meet certain income and citizenship requirements. Medicaid also covers certain free preventive services such as annual wellness exams. Overall, health insurance in Maryland must meet certain legal requirements including covering essential health benefits and abiding by rate review systems. These laws are in place to ensure that all Marylanders have access to quality and affordable health coverage.

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What are the legal requirements for health insurance?

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