CareFirst of Maryland Health Insurance Plans in Montgomery County, MD

Updated July 2026 · MarylandPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

CareFirst of Maryland offers both HMO and PPO plans on the Maryland Health Connection marketplace in Montgomery County.
Montgomery County is part of Maryland Rating Area 1, which has 4 marketplace carriers for the 2026 plan year.
Maryland Medicaid (HealthChoice) covers adults up to 138% FPL, pregnant women up to 250% FPL, and children up to 300% FPL.
Subsidies are available for individuals and families with incomes between 100% and 400% FPL through the Maryland Health Connection.

Navigating health insurance options in Montgomery County, Maryland, involves understanding the plans available through the state's marketplace, Maryland Health Connection. CareFirst of Maryland is a prominent carrier offering various plan types, including both Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans, to residents in this area. For 2026, Montgomery County is part of Rating Area 1, which provides residents with a choice of 4 different health insurance carriers. Many individuals and families may qualify for financial assistance in the form of premium tax credits and cost-sharing reductions, significantly lowering the cost of coverage.

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What CareFirst of Maryland Plans Are Available in Montgomery County?

In Montgomery County, CareFirst of Maryland provides a range of health insurance plans through the Maryland Health Connection. Unlike some states, Maryland's marketplace offers a choice of plan structures, including HMO, PPO, and Exclusive Provider Organization (EPO) options. CareFirst of Maryland specifically offers both HMO and PPO variants, giving residents flexibility in choosing a plan that aligns with their preferred provider network and referral requirements. HMO plans typically require you to choose a primary care provider (PCP) within the network and get referrals for specialist visits, offering a more coordinated care experience. PPO plans, on the other hand, generally allow you to see specialists without a referral and offer some coverage for out-of-network care, though at a higher cost. Understanding these differences is crucial for selecting the best plan for your healthcare needs.

Understanding Your Eligibility for Subsidies in Maryland

Maryland's health insurance marketplace, Maryland Health Connection, provides financial assistance to make coverage more affordable. These subsidies come in two main forms:

Premium Tax Credits (PTC): These reduce your monthly premium payments. Eligibility is based on household income relative to the Federal Poverty Level (FPL). In Maryland, individuals and families with incomes between 100% and 400% FPL may qualify for these credits.
Cost-Sharing Reductions (CSRs): These lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance. CSRs are available only with Silver-tier plans and are typically for those with incomes up to 250% FPL.

To determine your exact eligibility and the amount of assistance you might receive, it is essential to apply through the Maryland Health Connection. A licensed health insurance producer can also help you calculate your potential subsidies and compare plan costs.

Maryland Medicaid and Children's Health Programs

Maryland has an expanded Medicaid program, known as Maryland Medicaid or HealthChoice, which provides comprehensive health coverage for low-income residents.

Adults: Adults with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Maryland Medicaid. This means that unlike non-expansion states, there is no "coverage gap" for those below the FPL who do not qualify for marketplace subsidies.
Pregnant Women: Maryland offers one of the most generous Medicaid programs for pregnant women, covering those with incomes up to 250% FPL. This coverage includes comprehensive prenatal care, labor and delivery, and extended postpartum care. Applications can be submitted through the Maryland Health Connection or the local Department of Social Services.
Children: The Maryland Children's Health Program (MCHP), the state's CHIP equivalent, covers uninsured children with household incomes up to 300% FPL.

These programs are vital safety nets, ensuring that vulnerable populations in Montgomery County and across Maryland have access to necessary healthcare services.

Health Insurance Carriers in Montgomery County

Montgomery County, Maryland, is part of Rating Area 1, which covers a significant portion of the state including Allegany, Anne Arundel, Baltimore, Baltimore, Calvert, Caroline, Carroll, Cecil, Charles, Dorchester, Frederick, Garrett, Harford, Howard, Kent, Montgomery, Prince George's, Queen Anne's, Somerset, St. Mary's, Talbot, Washington, Wicomico, Worcester counties. In 2026, 4 carriers offer marketplace plans in Rating Area 1 on the Maryland Health Connection:

CareFirst BlueChoice
CareFirst of Maryland
Optimum Choice
Wellpoint

CareFirst of Maryland is one of the key providers, offering a variety of HMO and PPO plans to suit different needs. When comparing plans, consider not only the premiums but also the deductibles, copayments, coinsurance, and the network of hospitals and doctors. Montgomery County is a vibrant and populous area, home to 1,065,949 residents, per U.S. Census Bureau ACS 2024 5-year estimates. The county has a median household income of $132,450 and an uninsured rate of 7.0%, which is below the national average. The county is served by 7 acute care hospitals, including Holy Cross Hospital in Silver Spring, Adventist Healthcare White Oak Medical Center in Silver Spring, Medstar Montgomery Medical Center in Olney, Suburban Hospital in Bethesda, Adventist Healthcare Shady Grove Medical Center in Rockville, Holy Cross Germantown Hospital in Germantown, and Walter Reed National Military Med Cen in Bethesda.

Choosing the Right CareFirst of Maryland Plan in Montgomery County

Selecting the best CareFirst of Maryland plan for your needs in Montgomery County depends on several factors, including your income, health status, and preferred doctors. Here's a general guide:

Your Situation	Recommended Action / Plan Tier	Key Consideration
Low Income (below 138% FPL)	Apply for Maryland Medicaid (HealthChoice)	Comprehensive coverage with no premiums or very low costs.
Moderate Income (100-250% FPL)	Silver Plan with Cost-Sharing Reductions (CSRs)	Lowest out-of-pocket costs (deductibles, copays) in addition to premium tax credits.
Higher Income (250-400% FPL)	Bronze, Silver, or Gold Plan with Premium Tax Credits	Balance monthly premium with expected healthcare usage. Bronze for low usage, Gold for high usage.
Income above 400% FPL	Any Metal Tier Plan (no subsidies)	Focus on network, deductible, and out-of-pocket maximum that fits your budget and health needs.
Prioritizing low monthly premium	Bronze Plan (CareFirst of Maryland)	Higher deductibles and out-of-pocket costs, best for those who expect minimal healthcare use.
Prioritizing lower out-of-pocket costs	Gold Plan (CareFirst of Maryland)	Higher monthly premiums, but lower deductibles and copays, ideal for frequent healthcare users.

A licensed health insurance producer can provide personalized guidance, helping you compare specific CareFirst of Maryland plans, understand their networks, and maximize any available financial assistance. Their services are typically free to you.

Frequently Asked Questions

What types of CareFirst of Maryland plans are available in Montgomery County?

In Montgomery County, CareFirst of Maryland offers both HMO and PPO structured plans on the Maryland Health Connection marketplace. These plans are available alongside options from other carriers in Rating Area 1.

Can I get a subsidy for CareFirst of Maryland plans in Montgomery County?

Yes, if your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits and cost-sharing reductions when enrolling in a CareFirst of Maryland plan through the Maryland Health Connection. These subsidies can significantly lower your monthly premiums and out-of-pocket costs.

How many health insurance carriers operate in Montgomery County?

For the 2026 plan year, Montgomery County residents in Rating Area 1 can choose from plans offered by 4 different carriers on the Maryland Health Connection. These include CareFirst BlueChoice, CareFirst of Maryland, Optimum Choice, and Wellpoint.

What is Maryland Health Connection?

The Maryland Health Connection is Maryland's official state-based health insurance marketplace. It's where individuals and families can compare health plans, apply for financial assistance, and enroll in coverage, including plans from CareFirst of Maryland.