CareFirst of Maryland Health Insurance in Prince George's County, MD
- In 2026, CareFirst of Maryland is one of 4 carriers offering marketplace plans in Prince George's County's Rating Area 1.
- Maryland Health Connection, the state's marketplace, offers HMO, PPO, and EPO plans, including PPO options from CareFirst of Maryland.
- Maryland expanded Medicaid (HealthChoice) in 2014, covering adults with incomes up to 138% of the Federal Poverty Level.
- Prince George's County, with a population of 959,754, has an uninsured rate of 11.4%, per U.S. Census Bureau ACS 2024 5-year estimates.
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What CareFirst of Maryland Plans Are Available in Prince George's County?
CareFirst of Maryland, and its affiliate CareFirst BlueChoice, offer a range of health insurance plans on the Maryland Health Connection marketplace for residents of Prince George's County. Unlike some states, Maryland's marketplace includes PPO (Preferred Provider Organization) plans in addition to HMO (Health Maintenance Organization) and EPO (Exclusive Provider Organization) options. This means consumers in Prince George's County have greater flexibility in choosing a plan structure that aligns with their preferences for provider choice and referral requirements. When selecting a CareFirst of Maryland plan, you'll typically encounter different metal tiers: Bronze, Silver, Gold, and Platinum. These tiers categorize plans by how they split healthcare costs with you:- Bronze Plans: These plans have the lowest monthly premiums but the highest deductibles and out-of-pocket maximums. They are designed for individuals who anticipate needing minimal medical care or want protection against catastrophic costs.
- Silver Plans: Offering a balance between monthly premiums and out-of-pocket costs, Silver plans are popular. They are especially beneficial for those who qualify for Cost-Sharing Reductions (CSRs), which can significantly lower deductibles, copayments, and out-of-pocket maximums.
- Gold Plans: With higher monthly premiums than Bronze or Silver, Gold plans feature lower deductibles and out-of-pocket maximums. They are suitable for individuals who expect to use medical services frequently and prefer to pay more upfront for lower costs at the point of care.
- Platinum Plans: These plans have the highest monthly premiums but the lowest deductibles and out-of-pocket costs. They are ideal for those with extensive medical needs who want the most comprehensive coverage and minimal out-of-pocket expenses during the year.
Understanding Financial Assistance and Maryland Medicaid in Prince George's County
Many residents in Prince George's County may qualify for financial assistance to make health insurance more affordable. This assistance is available through Maryland Health Connection in two main forms:Premium Tax Credits (Subsidies): These credits reduce your monthly premium payment. Eligibility is based on household income and size, generally available to individuals and families with incomes between 100% and 400% of the Federal Poverty Level (FPL). Maryland also offers additional state-based subsidies to further reduce costs for residents.
Cost-Sharing Reductions (CSRs): Available exclusively with Silver-tier plans, CSRs lower the amount you have to pay for deductibles, copayments, and coinsurance. You must have an income between 100% and 250% of the FPL to qualify for CSRs. These reductions can significantly decrease your out-of-pocket costs when you receive care.
For those with lower incomes, Maryland offers expanded Medicaid coverage, known as Maryland Medicaid or HealthChoice. Maryland expanded Medicaid in 2014, making it available to adults in Prince George's County with incomes up to 138% of the Federal Poverty Level. This program provides comprehensive health benefits with little to no cost. Additionally, pregnant women with incomes up to 250% FPL can qualify for Maryland Medicaid, which covers extensive prenatal, delivery, and postpartum care. The Maryland Children's Health Program (MCHP), the state's CHIP equivalent, covers uninsured children up to 300% FPL. You can apply for these programs through Maryland Health Connection or your local Department of Social Services.
Health Insurance Carriers in Prince George's County
In 2026, 4 carriers offer marketplace plans in Rating Area 1, which covers 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. These carriers provide a range of health insurance options for residents of Prince George's County through Maryland Health Connection. The confirmed carriers for Prince George's County's Rating Area 1 for the 2026 plan year are:- CareFirst BlueChoice
- CareFirst of Maryland
- Optimum Choice
- Wellpoint
Choosing the Right Health Plan in Prince George's County
When selecting a health insurance plan in Prince George's County, consider your healthcare needs, budget, and preferred doctors. Here's a decision-making framework:| Your Situation | Recommended Action |
|---|---|
| Income below 138% FPL (e.g., ~$20,120 for an individual) | Apply for Maryland Medicaid (HealthChoice) through Maryland Health Connection. You likely qualify for comprehensive, low-cost coverage. |
| Income 100%-250% FPL (e.g., ~$14,580 - ~$36,450 for an individual) | Focus on Silver plans on Maryland Health Connection. You'll likely qualify for significant premium tax credits and valuable Cost-Sharing Reductions, lowering both your monthly premium and out-of-pocket costs. |
| Income 250%-400% FPL (e.g., ~$36,450 - ~$58,360 for an individual) | Explore Silver, Gold, or Platinum plans on Maryland Health Connection. You'll still qualify for premium tax credits to lower your monthly costs. Compare deductibles and copays to find the best balance. |
| Income above 400% FPL (e.g., above ~$58,360 for an individual) | You can purchase any plan on Maryland Health Connection at full price. Consider the balance between monthly premiums and expected healthcare usage. PPO options from carriers like CareFirst of Maryland may offer greater flexibility. |
| You prefer a broad network or travel frequently | Look for PPO plans offered by CareFirst of Maryland or CareFirst BlueChoice, which generally provide more flexibility in choosing providers outside of a primary care physician referral. |
| You prioritize lower monthly premiums | Consider Bronze plans, but be aware of higher deductibles. If you anticipate minimal medical needs, this could be a cost-effective choice. |
Frequently Asked Questions
What types of CareFirst of Maryland plans are available in Prince George's County?
CareFirst of Maryland, along with CareFirst BlueChoice, offers both PPO and HMO health insurance plans on the Maryland Health Connection marketplace in Prince George's County. This provides a range of options for consumers seeking different network structures and flexibility.
Can I get financial assistance for CareFirst of Maryland plans in Prince George's County?
Yes, individuals and families in Prince George's County with incomes between 100% and 400% of the Federal Poverty Level may qualify for premium tax credits and cost-sharing reductions when purchasing a CareFirst of Maryland plan through Maryland Health Connection. Maryland also offers additional state-based subsidies to further reduce costs.
How does Maryland Medicaid (HealthChoice) work in Prince George's County?
Maryland expanded Medicaid in 2014 (known as HealthChoice). Adults in Prince George's County with incomes up to 138% of the Federal Poverty Level are eligible for comprehensive, low-cost health coverage through Maryland Medicaid. Applications can be submitted via Maryland Health Connection or the local Department of Social Services.
Where do Prince George's County residents go for acute hospital care?
Prince George's County does not have any acute care hospitals within its boundaries. Residents needing inpatient or emergency acute care typically travel to neighboring counties, which are part of the same multi-county Rating Area 1, for hospital services.