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

CareFirst of Maryland Health Insurance Plans in Silver Spring, MD

CareFirst of Maryland offers both HMO and PPO plans on the Maryland Health Connection marketplace in Silver Spring for 2026.
Silver Spring is part of Maryland Rating Area 1, where 4 carriers offer marketplace plans, including CareFirst BlueChoice, CareFirst of Maryland, Optimum Choice, and Wellpoint.
Maryland residents with household incomes between 100% and 400% of the Federal Poverty Level (FPL) may qualify for significant premium subsidies.
Adults in Maryland with incomes up to 138% FPL may qualify for Maryland Medicaid (HealthChoice), which provides comprehensive, low-cost coverage.

Navigating health insurance options in Silver Spring, Maryland, means understanding the specific plans available from carriers like CareFirst of Maryland through the state's marketplace, Maryland Health Connection. CareFirst of Maryland is a prominent provider in Rating Area 1, which encompasses Silver Spring and the entirety of Montgomery County. Shoppers in this area have access to a range of plan types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) structures, allowing for flexibility in network choice and cost-sharing. Whether you're seeking comprehensive coverage for yourself or your family, understanding CareFirst of Maryland's offerings alongside other local carriers is key to making an informed decision about your health coverage in 2026.

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What CareFirst of Maryland Plans Are Available in Silver Spring?

CareFirst of Maryland is one of four confirmed carriers offering health insurance plans on the Maryland Health Connection marketplace in Rating Area 1 for the 2026 plan year. Unlike some states where PPO plans are only available off-exchange, Maryland's marketplace includes PPO options from CareFirst of Maryland and CareFirst BlueChoice, alongside HMO and EPO plans. This means that residents of Silver Spring can choose from a variety of plan structures to best fit their healthcare needs and preferences for provider access. Plans are categorized into metal tiers: Bronze, Silver, Gold, and Platinum.

Bronze plans: These plans typically have the lowest monthly premiums but the highest deductibles and out-of-pocket costs. They are designed primarily for catastrophic coverage, covering essential health benefits after the deductible is met.
Silver plans: Silver plans offer a balance between monthly premiums and out-of-pocket costs. They are particularly valuable for individuals and families who qualify for Cost-Sharing Reductions (CSRs), which reduce deductibles, copayments, and out-of-pocket maximums for those with incomes up to 250% FPL.
Gold plans: With higher monthly premiums than Bronze or Silver, Gold plans offer lower deductibles and out-of-pocket maximums. They are ideal for individuals who anticipate needing frequent medical care or who prefer more predictable costs throughout the year.
Platinum plans: These plans have the highest monthly premiums but the lowest out-of-pocket costs, often with very low or no deductibles. They are suitable for those who expect extensive medical services and want maximum financial predictability.

When selecting a CareFirst of Maryland plan, consider your expected medical needs, preferred doctors, and budget. An agent can help you compare specific plan benefits and network details.

Understanding Health Insurance Costs and Subsidies in Silver Spring

The cost of health insurance in Silver Spring, including plans from CareFirst of Maryland, can vary significantly based on the metal tier, plan type (HMO, PPO, EPO), and your age. However, many residents qualify for financial assistance to make coverage more affordable. The Maryland Health Connection marketplace provides premium tax credits (subsidies) and Cost-Sharing Reductions (CSRs) to eligible individuals and families.

Federal Poverty Level (FPL)	Potential Financial Assistance	Key Benefit
Below 138% FPL	Maryland Medicaid (HealthChoice)	Comprehensive, low-cost or no-cost coverage.
100% - 150% FPL	Enhanced Premium Tax Credits & Strong CSRs	Very low premiums, significant reductions in deductibles/copays on Silver plans.
150% - 200% FPL	Enhanced Premium Tax Credits & Moderate CSRs	Reduced premiums, good reductions in deductibles/copays on Silver plans.
200% - 250% FPL	Enhanced Premium Tax Credits & Basic CSRs	Reduced premiums, some reductions in deductibles/copays on Silver plans.
250% - 400% FPL	Enhanced Premium Tax Credits	Reduced monthly premiums across all metal tiers.
Above 400% FPL	No Premium Tax Credits	Pay full premium, but guaranteed issue and comprehensive benefits.

For individuals in Silver Spring whose household income falls below 138% of the Federal Poverty Level (FPL), Maryland Medicaid (also known as HealthChoice) is available. This program provides comprehensive health coverage with minimal or no out-of-pocket costs. Maryland also offers expanded Medicaid for pregnant women up to 250% FPL and the Maryland Children's Health Program (MCHP) for children up to 300% FPL. These income thresholds are among the highest in the nation, reflecting Maryland's commitment to broad health coverage. Montgomery County, where Silver Spring is located, has a population of 1,065,949 per U.S. Census Bureau ACS 2024 5-year estimates. The county's median household income is $132,450, and its uninsured rate is 7.0%. Silver Spring itself has a population of 81,462, a median income of $99,860, and an uninsured rate of 9.9%. These figures highlight the diverse economic landscape and varying needs for affordable health coverage within the area. Holy Cross Hospital and Adventist Healthcare White Oak Medical Center, both in Silver Spring, are key acute care facilities serving residents.

Health Insurance Carriers in Silver Spring

In 2026, four carriers offer marketplace health insurance 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. Residents of Silver Spring have multiple options beyond CareFirst of Maryland. The confirmed carriers for this rating area are:

CareFirst BlueChoice
CareFirst of Maryland
Optimum Choice
Wellpoint

When comparing plans, consider not only the premiums and deductibles but also the provider networks. For example, if you have preferred doctors or need access to specific hospitals like Holy Cross Hospital or Adventist Healthcare White Oak Medical Center, ensure they are in-network with your chosen plan and carrier. Both CareFirst BlueChoice and CareFirst of Maryland offer PPO plans, providing broader network access compared to HMOs, which typically require referrals for specialists.

Making Your Health Insurance Decision in Silver Spring

Choosing the right health insurance plan for your needs in Silver Spring involves a few key steps. First, understand your household income relative to the Federal Poverty Level (FPL) to determine your eligibility for premium tax credits or Maryland Medicaid (HealthChoice). Then, consider your healthcare usage patterns:

If you rarely visit the doctor: A Bronze plan with lower premiums might be suitable, but be prepared for higher out-of-pocket costs if unexpected medical needs arise.
If you visit the doctor regularly or have chronic conditions: A Gold or Platinum plan, or a Silver plan with Cost-Sharing Reductions, could offer better value due to lower deductibles and copayments.
If you want more flexibility in choosing doctors: A PPO plan from CareFirst of Maryland or CareFirst BlueChoice might be preferable over an HMO or EPO, though it could come with a higher premium.

Finally, ensure that your preferred doctors, specialists, and hospitals, such as Medstar Montgomery Medical Center in Olney or Suburban Hospital in Bethesda, are included in the plan's network. A licensed health insurance producer can provide personalized guidance, compare plans from all available carriers, and help you enroll in the best option for your situation, all at no cost to you.

Frequently Asked Questions

Can I get CareFirst of Maryland PPO plans on the Maryland Health Connection marketplace?

Yes, CareFirst of Maryland, along with CareFirst BlueChoice, offers PPO plans on the Maryland Health Connection marketplace. Maryland is one of the states where PPO plans are available to subsidy-eligible shoppers, alongside HMO and EPO options.

What are the income limits for Medicaid in Silver Spring, Maryland?

In Maryland, adults with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Maryland Medicaid (HealthChoice). For a single individual, this threshold is approximately $20,782 per year in 2026.

How many health insurance carriers offer plans in Silver Spring?

In 2026, four carriers offer marketplace health insurance plans in Rating Area 1, which includes Silver Spring and all of Montgomery County. These carriers are CareFirst BlueChoice, CareFirst of Maryland, Optimum Choice, and Wellpoint.

Do I qualify for subsidies on CareFirst of Maryland plans?

Yes, if your household income is between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits (subsidies) that can significantly lower your monthly premiums for CareFirst of Maryland plans purchased through Maryland Health Connection. Those below 150% FPL may qualify for enhanced subsidies.