Health Insurance for Self -Employed in Maryland

The question of medical insurance is a common problem among the self-employed. Unlike those who are statutory employees, the self-employed do not typically have automatic access to a guaranteed-issue group medical plan through work. If you are self-employed, you are on your own for all manner of employee benefits, including health insurance. If you are in good health, this coverage is readily available in the private market. If you have health challenges, obtaining coverage may be more difficult.

Types of Insurance Plans

• Health insurance comes in a variety of forms. Indemnity plans, or fee-for-service plans, offer rich benefits and do not restrict you to specific providers. Premiums tend to be high. Health maintenance organizations, or HMOs, make premiums more affordable by restricting you to an approved network of providers. Additionally, you must go through a primary care physician, or PCP, before you can get benefits to see a specialist for nonemergency care. A preferred provider organization is similar to an HMO but does not require you to go through a PCP to see a specialist. Premiums in these plans tend to be lower than indemnity plans but higher than comparable PPOs.

Purchase an Individual Policy

• If you are in good health, you can easily purchase an individual insurance policy of any kind. You can buy one to cover just yourself or you can buy a family plan, which will cover your spouse and children as well. This is particularly important if your spouse does not have access to a plan at work. Simply speak to a licensed health insurance broker for details.

Purchase a Group Plan

• If you have employees, you may consider purchasing a group plan to cover all of your employees, along with yourself. You must have a minimum group size of two members, and you must subsidize the benefits of all qualified workers. You cannot pick and choose which workers receive health care benefits but must offer them to all your full-time workers. Additionally, you must have a minimum participation rate.

  However, you may purchase a small business health plan without having any employees.

The Maryland Health Insurance Plan

• The State of Maryland maintains a separate risk pool for those who do not have access to medical insurance through traditional, market-based plans. If you have a preexisting condition, or you have recently lost coverage, you may qualify for MHIP, or the Maryland Health Insurance Plan. MHIP gives qualified plan members a variety of choices, including a low deductible plan and a high-deductible plan, which helps keep premiums manageable. For those with limited incomes, you may be able to qualify for a subsidized plan, MHIP+. See "Resources" for more information.

Alternatives

• If you have health issues, you may wish to get coverage via your spouse, if your spouse has access to a workplace group health care plan. This will allow you access to a guaranteed issue policy, though you will have to wait until the open enrollment period at your spouse's workplace to initiate coverage. You may also be able to get coverage via the Veterans Administration health care system if you are an honorably discharged veteran, or via Medicare if you are over age 65.