Private Health Plans for the Self-Employed in Maryland

I am an independent, licensed health insurance broker, and I am licensed in Maryland. If you are self-employed, a 1099 contractor, or a freelancer, this page covers the options that sit outside the Marketplace — what is actually available in Maryland, what the trade-offs are, and when a private plan is the wrong answer. There is no fee for my help. The insurance company pays the broker, not you.

Maryland caps short-term coverage at 90 days — far shorter than the 36 months some states allow.

Maryland at a glance for the self-employed

Maryland runs its own exchange, Maryland Health Connection. Five carriers are selling for 2026 and 2027: two CareFirst companies, Kaiser Permanente, Optimum Choice and Wellpoint. Aetna left after 2025. Enrollment actually grew about 3% for 2026, to about 256,000.

• Maryland softens the subsidy cliff. Maryland Premium Assistance replaces lost federal help for people up to 400% of the poverty level. It covers it fully under 200% and partly above that. For 2027 the state may scale back to replacing 25% of lost subsidies above 250%.
• Young adult discount. The Young Adult Subsidy Program now covers enrollees up to age 37 and is permanent.
• Reinsurance since 2019 keeps full-price premiums lower than they would otherwise be. Carriers still proposed about 14% more for 2027.
• Pregnancy is a qualifying event in Maryland, with a 90-day window to enroll.

Above 400% of the poverty level, neither federal nor state help applies, and short-term plans are capped at 90 days, so a full-price comparison matters.

The 400% line matters more here than most people expect. For 2027 the credit stops above $63,840 for one person and $132,000 for a family of four, and there is no phase-out. See the full 2027 income limits.

Your private options in Maryland

• Short-term plans. Maryland limits short-term coverage to 90 days with no renewal, so it only covers a brief gap.
• State subsidies. Maryland adds its own premium help for households up to 400% of the poverty level, which can change the math for self-employed people just under the line.
• Medically underwritten private plans. Health questions up front, often lower premiums for healthy applicants, broad PPO networks, and applications accepted any month.
• Supplemental coverage. Accident, critical-illness and hospital plans can soften a high deductible. How it works.

When private is the right call in Maryland, and when it is not

With five carriers on Maryland Health Connection for 2027 and proposed 2027 increases averaging about 14%, a healthy Maryland freelancer or business owner over the subsidy line often saves real money with a private plan.

Stay with Maryland Health Connection if you have an ongoing condition, are pregnant or planning to be, take expensive prescriptions, or qualify for a meaningful tax credit, including Maryland's own state help. If that is you, I will say so.

The tax piece

Most self-employed people can deduct their health insurance premiums, which also lowers the income that counts toward a subsidy. How it works for 1099 workers.

Maryland questions I hear a lot

Does Maryland help if I lost my federal subsidy?

Maryland Premium Assistance replaces lost federal help for people up to 400% of the poverty level, fully under 200% and partly above that. The 2027 program may be scaled back above 250%.

What is Maryland's Young Adult Subsidy?

Extra state help for young adults, now available up to age 37 and made permanent.

Which carriers sell plans on Maryland Health Connection?

Five for 2026 and 2027: two CareFirst companies, Kaiser Permanente, Optimum Choice and Wellpoint.

What if I earn more than 400% of the poverty level in Maryland?

Neither federal nor state help applies, so you pay full price. I compare that with private options that fit Maryland's rules at no cost.

Posey Health Solutions · National Producer Number 20609967 · licensed in Maryland and 30 other states. This page is general information, not advice about a specific plan, and it is not tax advice. Plan availability, carrier participation, and duration limits vary by county, carrier, and plan year, and the rules can change.