Maryland: Start Here
Beginner guide for Maryland—Maryland Health Connection, MIA external review, PA deadlines, and what to open next.
Read guideState playbook
Maryland
State insurers, legislation, and appeal resources for patients and advocates in Maryland.
4 guides
Maryland Prior Authorization Law
Insurance § 15-10B—2-day non-emergency PA, 24-hour emergency, 2-hour MH emergency admission, § 15-1009 payment protection.
Read guideMaryland Health Insurance Appeals and Grievances
§ 15-10A-02—30/45-day grievances, 24-hour emergency, deemed exhaustion, path to MIA § 15-10A-03.
Read guideMaryland External Review (MIA)
Commissioner complaint—IRO review, 4-month filing, 45-day standard, 24-hour emergency, carrier burden of proof.
Read guidePrior auth & internal appeals
Match the plan on the member ID card. Use the denial letter for where to file appeals.
- CareFirst BlueCross BlueShield
- Kaiser Permanente Mid-Atlantic
- UnitedHealthcare
- Wellpoint Maryland
- Maryland Health Connection
- Aetna Better Health of Maryland (Medicaid)
- HealthChoice / MDH
External appeals
After internal appeal, for eligible Maryland fully insured plans only.
- MIA — Appeals & grievances
- HEAU (free consumer help)
- Medicaid — Fair hearing (OAH)