Your Comprehensive

Maryland Medicaid

Guide

Published on
February 6, 2024
Last updated
February 6, 2024
Written by
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Katie Wilkinson
Reviewed by
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Quick Overview of Maryland Medicaid

Medicaid in Maryland is a crucial public health insurance program designed to provide health coverage to low-income individuals and families, ensuring access to essential medical services.

Managed by the Maryland Department of Health, the program encompasses a wide range of benefits, including doctor visits, hospital care, prescription drugs, and more, tailored to meet the health needs of its diverse beneficiaries, which include children, pregnant women, parents, seniors, and individuals with disabilities.

Maryland has expanded Medicaid under the Affordable Care Act (ACA), allowing a broader spectrum of residents to qualify based on income criteria. This expansion has significantly increased the number of Marylanders with access to affordable healthcare services.

The state also operates the Maryland Health Connection, an online marketplace where residents can apply for Medicaid coverage, making the enrollment process more accessible and streamlined.

Through these efforts, Maryland continues to enhance public health outcomes and reduce the rate of uninsured people across the state.

Benefits you get with Maryland Medicaid

Medicaid in Maryland offers a comprehensive range of covered services to meet the health needs of its beneficiaries. These services include, but are not limited to:

  1. Doctor Visits - Scheduled consultations with healthcare professionals for routine check-ups, diagnoses, and treatment plans.
  2. Hospital Services - Inpatient and outpatient services for medical conditions that require hospital admission or procedures.
  3. Prescription Drugs - Coverage for prescribed medications, including generics and some brand-name drugs, as necessary for treatment.
  4. Laboratory and X-Ray Services - Diagnostic services to aid in assessing and treating medical conditions.
  5. Mental Health Services - Includes counseling, therapy, and psychiatric services for individuals with mental health conditions.
  6. Substance Abuse Treatment - Programs and services for individuals struggling with substance use, including detoxification and rehabilitation.
  7. Dental Services - Preventative, diagnostic, and treatment services for oral health, with varying coverage for adults and enhanced benefits for children.
  8. Vision Services - Eye exams and, in some cases, coverage for glasses or contact lenses, particularly for children.
  9. Emergency Medical Services - Care for acute medical conditions that require immediate attention, including ambulance services.
  10. Family Planning Services - Services and supplies for individuals seeking contraception and reproductive health assistance.
  11. Home Health Services - Medical care provided in a patient's home, including nursing care, physical therapy, and other home-based services.
  12. Long-Term Services and Supports - Assistance for individuals with chronic illnesses or disabilities, including home and community-based services, to improve their quality of life.
  13. Pediatric Services - Comprehensive healthcare services tailored for children, covering preventive care, immunizations, and specialist care.
  14. Maternity and Newborn Care - Healthcare services for pregnant women and newborns, covering prenatal, delivery, and postnatal care.

These services aim to ensure that Medicaid beneficiaries in Maryland have access to a broad spectrum of healthcare options to maintain or improve their health status.

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Maryland Medicaid eligiblity rules

Eligibility for Medicaid in Maryland is determined by several factors, including income, household size, age, and specific health needs. The following are key criteria used to assess eligibility:

  1. Income Level: Maryland follows the Modified Adjusted Gross Income (MAGI) method for most applicants, aligning with the Affordable Care Act's expansion of Medicaid. Income thresholds vary by group, such as children, pregnant women, adults, and the elderly or disabled, typically set as a percentage of the Federal Poverty Level (FPL).
  2. Residency: Applicants must be residents of Maryland and intend to remain so. They must also be U.S. citizens, nationals, or certain non-citizens with qualifying immigration status.
  3. Household Size: The size of an applicant's household influences the income threshold for eligibility. Larger households have higher income limits.
  4. Age: Medicaid in Maryland covers individuals of all ages, but specific programs target certain age groups, such as children under the Maryland Children's Health Program (MCHP) or elderly individuals needing long-term care.
  5. Pregnancy: Pregnant women may qualify for Medicaid with higher income limits, receiving comprehensive prenatal, labor and delivery, and postpartum care.
  6. Disability Status: Individuals with disabilities may qualify for Medicaid under more lenient income guidelines and can access specialized services and supports.
  7. Special Circumstances: Maryland Medicaid includes coverage for individuals under special programs, such as the Breast and Cervical Cancer Diagnosis and Treatment Program and family planning services, which have unique eligibility requirements.

Applicants are encouraged to apply even if they're unsure about their eligibility, as Maryland offers multiple Medicaid programs catering to different needs. Applications can be submitted through the Maryland Health Connection, the state's health insurance marketplace, where eligibility determinations are made and appropriate programs are suggested.

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How to apply for Maryland Medicaid

Applying for Medicaid in Maryland can be accomplished through several methods, ensuring accessibility for all residents seeking healthcare coverage. Here's how to apply:

Online

The primary and most convenient way to apply for Medicaid is through the Maryland Health Connection, the state's official health insurance marketplace. Visit their website at marylandhealthconnection.gov to start your application. The online platform guides applicants through the process, allowing for uploading necessary documentation and real-time eligibility determination for some applicants.

Mobile App

Maryland Health Connection offers a mobile app, Enroll MHC, available for download on both Android and iOS devices. The app allows users to apply, renew, or update their Medicaid coverage.

In-Person

For personal assistance, you can apply at local health departments or through Connector Entities (organizations that provide free, in-person assistance across the state). Please find your nearest location by visiting the Maryland Health Connection website or calling their support center.

By Phone

Applicants can also apply by phone through the Maryland Health Connection Call Center. The number to call is 1-855-642-8572 (Deaf and hard of hearing use Relay service). The call center can assist in multiple languages.

Mail

While online and in-person applications are encouraged for efficiency and immediate feedback, applicants can also submit a paper application. You can download the application form from the Maryland Health Connection website or request a copy by calling the call center. Completed applications should be mailed to the address provided on the form.

Required Documentation

Regardless of the application method, be prepared to provide personal information and documentation for all household members applying for coverage. This includes, but is not limited to, proof of income, identification (such as driver's license or passport), proof of residency (such as utility bills or rental agreements), and information on current health insurance.

Assistance and Questions

For questions or assistance during the application process, contact the Maryland Health Connection Call Center at 1-855-642-8572. Assistance is available in multiple languages, and there are options for individuals who are deaf or hard of hearing.

Applying for Medicaid in Maryland is designed to be accessible, with multiple entry points to accommodate all residents' needs. The state provides resources and support to guide applicants online, by phone, or in person.

How to renew Maryland Medicaid

Renewing Medicaid coverage in Maryland is an annual requirement to ensure that beneficiaries continue to meet the eligibility criteria. The state aims to simplify the renewal process and provides multiple ways to complete it. Here's what you need to know about renewing Medicaid coverage in Maryland:

Notification

Approximately 45-60 days before your coverage expires, Maryland Health Connection will send you a renewal notice. This notice will detail the steps you need to take to renew your coverage and the deadline.

Methods to Renew

  1. Online: The easiest way to renew your Medicaid coverage is through the Maryland Health Connection website (marylandhealthconnection.gov). After logging into your account, you can complete the renewal process by updating your information and submitting the renewal application.
  2. Mobile App: Use the Enroll MHC app, available for Android and iOS devices, to renew your Medicaid coverage. The app lets you update your information and submit the renewal directly from your smartphone or tablet.
  3. By Phone: Call the Maryland Health Connection Call Center at 1-855-642-8572 (Deaf and hard of hearing use Relay service) for assistance renewing your coverage over the phone. The call center can also answer any questions about the renewal process.
  4. In-Person: For those who prefer or need assistance, in-person help is available through local health departments and Connector Entities across Maryland. Find the nearest assistance location by visiting the Maryland Health Connection website or calling the call center.
  5. Mail: Some individuals may receive a paper renewal form in the mail. Complete the form and mail it back to the address provided. If you prefer this method but have not received a form, contact the call center to request one.

Required Information and Documentation

You will need to review and update your personal information, including income, household size, and any changes in eligibility factors. Be prepared to provide supporting documentation if significant changes have occurred since your last application or renewal.

Deadlines

It's important to complete your renewal by the deadline specified in your renewal notice to avoid a lapse in coverage.

Assistance

If you encounter any difficulties or have questions about renewing your Medicaid coverage, the Maryland Health Connection Call Center is available to help. Contact them at 1-855-642-8572. Assistance is offered in multiple languages, and there are options for the deaf and hard of hearing.

Renewing your Medicaid coverage in Maryland is critical to ensure uninterrupted access to healthcare services. The state provides various methods to renew, catering to different preferences and needs. Remember to act promptly upon receiving your renewal notice to maintain your coverage.

Additional programs through Maryland Medicaid

These programs are available to help family caregivers get paid for caring for loved ones on Maryland Medicaid.

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