Alyssa Lane
The state of Maryland offers a variety of medical insurance programs to cater to the needs of its residents. These include Medicaid, Medicare, and the Maryland Children's Health Insurance Program (MCHP). The application process for these programs can be completed online, over the phone, or in person at various locations, including local health departments and departments of social services. The state also provides resources for specific groups, such as older adults, individuals with disabilities, and those who have lost their job-based health insurance. Understanding the eligibility requirements and application procedures for these programs is essential for accessing the medical insurance coverage provided by the state of Maryland.
| Characteristics | Values |
|---|---|
| Who is eligible for medical insurance in Maryland? | Low-income families, children, seniors, and people with disabilities |
| What does medical insurance in Maryland cover? | Doctor visits, pregnancy care, prescription drugs, hospital and emergency services |
| How to apply for medical insurance in Maryland? | Online at myDHR, by telephone by calling the Maryland Health Benefits Exchange Consolidated Service Center at (855) 642-8572 or TTY (855) 642-8573, or in person at one of the 24 local departments of social services |
| What are the specific programs offered by Maryland? | Maryland Children's Health Insurance Program (MCHP), Medicare Savings Program, Medicare Buy-In Program, Long Term Care Medical Assistance (LTC), Maryland Women's Infant and Children (WIC) Program |
| What are the specific groups that Maryland targets to provide resources and support for? | Older Marylanders, families who have lost their job-based health insurance coverage, federal employees and contractors impacted by layoffs, firings, and changes in federal funding |
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What You'll Learn
Medicaid eligibility for low-income families, children, seniors, and people with disabilities
In Maryland, Medicaid is also called Medical Assistance, or MA. It is a health care program for low-income individuals of all ages. The program provides long-term care for the aged, blind, and disabled, called Long-Term Services and Supports (LTSS).
Medicaid Eligibility for Low-Income Families
If your household income is less than 138% of the Federal Poverty Level (FPL), you may qualify for Medicaid. For a family of four, this means earning less than $3,048 per month. These numbers tend to increase slightly each year. If your income is up to 200% of the FPL, your children may qualify for Medicaid. For a family of four, this means earning less than $4,661 per month.
Medicaid Eligibility for Children
The Maryland Children's Health Program (MCHP) provides full health benefits for children up to age 19. If your income is higher than 200% of the FPL, you may still qualify for the MCHP Premium. The MCHP Premium covers children in household incomes up to 300% of the FPL.
Medicaid Eligibility for Seniors
For Maryland residents aged 65 and over, there are several pathways to qualify for long-term care Medicaid. Firstly, if your income is very low, you may qualify for Medicaid. Additionally, the Medically Needy Pathway allows seniors who are over the income limit to become income-eligible by "spending down" their income on medical expenses. This includes spending on medical care, treatment, supplies, Medicare premiums, and prescription drugs.
Medicaid Eligibility for People with Disabilities
If you have a disability, you may qualify for Medicaid if your income and resources are very low. Your income must be below $350 monthly, and you must have less than $2,000 in resources. If your income is higher but you have high medical expenses, you may still qualify.
How to Apply for Medicaid in Maryland
You can apply for Medicaid online at the Maryland Health Connection website or via their mobile app. You can also apply by phone or in person at your local Social Services office or County Health Department. If you are disabled and receiving Medicare, or are 65 or older, you can apply online through myDHR.
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Medicare Savings Program
The Medicare Savings Program is designed to help individuals with their Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) premiums. If you qualify, the program might also pay your Part A and Part B deductibles, coinsurance, and copayments. To qualify for a Medicare Savings Program, you must typically have income and resources below a certain limit, although these limits vary by state and go up each year.
In Maryland, there are several programs designed to provide medical insurance for those who meet certain eligibility requirements. These include the Maryland Children's Health Insurance Program (MCHP), which provides full health benefits for children under the age of 19 and pregnant women of any age who meet the income guidelines. The Long Term Care Medical Assistance (LTC) program is another option for low-income individuals who need help covering the cost of nursing home care. The LTC program considers an applicant's resources in the five years prior to application when determining eligibility.
The Medicare Buy-In Program, also known as the Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB) program, is specifically designed to protect low-income Medicare beneficiaries from the costs of Medicare coverage, including out-of-pocket expenses. The QMB program serves individuals with modest assets (up to $9,090 per individual or $13,630 per couple) and a combined income that does not exceed 100% of the federal poverty level. The SLMB program, on the other hand, pays only the Part B premium for those with incomes between 100% and 120% of poverty and assets up to the same limits as QMB.
Applications for medical assistance programs in Maryland can be filed at your local health department, local department of social services, doctor's office, or hospital social work departments. You can also apply online or by telephone.
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Applying for Medical Assistance programs
Medical assistance in Maryland is provided through a variety of state and federal programs. These include Medicaid, Medicare, the Maryland Health Connection, and state programs designed to help with prescription drugs.
The application process for Medical Assistance programs can be completed in several ways and locations. Firstly, you can apply online at myDHR (https://mydhrbenefits.dhr.state.md.us). Alternatively, you can apply in person at one of the 24 local departments of social services under the Department of Human Services (DHS). Applications can also be filed at your local health department, Dr.'s office, or hospital Social Work Departments.
If you are specifically interested in Medicaid, also known as Medical Assistance (MA), you can apply through the Maryland Health Benefits Exchange Consolidated Service Center. The toll-free number is (855) 642-8572 or TTY (855) 642-8573. You can also apply online at https://www.marylandhealthconnection.gov/.
Long-Term Care Medical Assistance
If you are interested in Long-Term Care Medical Assistance (LTC), which covers the cost of nursing home care for eligible low-income individuals, you can apply online at https://mydhrbenefits.dhr.state.md.us/ or mail your application to your local health department or local department of social services.
Maryland Children's Health Insurance Program
The Maryland Children's Health Insurance Program (MCHP) provides full health benefits for children under the age of 19 and pregnant women of any age who meet the income guidelines. You can apply for MCHP through the Maryland Health Benefits Exchange Consolidated Service Center using the contact information provided above.
Medicare Buy-In Program
The Medicare Buy-In Program, also known as QMB (Qualified Medicare Beneficiary) and SLMB (Specified Low-Income Medicare Beneficiary), is designed to protect low-income Medicare beneficiaries from coverage costs. You can apply for this program through the same channels as Medicaid (Medical Assistance).
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Long-Term Care Medical Assistance
In Maryland, Medicaid is also called Medical Assistance or MA. The program that provides long-term care for the aged, blind, and disabled is called Long-Term Services and Supports (LTSS). The Maryland Department of Health is the administering agency.
Long-term care Medicaid programs have differing financial and medical eligibility requirements. The criteria change annually and vary with marital status, and Maryland offers multiple pathways towards eligibility.
To qualify for Medicaid long-term care benefits in Maryland, you must meet the following criteria:
- You must be a legal resident of Maryland and a U.S. citizen or have proper immigration status.
- You must be aged 65 or older, blind, or disabled. Medical requirements must align with the requested level of care.
- Your monthly income must be below a certain limit, which varies depending on the specific program and your marital status. For example, for Nursing Home Medicaid, all income must go towards care costs, except for a $102 monthly personal needs allowance. For Home and Community-Based Services (HCBS), income cannot exceed $2,901 per month for an individual.
- Your countable assets (like bank accounts and investments) must be under a certain limit, typically $2,500 for individuals and $3,000 for couples. Your primary home and car may be exempt at the time of application but may be subject to claims from the state.
Applications for LTC can be filed online or mailed to your local health department or local department of social services. You can also download the Long-Term Care/Waiver Medical Assistance (LTC) Application form. It is recommended to consult an experienced Medicaid attorney to guide you through the process and ensure you meet all the eligibility requirements.
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Losing job-based health insurance
Firstly, it is important to act fast as, in many cases, the deadline for getting coverage is 60 days after the old coverage ends. You will need to provide proof of your address and your current monthly income, so it is helpful to gather documents such as utility bills and notices about benefits from unemployment insurance.
Maryland Health Connection offers a range of health plans, and nine in ten people who enrolled last year qualified for financial help. You can use their Get an Estimate tool to compare the cost and benefits of their coverage with that of COBRA, for example. Your company may offer you Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage, which allows you to continue your current health coverage (usually up to 18 months) at an increased personal cost, as you will be paying the portion your employer used to pay.
If you qualify, you can enrol in Medicaid at any time. To qualify for Medicaid, a single person's monthly income must be below $1467, and a family of four's monthly income must be below $3013. This includes people with no income. You can apply for Medicaid online at myDHR (https://mydhrbenefits.dhr.state.md.us) or in person at one of the 24 local departments of social services.
Additionally, the Maryland Children's Health Insurance Program (MCHP) provides full health benefits for children under the age of 19 and pregnant women of any age who meet the income guidelines.
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Frequently asked questions
You can apply online at myDHR (https://mydhrbenefits.dhr.state.md.us) or in person at one of the DHS’s 24 local departments of social services. You can also apply by telephone by calling the Maryland Health Benefits Exchange Consolidated Service Center at (855) 642-8572 or TTY (855) 642-8573.
Medicaid is a health insurance program for low-income families, children, seniors, and people with disabilities in Maryland. It is administered by the state and pays medical bills with federal and state funds.
The MCHP provides full health benefits for children under the age of 19 and pregnant women of any age who meet the income guidelines. It covers doctor visits, pregnancy care, prescription drugs, hospital and emergency services, and more, at no cost.
The Medicare Buy-In Program, also known as QMB (Qualified Medicare Beneficiary) and SLMB (Specified Low-Income Medicare Beneficiary), is designed to protect low-income Medicare beneficiaries from the costs of Medicare coverage, including out-of-pocket expenses.
The Maryland Public Servants Resource website provides resources and support for Maryland’s federal employees and contractors impacted by layoffs, firings, and changes to federal funding. It includes information on unemployment insurance, job search and career support, legal resources, and health coverage.
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