How Maryland Medicaid Works
Medicaid is available to individuals and families with limited income and resources, including pregnant women and some immigrants.
Children up to age 19 may qualify for Medicaid coverage through the Maryland Children's Health Program (MCHP), even if their parents don't qualify.
Unlike most health plans, enrollment is available year-round.
If you need help applying for Medicaid or finding the right plan, dial 211 or connect with a Medicaid navigator program.
Who Qualifies for Medicaid?
Medicaid is typically available to those who financially qualify and are:
- An adult 20-64 years old
- A child 0-19 years old
- Pregnant individual
- Parent or primary caretaker
- Former foster care youth
If you receive other types of public assistance, you may automatically be offered Medicaid.
Medicaid costs are income-based and depend on family size. To get an idea of whether you qualify, recent guidelines indicate that coverage is available for a family of four with children at incomes up to $8,855 per month. However, eligibility changes. View the latest guidelines.
Pregnant Women
While pregnant, you may be eligible for Medicaid. You can apply at any time during the pregnancy. Coverage also extends past birth for 12 months, so you have time to access postpartum and other health services.
There are income limits.
Are Immigrants Eligible for Medicaid?
Depending on your immigration status, you may be able to apply for Medicaid. You typically qualify if you've lawfully been in the U.S. for 5 years.
However, children under 21 are not subject to the 5-year rule. Also, pregnant women (regardless of immigration status) are eligible for Medicaid.
You don't need a Social Security Number (SSN) or Taxpayer Identification Number to apply. If you request financial help and file taxes, you will be asked for your SSN.
Federal rules are changing, including the qualifications for financial help with a private plan. You can still apply, but costs may go up.
Read the Maryland Health Connection Frequently Asked Questions (FAQs) about immigration status.
Medicaid for Children
Children may qualify for additional Medicaid health benefits under the Maryland Children's Health Program (MCHP). It's the state's Medicaid program for children up to age 19. Costs may vary, depending on income and family size.
Maryland Children's Health Program
Like Medicaid, care is provided by a Managed Care Organization (MCO).
The MCO provides the following benefits for children:
- 歯の手入れ
- Doctor visits, including sick and well-visits
- 入院
- 実験室での作業とテスト
- メンタルヘルスサポート
- 物質使用処理
- 予防接種とインフルエンザの予防接種
- 処方薬
- 診療所までの送迎
- ヴィジョン
How Medicaid Works
Most people on Medicaid receive care through a Managed Care Organization (MCO).
If you're not enrolled in an MCO, your doctor must submit their fee to Medicaid for payment. These are fee-for-service plans.
What's a Managed Care Organization (MCO)?
MCOs are private insurance companies chosen to provide and manage Medicaid benefits.
The MCO covers your health care.
What's Covered?
Most health care services are covered by Medicaid.
The MCO covers basic health services:
- 定期健診や専門医を含む医師の診察
- 妊娠中のケア
- 家族計画と避妊
- 処方薬
- 病院と救急サービス
- 主要な メンタルヘルスサービス あなたの医者を通して
- Xrays and lab work
- Home health services
You'll also get coverage for dental care under Maryland's Healthy Smiles Program.
Finding an MCO
You have options for an MCO. Check which providers serve your area and whether your doctors and pharmacy are part of the MCO.
You can also view the additional services that each provides.
View a list of Managed Care Organizations to find the one for your situation.
How do I get help with enrollment?
If you have questions, free help is available in counties throughout Maryland. Navigators can answer questions in-person and help you find the most savings, and help with enrollment.
The navigator programs are offered through third parties. Find the one nearest you.
Far Western Counties
Where: Garrett, Allegany, Washington
Who: Western Maryland Health Insurance Connector (AHEC West)
Phone: 888-202-0212
Mid Western and Central Counties
Where: Frederick, Carroll, Howard, Baltimore, Baltimore City, Anne Arundel
Who: Health Care Access Maryland (HCAM)
Phone: 855-288-3667 and choose the navigator option.
Capital North
Where: Montgomery
Who: Montgomery County Health Connection
Phone: 240-777-1815
Capital South
Where: Prince George's County
Who: Prince George's Health Connect (PGC Health Connect)
Phone: 301-927-4500
Eastern Shore & Southern
Where: Harford, Cecil, Kent, Queen Anne's, Talbot, Caroline, Dorchester, Wicomico, Somerset, Worcester, Calvert, Charles, St. Mary's
Who: Seedco
Phone: 855-445-5540
Local health departments and departments of social services can also help. You can also call Maryland Health Connection at 1-855-642-8572 or attend a local event.
How Do I Enroll?
Medicaid enrollment is through Maryland Health Connection.
What is Maryland Health Connection?
It's a one-stop enrollment resource for Medicaid and private insurance. You can get an estimate of coverage costs before creating an account and applying for a plan.
登録はいつですか？
Enrollment is open year-round for MCHP and Medicaid, through Maryland Health Connection.
If you become pregnant, you can also enroll in a health plan or change it within 90 days of learning you're pregnant.
個人は、1 年に 1 回保険を更新する必要があります。更新時期になりましたらご連絡いたします。
What is the application process?
There are 3 ways to apply for Maryland Medicaid, and the Maryland Children's Health Program (MHCP):
After applying for help, you may need to verify your information, such as your income, citizenship, Social Security number, or other coverage.
You may also need to print, sign, and upload an affidavit to prove your information. 書類の種類について詳しく見る メディケイドの資格を得るために必要な情報と宣誓供述書を確認するために使用できます。
During the application, you'll also choose a Managed Care Organization (MCO).
Find a Doctor Who Takes Medicaid
Once you have Medicaid, you can use the Maryland Department of Health's Provider Finder tool to find a doctor or facility that accepts Medicaid.
関連する健康情報
メリーランド州の健康保険のオプション
Are you uninsured? There are a number of circumstances that may qualify you for free health insurance or a low-cost plan. Learn about Medicaid, private…
無料または低コストのヘルスケアを探す
無料または低料金の診療所やその他の医療リソースをお探しですか？ 健康サービスには、予防検診、臨床検査、産科ケアなどが含まれます。
医療費や医療費のサポートを受ける
医療費の支払いが滞っていませんか？あなただけではありません。メリーランド州や全国規模の団体が、医療費の一部を補助してくれるかもしれません…
処方箋
処方箋の調剤に助けが必要な場合は、州や製薬会社の患者支援プログラム、地元の非営利団体などが薬の費用を下げるお手伝いをします。…
メディケア給付
デフォルトのページ見出し メディケアは、65 歳以上の人、特定の障害を持つ 65 歳以下の人などに支援を提供する政府の健康保険プログラムです。
Find Dental Clinics in Maryland
歯科治療が必要ですか？保険に加入していないのに歯科治療が必要な場合は、無料または低料金の歯科医院を利用するのも一つの選択肢かもしれません。クーポン…
211 にダイヤルしてください
思いやりと慈悲深い担当者に24時間365日相談できます。また、関連リソースへの紹介も行っています。
支援プログラムを検討する
特典プログラムとサポートへの接続方法について学習します。
ユーティリティ
電気、ガス、水道料金補助プログラム。
税金
Free tax preparation help, software, tax credits
支援プログラムを検討する
特典プログラムとサポートへの接続方法について学習します。
ユーティリティ
電気、ガス、水道料金補助プログラム
税金
Free tax preparation help, software, tax credits
