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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.

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Who Qualifies for Medicaid?

Medicaid is typically available to those who qualify financially, although H.R. 1 may change eligibility.

For Maryland Medicaid, you must:

  • Be a Maryland resident
  • Be a U.S. citizen or a qualified non-citizen (see below)
  • Meet income requirements

There are also financial, medical, and technical eligibility requirements for certain ages or individuals with a disability.

Which noncitizens may qualify for Medicaid?

Some noncitizens may continue to qualify for Medicaid, including:

  • Lawful Permanent Residents (green card holders) who meet or are exempt from the five-year waiting period
  • Cuban and Haitian entrants
  • Compact of Free Association (COFA) migrants from the Marshall Islands, Micronesia, and Palau
  • Pregnant people and children who qualify

Pregnant Marylanders may still qualify for coverage through Maryland’s Healthy Babies program, regardless of immigration status.

Maryland Health Connection offers a Medicaid check-in to verify eligibility.

Noncitizens who may no longer qualify

Individuals who may no longer be eligible, starting in October 2026, include:

  • refugees
  • asylees
  • noncitizens granted parole for at least one year
  • certain noncitizen victims of abuse or trafficking

New work requirements

In addition to new eligibility requirements, new work requirements will also take effect in January 2027.

Starting in January 2027, some Maryland Medicaid members ages 19 to 64 must complete at least 80 hours of approved activities each month to qualify for or keep Medicaid coverage.

Activities may include:

  • working at a job or earning at least $580 a month
  • volunteering
  • participating in an approved job training program
  • attending school, college, technical school, or GED classes

New applicants subject to the requirement must meet it before applying. Existing members affected must also meet the requirement to maintain coverage.

Some people will be exempt, including:

  • children and older adults
  • pregnant people
  • people with disabilities
  • caregivers of young children
  • people managing serious health conditions
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Medicaid Renewals

Most Medicaid members currently renew coverage once a year. Some adults affected by the new federal requirements will need to renew every six months. Maryland Medicaid will let you know if this change applies to you and when you need to renew.

If you are affected by these changes, read our guide to H.R. 1 to learn about other health care options.

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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

Care is provided by a Managed Care Organization (MCO).

The MCO provides the following benefits for children:

  • Dental care
  • Doctor visits, including sick and well visits
  • Hospitalizations
  • Lab work and tests
  • Mental health support
  • Substance use treatment
  • Immunizations and flu shots
  • Prescription medicine
  • Transportation to medical appointments
  • Vision

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.

When Is Enrollment?

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.

Individuals need to renew their coverage at least once a year. You will be notified when it’s time for your renewal.

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What is the application process?

There are 3 ways to apply for Maryland Medicaid, and the Maryland Children's Health Program (MCHP):

  • Call 1-855-642-8572
  • Apply online.
  • Download the agency’s mobile app (Enroll MHC) on Apple or Android.

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. Learn more about the types of documents you can use to verify your information and the affidavits you may need to qualify for Medicaid.

During the application, you'll also choose a Managed Care Organization (MCO).

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.

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Find Resources Now

Find community resources for food, health care, housing and more in our database. Search by ZIP code.

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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:

  • Doctor visits, including regular checkups and specialists
  • Pregnancy care
  • Family planning and birth control
  • Prescription drugs
  • Hospital and emergency services
  • Primary mental health services through your doctor
  • 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.

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.

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