Medicaid Eligibility in Maryland

Calendar Icon Updated February 11, 2019
Medicaid

Medicaid is a nationwide program that  provides free and/or affordable health care coverage for millions of  citizens including children, expectant mothers, seniors, individuals  with disabilities, and low-income families. Benefits include primary  care, prescription, dental, eye care, hospitalizations, specialized  care, and mental health services.

Maryland’s Medicaid program is managed by the Department of Health.  If you or your family members reside in the state of Maryland and wish  to apply for affordable healthcare, you can apply with the local  Department of Health.

Maryland’s Requirements for Medicaid Qualification

There are several groups of individuals that may be eligible to  receive Medicaid in the state of Maryland. As a direct result of the  health care reform in 2014, benefits have been extended to most adults  under the age of 65 who have a combined household income at or below  138% of the Federal Poverty Level.

To qualify for Medicaid in Maryland you must:

  • Be a resident of Maryland
  • Be a US citizen or meet immigration status requirements
  • Meet income limits
  • Meet asset requirements (for those applying for long-term care)
  • Meet medical requirements (for those applying for long-term care and other special programs)

How to Apply for Medicaid in in Maryland

Maryland Medicaid offers several programs you can apply for depending  on your medical needs and eligibility. You can apply at any time as  there is no open enrollment period. Those who receive Supplemental  Security Income automatically qualify for Medicaid and do not need to  apply. There are a few methods to apply.

Adults, Children, Former Foster Care Youth, Parents or Caretaker Relatives, and Pregnant Woman can apply by:

  • Visiting www.marylandhealthconnection.gov and applying online
  • Visiting your local health department or department of social services
  • Downloading a mobile app and applying by phone
  • Call 1-855-642-8572 (TTY:1-855-642-8573)

Applicants age 65 or older, disabled, or in need of long-term care, can apply by: 

What Does Medicaid Cover in Maryland?

Medicare in Maryland covers several medical services including:

  • Ambulance travel and emergency services
  • Clinic services
  • Dental services
  • Diabetes care
  • Screening, diagnosis, and treatment services
  • Eyewear
  • Family planning
  • Hearing aids
  • Home health services
  • Hospice
  • Inpatient and outpatient hospital care
  • Labs and x-rays
  • Medical equipment and supplies
  • Mental health care
  • Personal care services
  • Pharmacy services
  • Physical therapy
  • Physician services
  • Footcare
  • Vision
  • Substance abuse treatment

Your chosen Managed Care Organization will cover the cost of visits  to the doctor, prenatal care, prescription drugs, hospital and emergency  services, and primary mental health services.

Maryland’s Children’s Health Program covers doctor’s visits,  hospitalizations, lab work, tests, immunizations, prescriptions, dental  care, and vision.

Income Requirements for Maryland Medicaid

One of the biggest requirements for Maryland Medicaid is income  limits. You will be asked to provide information based on your household  size and total monthly income. You will need to include the income of  all working members of your household applying for coverage. For  instance:

  • An adult applying for insurance with a household size of 3 is eligible for coverage if they make $28,180 or less per year.
  • A single expectant mother is eligible for coverage provided she makes $42,874 a year or less.
  • A child applicant in a household size of 2 is eligible for  insurance if the combined household income does not exceed $34,266.

You can learn more specific income limit information by clicking here.

How Much Does Medicaid Cost in Maryland?

The cost of your Medicaid in Maryland will depend upon your income  and how much of the service the state of Maryland and your Managed Care  Organization cover. Though most low-income families, children, and  expectant women don’t pay any out-of-pocket costs, the state reserves  the right to ask for cost sharing for coinsurance, copayments,  deductibles, and additional medical services.

As of 2013, the maximum allowable amount the state of Maryland can ask for out of pocket costs is $4 copay for  non-institutional care, $8 for non-emergency hospital care, $4 for  preferred prescription drugs, and $8 for non-preferred prescription  drugs.

Prescription Drugs with Medicaid in Maryland?

Prescription costs are covered either by Medicaid or your MCO. If  you’re looking to see if a specific medication is covered, you can click  here for a list of preferred medications.

Which Medicaid plan is best in Maryland?

Maryland Medicaid offers several Managed Care Organizations (MCO) for you to choose from including:

  • Aetna Better Health
  • Amerigroup Community Care
  • Jai Medical Systems
  • Kaiser Permanente
  • Maryland Physician Care
  • MedStar Family Choice
  • Priority Partners
  • University of Maryland Health Partners
  • United Healthcare

You’ll want to review each MCO carefully to see who provides the most coverages for services you and your family need.

For more information on Maryland Medicaid and how you and/or a family member can apply, please visit the Maryland Department of Health.

Eligibility Team

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