Medical Assistance

In Maryland, once an individual is determined eligible for SSI, they are automatically entitled to receive Medical Assistance (also called Medicaid) health insurance, (MA). However, receiving MA does not automatically entitle you to SSI. MA provides a comprehensive health care plan. Medically needy families or children who meet the income and asset eligibility requirements can apply for Medicaid. Read more information on Medicaid services, or call 1-800-492-5231 or 410-767-5800.

Medical Assistance for Families will provide comprehensive health care to many parents and other family members caring for children who are up to age 20. Eligibility depends on family size and income. There is no limit on assets. Read the application information or call 1-800-456-8900.

Effective January 1, 2017, the Department of Health and Mental Hygiene will cover medically necessary Applied Behavior Analysis (ABA) therapy services for Maryland Medical Assistance enrolled members under the age of 21. Frequently Asked Questions about ABA from the Maryland Department of Health and Mental Hygiene.

Maryland Children’s Health Program (MCHP)
Children who are age 18 or younger and not receiving SSI (as well as pregnant women of any age) may qualify for MA through the Maryland Children’s Health Program (MCHP). Eligibility depends on family size and income. Starting October 1, 2013, you can apply for MCHP through Maryland Health Connection. You can also call 1-855-MHC-8572 (1-855-642-8572) to apply over the phone.

Children’s Medical Services Program (CMS)
Children’s Medical Services, also called CMS, is a program of the Maryland Department of Health and Mental Hygiene. CMS can help low-income, uninsured or underinsured Marylanders ages 0-21 years get specialty care for a chronic illness or disability by paying for needed services.

Early, Periodic, Screening, Diagnosis and Treatment (EPSDT)
The Early Periodic Screening, Diagnosis, and Treatment (EPSDT) is the child health component of Medicaid.

Find a Medicaid Provider:

HealthChoice
The HealthChoice Program provides health care to most Medicaid recipients. Eligible Medicaid recipients enroll in a Managed Care Organization (MCO) of their choice and select a Primary Care Provider (PCP) to oversee their medical care. The MCO enrollee selects a PCP who is part of their selected MCO’s provider panel either at the time of enrollment with the enrollment broker or once enrolled in their MCO.

Medical Home Initiatives for Children with Special Health Care Needs
Medical home is a philosophy in which a care team is developed to help the family access, coordinate and understand specialty care, educational services, out-of-home care, family support and other public and private community services that are important for the overall health of the child and family. This is done primarily with the primary care physician’s office.

Medicare
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

What is the difference between Medicare and Medicaid?
Medicare is an insurance program. Medical bills are paid from trust funds which those covered have paid into. It serves people over 65 primarily, whatever their income; and serves younger disabled people and dialysis patients. Medicaid is an assistance program. Medical bills are paid from federal, state and local tax funds. It serves low-income people of every age.