MCHP Premium

Must also be a resident of Maryland, and a United States citizen or an alien within certain categories.  See COMAR 10.09.11.06 to determine if you are an eligible US Citizen.

• Children under age 19, who are not eligible for medicaid, and whose countable Income is under 200% of the federal poverty level.
• Pregnant women whose countable income is at or below %250 of the federal poverty level.

MCHP Premium

• Countable income between 200-300% of the federal poverty level.  You pay a small premium for the health insurance.

The "countable income" is the gross income minus certain "disregards."

For a pregnant or postpartum woman, the gross income is all income of the woman and of her spouse and children under 21 who live with her.

For a child, the gross income is all income of the parents and of siblings if the parents choose to include them. 

An alien who is not eligible because of immigration status can receive services that are necessary for the treatment of an emergency medical condition, including labor and delivery.

State Regulations: In the medical Assistance Program, the Maryland regulations are by far the most important source of law.  Rarely are the federal regulations, the state statute, and the federal statute useful in understanding the governing law.

• Eligibility: COMAR 10.09.24.00 to 10.09.24.9999 - Covering financial and non-financial eligibility conditions. (Scroll down to 10.09.24 Medical Assistance Eligibility)

• Coverage: The kinds of medical conditions and medical treatments that are covered by Medical Assistance is very long and very detailed.  Generally, the regulations about what is and what is not covered are in COMAR 10.09.01.00 to 10.09.74.9999

• Appeals: COMAR 10.01.04.00 to 10.01.04.9999.  (Scroll down to "10.01.04 Fair Hearing Appeals Under the Maryland State Medical Assistance Program" and click it to open the list of regulations.

Federal Regulations: Generally - 42 CFR Chapter IV The specific part of the federal regulations that are most likely to be of some value to Medical Assistance applicants or recipients are listed below.

• Eligibility - 42 CFR §§435.2 to 435.1102

• Covered services - 42 CFR §§440.1 to 440.270

Federal Law: 42 U.S.C., Chapter 7, Subtitle XXI

State Law: Md. Ann Code Health General §15-101 to §15-135 

State Policy Materials

MCHP Annual and Monthly Income Limits based on the Federal Poverty Guideline Income Percentages (2008 Figures Below):

MCHP Premium Annual and Monthly Income Limits based on the Federal Poverty Guideline Income Percentages (2008 figures below):

MCHP Premium Participants must pay a family contribution as a requirement of enrollment:

• If income is between 200%-250% of the Federal Poverty Guidelines the contribution is 2% of the income of a family size of 2 at the rate of 200% of the Federal Poverty Guidelines.

• If income is between 250%-300% of the Federal Poverty Guidelines the contribution is 2% of the income of a family size of 2 at  the rate of 250% of the Federal Poverty Guidelines.

Consideration of Family Income: Income Disregards (applies the same to both MCHP and MCHP Premium participants)

Same for both MCHP and Premium

1. Earned Income Disregard. The following disregards are deducted from countable gross family income:

   1. $90 monthly for each employed family member whether working full-time or part-time; and

   2. The documented amount of child care expenses paid to an individual who is not a legally responsible relative, not to exceed:

      1. $175 monthly per child ($200 monthly per child for children less than 2 years old) if the parent or parents are employed at least 100 hours per month, or

      2. $100 monthly per child if the parent or parents are employed less than 100 hours per month.

2. Disregard of Child Support Received by a Family Member.

   1. The first $50 of monthly child support payments received or expected to be received by a member or members of a family is deducted from the support payments received by that family.

   2. The $50 maximum disregard is applied to the total amount of child support received by a family irrespective of the number of family members receiving support payments.

3. Disregard of Child Support and Alimony Paid by a Family Member. The actual amount of child support and alimony paid by a family member to dependents not living with the applicant is deducted from the countable net family income.

Last review 10/21/08 (PLL/M.A.J.)

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