Medicaid in Maryland

This article answers frequently asked questions about Medicaid in Maryland.  See below for information on applying.

This article provides general information, not specific legal advice. We make every effort to keep this information current. However, the law sometimes changes. If you have particular legal questions, contact a lawyer. You may be eligible for free legal services through Maryland Legal Aid or a volunteer lawyer program. Know your rights!

Frequently Asked Questions

• I need health care, but I can’t afford it.  Is there a program to help me?
• What is Medicaid?
• Could I be eligible?
• What if my income is higher?
• What about my children?
• I am pregnant.  Could I qualify?
• I aged out of foster care.  Could I qualify?
• I get Temporary Cash Assistance.  Could I qualify?
• I get Supplemental Security Income (SSI).  Could I qualify?
• I have a disability. Could I qualify?
• I am 65 or over. Could I qualify?
• I am in a nursing home.  Could I qualify?
• I receive Medicare.  Could I qualify?
• When can I enroll in Medicaid?
• How do I apply for Medicaid?
• How quickly could I find out if I am eligible?
• If I am found eligible for Medicaid when does my coverage begin?
• What if I am denied Medicaid?
• How do I get help?

I need health care, but I can’t afford it.  Is there a program to help me?

If you are eligible, you could get free or low-cost health care through Medicaid, also called Medical Assistance. 

What is Medicaid?

Medicaid is a public health insurance program that provides free or low-cost health insurance for eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.

Could I be eligible?

Being eligible for Medicaid depends on your income level, age, family size, and if you are pregnant or a person with a disability. To be eligible for Medicaid in Maryland, you must: 

• be a Maryland resident,
• be a U.S. Citizen or a qualified non-citizen, and
  • A qualified noncitizen is a person who is lawfully present in the U.S. For additional information see Immigration Status Requirements and exceptions.
• meet income limit for your coverage group

For certain Medicaid programs you must also meet technical, financial and medical eligibility requirements. For example, if you apply based on being age 65+, blind or disabled or need long term care, you will need to meet income and asset limits.

Income and asset limits are updated each year. For additional information see Income and Asset Limits by Coverage Group and Program.

NOTE: You may still be eligible if your income is higher than the limit listed. There are some exceptions to countable income when figuring out if you are eligible.  

For additional information, see Am I Eligible for Medicaid.

What if my income is higher?

If your income is higher than the Medicaid eligibility limit, you may qualify for financial help to buy a private health plan through Maryland Health Connection.  You may also fall into a special category and still qualify for Medicaid.  The only way to know for sure if you are eligible is to apply. For information on applying for Medicare see How to Apply. 

What about my children?

Your children could qualify for Medicaid depending on your household income compared to the Federal Poverty Level. If you make less than $8,855 per month (for a family of 4), you may qualify. See Maryland Children's Health Program (MCHP) - Am I eligible for the MCHP Program?

If your income is higher, your children might qualify for Medicaid even if you do not. The Maryland Children’s Health Program (MCHP) provides free coverage to eligible uninsured children whose family earns too much money to get Medicaid, but not enough to afford private health insurance. The MCHP would help to cover your children’s doctor visits, immunizations, prescriptions, and other medical services. If qualified, you would pay a monthly premium per month, the exact amount depending on household income and family size.  

See Code of Md. Regulations, 10.09.43.03.

I am pregnant.  Could I qualify?

Yes, if you are pregnant, you could qualify for Medicaid.  If you make less than $7,260 per month you may qualify (family of 4). See Am I Eligible for Medicaid. 

I aged out of foster care.  Could I qualify?

Young adults up to age 26 who aged out of foster care in Maryland qualify for Medicaid, no matter what their income is.

I get Temporary Cash Assistance.  Could I qualify?

If you get Temporary Cash Assistance (TCA), you can qualify for Medicaid.  Even if you lose your Temporary Cash Assistance – you may qualify for an extension of Medicaid benefits for 6 to 12 months.  You must be screened to see if you qualify for Medicaid for another reason. 

I get Supplemental Security Income (SSI).  Could I qualify?

If you get Supplemental Security Income (SSI), then you are automatically eligible for Medicaid.

I have a disability. Could I qualify?

If you have a disability or are blind, you could qualify for Medicaid if your income and resources are very low.  Your income must be below $350 monthly, and you must have less than $2,500 in resources.  If your income is higher, but you have high medical expenses, you could still qualify.

See the related article: Medical Assistance (Medicaid) - Aged, Blind and Disabled (MA-ABD)

I am 65 or over. Could I qualify?

If you are 65 or over, you could qualify for Medicaid if your income and resources are very low.  Your income must be below $350 monthly, and you must have less than $2,500 in resources.  If your income is higher, but you have high medical expenses, you could still qualify.

I am in a nursing home.  Could I qualify?

Medicaid can pay for someone in a nursing home.  Medicaid has different rules for nursing home residents.  Call 1-800-332-6347, apply for benefits online (formerly SAIL), or by going to your local Department of Human Services (DHS). 

I receive Medicare.  Could I qualify?

If you have Medicare, you could qualify for Medicaid if your income is low enough.  There are also Medicaid programs to help you pay your health care costs.  They can pay for your Medicare premiums and co-pays, if you have low income and assets.   

• Qualified Medicare Beneficiary (QMB) pays for your premiums and co-pays depending on your household income compared to the Federal Poverty Level.  If your income is $1,350 monthly income and $9,950 of resources for a single person, you may qualify. See Medicare Savings Programs. 
• Specified Low Income Medicare Beneficiary (SLMB), pays for your premiums and co-pays depending on your household income compared to the Federal Poverty Level.  If your income is $1,616 monthly income and $9,950 of resources for a single person, you may qualify See Medicare Savings Programs.

When can I enroll in Medicaid?

The Medicaid enrollment period is year-round.

How do I apply for Medicaid?

There are many ways to apply. 

• Apply online at the Maryland Health Connection website or via their mobile app.
• Apply by phone at 1-855-642-8572. 
• Apply in person at your local Department of Human Services Office or County Health Department.

If you are disabled and currently receiving Medicare, or are age 65 or older:

• Apply online through myDHR.
• Apply in person at your local Department of Human Services Office or County Health Department.

Get in-person help to apply.  A Connector organization can help you.  You can use this map to find your Connector organization. 

How quickly could I find out if I am eligible?

You may be able to find out immediately if you are eligible based on your income.  Otherwise, you should find out within 30-60 days. 

If I am found eligible for Medicaid when does my coverage begin?

Your coverage begins on the first day of the month you applied.  You also may be able to get help with medical bills that you incurred up to 3 months before you applied.  Applicants who need retroactive coverage and did not select this option during online enrollment should contact their local Health Department or Department of Human Services. 

What if I am denied Medicaid?

If you are denied Medicaid, you have a right to an appeal.  If you are cut off from Medicaid, and you want to keep getting benefits while you wait for an appeal hearing, you must ask for the appeal within 10 days. In general, you have 90 days to file an appeal. See File an Appeal. 

How do I get help?

You may be able to get legal help for your hearing or to solve Medicaid problems.  For help with Medicaid, contact the Your local Legal Aid office.