Medical Assistance (also called Medicaid) is a program that pays the medical bills of people who have low income and cannot afford medical care. Medicaid enrolls most participants in the state's Managed Care Organization, HealthChoice, and pays for hospital, doctors, prescriptions, etc., according to terms of the managed care plan.
Disabled or Blind or 65 or older
To qualify for benefits you must meet all of the following:
- You have a significant physical or mental medical impairment.
- Your condition has lasted (or will last) for at least twelve months or it is expected to result in death.
- You are unable to perform "substantial gainful activity"- that is a job of any type. Sometimes volunteer work will count if the work is "substantial."
Income is below "medically needy income level" for household size, or "incurred" medical expenses equal the "spend down" amount by which income exceeds the income limit.
Medically Needy Monthly Income Level - Eligibility limit by household size
Persons dependent Amount
The medically needy resource standards of the Medical Assistance - Aged, Blind and Disabled (MA-ABD) program have been effective since July 1, 1989. Revisions to existing standards can be found in the Code of Maryland Regulations (COMAR) 10.09.24.07
After excluded assets (such as the home), asset limit by household size:
each additional person Add $100
Regulations (COMAR) 10.09.24.08
Department of Social Services. Find your local DSS Office
- You can appeal any denial, termination, or reduction of benefits
- Appeals must be filed in writing at the DSS office. It is best to file it in person and to get a receipt showing that you filed the appeal.
- Appeals must be filed within 90 days of the action, or you cannot appeal.
- If you file within 10 days of notice that benefits are being terminated or reduced, they will continue until the decision. If you do not appeal within 10 days, the termination or reduction will happen.
Appeal rights and hearings in the Medical Assistance Program are controlled by the regulation at COMAR 10.01.04..
Source of Funds:
State and federal
Sources of Law:
State Regulations: In the Medical Assistance Program, the Maryland Regulations are by far the most important source of law. The federal regulations, the state statute, and the federal statute are rarely 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.