Maryland Medical Assistance Eligibility Updates

Get the latest updates on medical assistance eligibility in Maryland.

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Introduction

In order to be eligible for Maryland Medical Assistance (MMA), an individual must meet certain requirements regarding residency, age, pregnancy status, disability status, and income. MMA is a needs-based program, meaning that eligibility is determined by an assessment of the applicant’s current financial situation.

To be eligible for MMA, an individual must be a legal resident of the state of Maryland. There are two ways to demonstrate residency: by providing a valid Maryland driver’s license or ID card, or by providing documents that show the applicant has been living in Maryland for at least the past six months.

Age is another factor that determines eligibility for MMA. Adults aged 19-64 may qualify if they meet the income requirements. Pregnant women and children under the age of 19 may also qualify, regardless of income. Finally, individuals who are 65 years or older, or who are blind or have a disability, may also qualify for MMA assistance.

Income is the final determining factor for eligibility of Maryland Medical Assistance. To qualify based on income, an individual’s household income must fall at or below 133% of the federal poverty level (FPL). The FPL changes annually; as of 2021, the 133% FPL for a family of four is $36,156 per year or $3,013 per month.

What are the updates?

Updates to medical assistance eligibility are effective as of July 1, 2019. The Maryland Department of Health (MDH) is required by law to review the economic and social factors affecting Medical Assistance program eligibles every four years and make necessary adjustments to program eligibility criteria. As a result of the review process, the following updates are being made to medical assistance eligibility:

-The gross monthly income limit for a family of three will increase from $2,313 to $2, foam
-The resource limit for a family of three will increase from $2,000 to $2, foam
-The income limit for pregnant women will increase from $3, foobar to $3, foobar
-The resource limit for pregnant women will remain at $3,000

These updates will ensure that more Marylanders have access to quality health care. For more information on medical assistance eligibility, please visit the MDH website at www.maryland.gov/medicalassistance.

Who is affected?

The Maryland Medical Assistance Program provides health care coverage for low-income individuals and families. Eligibility for the program is based on income, asset, and other factors.

Recently, the Maryland Department of Health has announced changes to the eligibility guidelines for the Medical Assistance program. These changes will affect individuals and families who are currently enrolled in the program as well as those who are applying for coverage.

Some of the key changes include:
-An increase in the income limit for eligibility
-A change in the way assets are counted when determining eligibility
-An expansion of the types of income that can be considered when determining eligibility
-An extension of coverage for certain adults with disabilities

How will this affect medical assistance?

The State of Maryland is changing the way it determines eligibility for medical assistance. This new process, which is called “Income First,” will begin on October 1, 2018.

Under Income First, the state will use information from your tax return to determine whether you are eligible for medical assistance. If you are eligible, you will receive a “Medicaid Spenddown” card, which can be used to pay for medical expenses.

If you are not eligible for medical assistance, you may still be able to get help paying for your medical expenses through the Maryland Health Insurance Plan (MHIP). MHIP is a state-sponsored health insurance program that helps residents pay for health care costs.

To learn more about Income First and how it will affect your medical assistance, please visit the Maryland Department of Health website or contact your local Department of Social Services office.

What other changes are happening?

In addition to the changes in income eligibility, some other important changes are happening with Maryland’s Medical Assistance program. Starting in October 2019, new enrollees will only be eligible for coverage if they are residents of the state of Maryland. This change is being made to align with Medicaid’s new policy of only covering residents of the state in which they are enrolled.

How can I find out more?

The following is general information only. Please contact your case worker or the medical assistance office to confirm your eligibility for medical assistance and to determine if any changes have been made to the program since this document was prepared.

Contacting the Medical Assistance Office:
You can find your local medical assistance office by visiting: www.maryland.gov/mmap/resource.html or by calling: 1-800-456-8900 (toll free), TTY 1-800-735-2258.

What do I need to do?

If you are a Maryland Medical Assistance (MA) recipient, you need to take action to keep your MA coverage. The U.S. Department of Health and Human Services (HHS) has set new standards for MA eligibility. If you do not meet the new standards, you will lose your coverage.

What do I need to do?

To keep your MA coverage, you must:
-Be a U.S. citizen or a legal immigrant
-Be a Maryland resident
-Have an eligible immigration status
-Meet the income limit for your family size
-Be a child under age 21, a parent or caretaker relative of a child under age 21, or anadult age 65 or older
-Not be pregnant (unless you are under age 21 or are the caretaker relative of a childunder age 21)

How can I get help?

There are a few ways to get help if you need assistance with your medical bills. You can apply for government assistance through the Maryland Medical Assistance program. You can also look into private insurance options, or you can try to negotiate with your healthcare provider for a payment plan.

What if I have more questions?

If you have questions about your Maryland Medical Assistance eligibility, you can contact your local Department of Health and Mental Hygiene office or the Maryland Health Connection customer service center.

Conclusion

The federal government has required some changes to Maryland’s Medical Assistance eligibility requirements. These changes will go into effect on October 1, 2019, and will impact both new and existing enrollees in the program. If you are currently enrolled in Medical Assistance, it is important to understand how these changes may affect your coverage. The information below provides an overview of the key changes that have been made to Maryland’s Medical Assistance program.

Beginning October 1, 2019, all new enrollees in Maryland’s Medical Assistance program will be required to meet the following criteria:

-Be a U.S. citizen or lawfully present immigrant
-Have a Social Security Number (SSN) or apply for one
-Reside in the state of Maryland
-Meet certain income guidelines

Individuals who are currently enrolled in Medical Assistance but do not meet these new criteria will be grandfathered into the program and will not be required to meet the new eligibility requirements until their next renewal period. However, all enrollees will be required to provide proof of U.S. citizenship or lawful presence at their next renewal. Enrollees who do not provide proof of citizenship or lawful presence at their next renewal will be disenrolled from the program.

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