- Introduction to the Maryland Medical Assistance Manual
- Eligibility requirements for medical assistance
- How to apply for medical assistance
- What medical assistance covers
- How to use medical assistance
- What to do if you have a problem with medical assistance
- How to appeal a decision about medical assistance
- Glossary of terms used in the Maryland Medical Assistance Manual
- Contact information for medical assistance
- Other resources for information about medical assistance
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Introduction to the Maryland Medical Assistance Manual
The Maryland Medical assistance Manual (the “Manual”) provides policies and procedures for staff of the Division of health care Finance and Policy (DHCFP) and contracted managed care organizations (MCOs), as well as other entities that participate in the Maryland Medical Assistance Program.
The Manual reflects the interpretations of the statutes, regulations and other guidance governing the Maryland Medical Assistance Program by DHCFP. In the event that there is a conflict between this Manual and federal or state statutes, regulations or other guidance, the applicable federal or state statutes, regulations or other guidance shall govern.
It is important to note that MCO policies and procedures may differ from those described in this Manual. MCOs must follow all rules and regulations applicable to them, as well as any additional requirements imposed by their contracts with DHCFP. Please contact your MCO if you have questions about its policies or procedures.
Eligibility requirements for medical assistance
In order to be eligible for medical assistance, an individual must meet certain criteria set forth by the state of Maryland. These criteria include residency requirements, income and asset limits, and citizenship or immigration status. Individuals who meet these criteria may then apply for medical assistance through the state’s online application portal.
How to apply for medical assistance
The Maryland Medical Assistance Manual is a resource that provides information on how to apply for medical assistance. In order to be eligible for medical assistance, you must meet certain income and resource requirements. You may also be required to provide proof of U.S. citizenship or lawful presence in the United States
If you are found to be eligible for medical assistance, you will be enrolled in a managed care organization (MCO). You will be required to select an MCO from a list of approved MCOs. Once you have selected an MCO, you will be required to receive all of your health care services through that MCO.
If you have any questions about the Maryland Medical Assistance program, or if you need help applying for medical assistance, please contact your local Department of Social Services office.
What medical assistance covers
Medical assistance (MA) provides health care coverage for low-income adults, children, pregnant women, people with disabilities, and the elderly. MA covers a wide range of services, including doctor visits, hospital stays, prescription drugs, mental health services, and more.
How to use medical assistance
The Maryland Medical Assistance Manual is a reference guide for individuals and providers who participate in the Maryland Medical Assistance (Medicaid) Program.
The manual provides information on program eligibility, covered services, provider enrollment and billing procedures, and other topics.
It also includes helpful contact information for the various Medicaid offices around the state.
What to do if you have a problem with medical assistance
If you have a problem with medical assistance, you should first contact your local department of social services. If you are still not satisfied, you can contact the Maryland Department of Health and Mental Hygiene, Office of Health Care Quality at 1-800-633-8100.
How to appeal a decision about medical assistance
The Maryland Medical Assistance Manual is a document that provides policy and procedural guidance to staff who administer the state’s medical assistance program. The manual is updated periodically as program rules and regulations change.
If you disagree with a decision made about your medical assistance, you have the right to file an appeal. An appeal is a request for a review of the decision. You may file an appeal if you think:
-The decision was made in error
-You were denied medical assistance that you are entitled to receive
-You were told you must pay back medical assistance that you received
-The amount of medical assistance you were approved for is too low
To file an appeal, you must submit a written request to the office that made the decision. Your request must be received within 60 days of the date on the notice of the decision. You will be notified in writing of the outcome of your appeal.
Glossary of terms used in the Maryland Medical Assistance Manual
Ablation: The medical procedure of destroying or removing tissue.
Absolute poverty line: The minimum level of income necessary to meet basic needs.
Acute: Describes a disease or condition that comes on suddenly and usually lasts for a short period of time.
Addiction: A physical and/or psychological dependence on a substance, such as drugs or alcohol.
Advance directive: A legal document that allows you to state your preferences for medical care in the event that you are unable to communicate your wishes yourself.
Adverse event: An unexpected or dangerous event that occurs during medical treatment.
Alternative medicine: Any type of healing that is not considered mainstream, such as acupuncture or herbal remedies.
Analgesic: A medication used to relieve pain.
Anesthesia: A medically induced state of unconsciousness used to prevent pain during surgery or other procedures.
Contact information for medical assistance
The Maryland Medical Assistance Manual is a resource for health care professionals who participate in the Maryland Medical Assistance program. It provides the latest information on program benefits, provider enrollment, billing and claims processing, and much more.
The manual is available online at:
You may also contact the Department of Health and Mental Hygiene’s Office of Health Care Access at:
1-800-456-8900 (toll free) or 410-767-5346
Other resources for information about medical assistance
The Maryland Medical Assistance Manual is a resource for information about medical assistance.
There are other resources for information about medical assistance. The Centers for Medicare and Medicaid Services (CMS) website provides general information about medical assistance programs and services. State Medicaid websites also provide information about medical assistance programs and services.
The National Institutes of Health (NIH) website provides general information about health care, including information about medical assistance programs. The NIH website also includes links to other resources, such as the National Library of Medicine, which provides access to a variety of health care information resources.