Maryland Medicaid Eligibility and Enrollment
- Thinking of applying for Medicaid in Maryland? Here's everything you need to know, including what’s covered, eligibility requirements and how to apply.
Understanding Medicaid in Maryland
Older adults who require assistance with medical bills may wish to investigate Medicaid in Maryland. As of August 2020, the Medicaid and CHIP programs in the state have almost 1.4 million people enrolled and receiving assistance. The state adopted targeted enrollment strategies in 2013 that have seen enrollment increase by more than 60%, and there are a number of programs designed to help people as they age.
What Is Maryland Medicaid?
Maryland Medicaid, also known as Medical Assistance or MA, is a joint federal and state government program that helps a wide range of low-income residents to access health care. In addition to regular Medicaid, Maryland has Long-Term Services and Support (LTSS), which helps more than 42,000 people who require long-term care. There are also specific waivers that help certain segments of the population, including people aged 65 and over.
What Does Maryland Medicaid Cover?
The regular Medicaid program for older adults, known as the Aged, Blind and Disabled Program, pays for a wide range of healthcare services for recipients. Benefits can include ambulance services, mental health care, eye exams and some medical supplies. Services and products that aren’t covered include dental services and over-the-counter medications.
Home and community based services waivers offer a wider range of services. Many waiver programs are designed to help seniors stay living in their home or the community. To aid in this goal, they cover in-home personal care services, medical day care, home modifications and meal delivery. Medicaid also pays for nursing home care for eligible beneficiaries.
Who Is Eligible for Medicaid in Maryland?
In 2013, Maryland expanded Medicaid to provide coverage to nearly all adults who meet financial eligibility requirements. There are also programs aimed at specific segments of the population, including children, pregnant women, former foster care youth and people aged 65 and over. Some programs, such as waivers and long-term care support, have different eligibility criteria.
Financial Eligibility Criteria
As a program designed to aid low-income residents, the financial eligibility criteria for Medicaid are the most detailed. To be eligible, applicants must meet both asset and income limits, and these limits change depending on the exact program and the make up of the applicant’s household.
Older adults are generally eligible through the Aged, Blind & Disabled Program. Financial eligibility differs based on the applicant’s marital status and whether both spouses are applying for the program. For single applicants in 2020, the income limit is $350 per month. Married couples can have an income of up to $392 per month. The asset limit is $2,500 for singles and $3,000 for married couples. If only one spouse is applying, that $3,000 is for the applicant.
For Medicaid waiver programs, such as Home and Community Based Services, the income limit is raised to $2,349 per month. When a married couple is applying, this is $2,349 for each spouse, or $2,349 for the applicant if only one spouse is applying. The asset limit drops to $2,000 for singles and married couples where one spouse is applying, although the non-applicant spouse can keep $128,640 worth of assets.
The final category of interest to older adults is nursing home assistance. Maryland doesn’t have a specific income limit for nursing home assistance. Instead, an applicant's income cannot exceed the cost of nursing home care. This income goes toward the cost of care, minus a small personal needs allowance, and the state pays any outstanding amount. The asset limits for this program are the same as for waiver programs.
It should be noted that certain assets are not considered in a Medicaid application. Personal belongings, a car and household furnishings are all exempt. Generally, an applicant's house is also exempt as long as it’s their primary place of residence, or there’s a non-applicant spouse living in the home.
Other Eligibility Criteria
There are certain other eligibility criteria that applicants also need to meet. All applicants must be residents of Maryland and either a U.S. citizen or a non-citizen who is a qualified immigrant. The full list of qualified immigrant statuses can be found on the Department of Health’s website.
Older adults applying for the Aged, Blind and Disabled program must be aged 65 or older, although there are no other functional criteria. Most waiver programs state that recipients must require a certain level of care. This differs depending on the program, though in most cases, it’s based on how much assistance applicants need with activities of daily living or instrumental activities of daily living. People applying for nursing home coverage must be medically assessed as requiring skilled nursing care.
Can I Apply If I Don’t Meet the Criteria?
Maryland does offer pathways to Medicaid for people who earn more than the income limit. Specifically, there’s a medically needy pathway for people with high medical expenses. In this program, the income a person earns over the Medicaid limit, known as excess income, is used to pay for medical bills such as treatment or supplies. This is called spending down. When a person has spent their income down to the Medicaid income limit, they will be eligible for Medicaid for the remainder of the spend-down period.
The best way for older adults to know if they are eligible for Medicaid is to apply. Medicaid officers will be able to assess their circumstances and help them find aid.
How Do I Enroll in Medicaid in Maryland?
Medicaid in Maryland has different application processes for each program. People aged 65 and over can apply online through MyDHR. Alternatively, older adults can apply in person or mail a completed application form to their local department of social services. There are applications available online in English and Spanish. Those who receive the Supplemental Security Income (SSI) are automatically eligible and don’t need to apply.
Older adults who are applying for Long-Term Services and Supports need to apply online through MDThink or in person by mail to their local department of social services. More information about the different ways to apply for Maryland Medicaid can be found at the Department of Health website.
Contact Information for Maryland Medicaid
People looking for general information about Medicaid can call (410) 767-5800. Alternatively, local Department of Human Services offices can provide information about Medicaid in Maryland and help people with applications. There are 24 offices throughout the state.