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Maryland’s Free and Low Cost Health Care Programs

Maryland’s Free and Low Cost Health Care Programs. Who Qualifies, How to Enroll and What’s Covered. Free Health Care Programs in Maryland. Medical Assistance for Families Maryland Children’s Health Program for Children and Pregnant Women Primary Adult Care Program.

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Maryland’s Free and Low Cost Health Care Programs

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  1. Maryland’s Free and Low Cost Health Care Programs Who Qualifies, How to Enroll and What’s Covered

  2. Free Health Care Programs in Maryland • Medical Assistance for Families • Maryland Children’s Health Program for Children and Pregnant Women • Primary Adult Care Program

  3. Q. Who qualifies for these programs ? • Eligibility workers at the local health department and department of social services look at: • Citizenship and state residency • family size • income to determine if someone is eligible for free health care under these different programs.

  4. Big Picture Improvements: • Families no longer need to provide proof of assets or income to apply for free health insurance. • All Medicaid applicants need not be interviewed to apply and qualify for any of the state’s free health care programs. • Applying for coverage for multiple family members can be done with one single application, even though those individuals may be covered by different programs.

  5. Medical Assistance for Families(MA4F) • Newest program (started July 1, 2008) • Expanded eligibility for low-income parents and caregivers • To qualify, the family’s can earn up to 116%FPL or about $25,600 for a family of four

  6. Medical Assistance for Families(MA4F) • Who is eligible? • Legal US resident for 5 yr + Maryland • Parents and adult care givers (any age) • Young adults living on their own (19-21 years old) • At or below 116% FPL • Example: Family of four making $25,600 or less. • Childcare costs and unpaid medical bills can be deducted from income to make them eligible.

  7. Medical Assistance for Families(MA4F) • How to Enroll • Fill out an application completely and correctly • Send a copy of: • State issued photo ID • Social Security Card/immigration papers • Birth Certificate

  8. Medical Assistance for Families(MA4F)What’s covered: • Doctors visits, including regular check ups • Inpatient and outpatient hospitals services • Emergency room care • Specialty Care • X-ray and laboratory services • Low-cost and no-cost RX • Family planning services and free birth control prescriptions • OB/GYN care for women • Care for pregnant women • Home health services and hospice services • Physical Therapy • Mental Health services • Outpatient treatment for drug and alcohol abuse • Targeted case management for HIV infected individuals • Dental and vision services for beneficiaries under 21 • Immunizations for beneficiaries under age 21 • Transportation services • Pays for any documents unpaid medical bills 3 months prior to activation • Serves as secondary insurance for adults with other coverage

  9. Maryland Children’s Health Program(MCHP) • SCHP Reauthorization program • Very generous coverage in Maryland; subsidized for middle-income families • Comprehensive, free coverage for children from birth to age 18

  10. Maryland Children’s Health Program(MCHP) • Who is eligible? • Legal US resident for 5 yr + Maryland • Parents and adult care givers (any age) • Young adults living on their own (19-21 years old) • At or below 116% FPL • Example: Family of four making $25,600 or less. • Childcare costs and unpaid medical bills can be deducted from income to make them eligible.

  11. Maryland Children’s Health Program(MCHP) • How to Enroll • Fill out an application completely and correctly • Send a copy of: • State issued photo ID • Social Security Card/immigration papers • Birth Certificate

  12. Maryland Children’s Health Program(MCHP)What’s covered: • Doctors visits, including regular check ups • Inpatient and outpatient hospitals services • Emergency room care • Specialty Care • X-ray and laboratory services • Low-cost and no-cost RX • Family planning services and free birth control prescriptions • OB/GYN care for women • Care for pregnant women • Home health services and hospice services • Physical Therapy • Mental Health services • Outpatient treatment for drug and alcohol abuse • Targeted case management for HIV infected individuals • Dental and vision services for beneficiaries under 21 • Immunizations for beneficiaries under age 21 • Transportation services • Pays for any documents unpaid medical bills 3 months prior to activation • Serves as secondary insurance for adults with other coverage

  13. Primary Adult Care Program(PAC) • Only program for low-income adults without children • Covers basic health care needs • Aims to build wellness through prevention and quality primary care

  14. Primary Adult Care Program(PAC) • Who’s covered? • Childless adults • Legal US Citizens for 5 years • Earning up to 116% FPL; asset limit Example: Family of 1 making about $12,000 yr. or less;

  15. Primary Adult Care Program(PAC) • How to enroll: • Fill out an application completely and correctly • Send a copy of: • State issued photo ID • Social Security Card/immigration papers • Birth Certificate • Proof of income

  16. Primary Adult Care Program(PAC)What’s Covered? • Doctors visits, including regular check ups • Family planning & birth control • Prescription medicines for nominal cost • Some x-ray and lab services • For diabetics: Eye exams, glasses and foot care • Primary mental health services through doctor • Other benefits that vary by provider • Substance abuse servcies limited to buprenorphine and buprenorphine/nalozone combination at designated sites

  17. Primary Adult Care Program(PAC)What’s NOT Covered? • In-patient hospital care & emergency room services • Specialty services (including substance abuse except as noted above • Early Periodic Screening, Detection & Treatment Services • No retroactive payment of outstanding/prior bills

  18. Resources for more information: • Got healthcare? Call 211 • Baltimore HealthCare Access: (410)649-0500 • DHMH’s Got Healthcare? Webpage • Working Families and Small Business Health Coverage Act Webpage

  19. Contact Information Suzanne Gilbert, MSW, MPH Community Outreach and Development Dir Maryland Citizens’ Health Initiative Health Care for All! Coalition suzanne@healthcareforall.com Phone: (410)235-9000 Fax: (410)235-8963

  20. Thank you!

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