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Suburban Maryland Health Care Info for Adults

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MEDICAID HEALTH INSURANCE

Medicaid is a state health insurance program. It is also called Medical Assistance or MA.

To get Medicaid:

  • You must live in Maryland.
  • You must:
    • Be a parent or family member caring for a child; or
    • Be pregnant; or
    • Be 65 or older, blind, or disabled; or
    • Need care at home; or
    • Have breast or cervical cancer.
  • You must have a low income. For example:
Number of people in your family Your income each month must be less than:*
1 $1,111
2 $1,499
3 $1,888
4 or more For each additional person, add $388
to the number just above

Attention: This chart applies to a parent or family member caring for a child. If your income is a little higher than the numbers above, you should still apply.
* These are the numbers for 2013. They will go up a small amount each year.

  • Your income can be higher if:
    • You have high medical bills;
    • You have work income or pay for child care;
    • You need care at home;
    • You have breast or cervical cancer; or
    • You are pregnant (for example, $4,070 a month for a family of three in 2013).
  • Your income must be lower if you are a single person who is 65 or over, who is blind, or who is disabled.
    • If you do not get SSI, you cannot have more than $350 a month in income.
    • If you get SSI, you should get Medicaid with it.
    • If you have Medicare and a low income, you may also be able to get Medicaid.

You must be a U.S. citizen or meet certain immigration requirements to get Medicaid. 

Most people with Medicaid get their health care through a managed care plan.

The plans are: Amerigroup, Maryland Physicians Care, Priority Partners, and United Healthcare. Medicaid pays for:

  • Prescriptions.
  • Doctor visits, including specialists.
  • Hospital stays.
  • Mental health services.
  • Some other health care services.

Medicaid may even pay for medical care you got in the three months before you apply. You may have to pay a small amount for some services.

How to apply for Medicaid:

To keep getting Medicaid:

The Department of Health and Mental Hygiene will send you a form. Fill out the form and return it right away so your health insurance does not get cut off.

OTHER PROGRAMS TO HELP YOU PAY FOR CARE

If you have a low income (for example, $1,499 a month for a family of two in 2013):

  • Maryland Primary Adult Care (PAC) pays for visits to a family doctor, and for family planning services, mental health services, and part of the cost of prescriptions at some pharmacies.
  • Some immigrants cannot get this program. Call to find out if you should apply.
  • Call Maryland PAC at 800-226-2142. You can also get the application online at www.dhmh.state.md.us/mma/pac.

If you are pregnant:

  • The Maryland Children’s Health Program (MCHP) pays for doctor visits, labor and delivery, prescriptions, dental and vision care, family planning, and substance abuse services. It also pays for transportation to medical appointments.
  • You must have a low income (for example, $4,070 a month for a family of three in 2013).
  • You must be a U.S. citizen or meet certain immigration requirements.
  • To apply, call 800-456-8900. Or go to www.dhmh.state.md.us/mma/mchp. You can also apply online atwww.marylandSAIL.org.

If you are disabled, if you are 65 or older, or if you need a kidney transplant or dialysis:

  • You can get Medicare if you or your spouse gets a Social Security check. If you are getting Social Security because of your disability, you may have to wait to get Medicare. You can also get Medicare if you have end stage renal disease or Lou Gehrig’s disease (ALS).
  • Medicare pays most of the bills for doctor and hospital care. Medicare also pays for many prescription drugs and some nursing home care. You have to pay for part of the care you get.
  • You can apply for Medicare at your local Social Security office. Or call 800-772-1213.
  • If you have a low income, Medicaid may help you pay some of your Medicare costs. Medicaid has two programs that can pay the monthly Medicare premium that is taken out of your Social Security check and possibly other Medicare costs too. These programs are called QMB and SLMB. Call the Maryland Department of Aging at 800-243-3425. Or call the Maryland State Health Insurance Assistance Program at 301-590-2819 for Montgomery County or 301-265-8450 for Prince George’s County for help applying.

If you have HIV or AIDS:

  • The Maryland AIDS Insurance Assistance Program can help pay your health insurance premiums. Call 800-205-6308 or 410-767-6535. Or visit http://ideha.dhmh.maryland.gov/OIDPCS/CHCS/SitePages/Home.aspx to apply.
  • You can call the Infectious Disease and Environmental Health Administration at 800-358-9001 for help paying for HIV and AIDS medications and visits to HIV-specific medical clinics.

If you live in Montgomery County:

  • Montgomery Cares pays for prescriptions, visits to health care providers, and help managing chronic illnesses like diabetes and high blood pressure.
  • You must be at least 18 years old.
  • Your immigration status does not matter.
  • You must have a low income (for example, $4,070 a month for a family of three in 2013).
  • Call 311 or 240-777-0311 to get more information.
  • You can call any of the clinics listed on the Montgomery Cares website to make an appointment: www.montgomerycares.org/cs/clinics/list.You may have to pay for some services, based on your income.

Consider buying private health insurance.

  • This can cost a lot.
  • When you apply, you will have to answer questions about your health. You may need a physical exam.
  • Private insurance may turn you down because of a health problem you had before you applied. This is called a pre-existing condition. Even if you are accepted, the insurance may not cover your pre-existing condition. Make sure to ask if the insurance will pay for all the services you need.
  • If you have a pre-existing condition, you may qualify for Maryland Health Insurance Plans (MHIP, MHIP+ and MHIP Federal). Your immigration status does not matter. Call 888-444-9016. Or visitwww.marylandhealthinsuranceplan.state.md.us.
  • To find health insurance companies in Maryland, go to www.mdinsurance.state.md.us. Click on “Consumer Information,” then “Publications”.

HOW TO GET CARE IF YOU ARE NOT A U.S. CITIZEN

You do not have to be a U.S. citizen to get health care and health insurance in Maryland. Applying will not hurt your immigration status.

If you meet the other requirements for getting Medicaid, you probably can get benefits if:

  • you are a Legal Permanent Resident, or
  • you are a refugee, or
  • you are an asylee.

Some other immigrants can also get Medicaid. Call the Maryland Medical Assistance Help Lines at 800-456-8900. Or visit http://www.dhr.state.md.us/blog/?page_id=805 to get the address for your local Department of Social Services’ office. Or call Maryland Legal Aid at 888-215-5316.

Some immigrants can get other programs:

  • Call the Maryland Primary Adult Care (PAC) program at 800-226-2142.
  • Call the Maryland Health Insurance Plan (MHIP) at 888-444-9016.
  • Call 311 or 240-777-0311 to learn about Montgomery Cares if you live in Montgomery County.
  • Some immigrants who are pregnant can get the Maryland Children’s Health Program (MCHP). To apply, call 800-456-8900. Or go to www.dhmh.state.md.us/mma/mchp. You can also apply online at www.marylandSAIL.org.
  • Some immigrants who are pregnant and live in Montgomery County, can get prenatal care through the Maternity Partnership Program. You may have to pay a fee for some services. Call 240-777-1245 to apply.

If you cannot get other insurance, find out about Emergency Medicaid:

  • Emergency Medicaid covers the birth of your child and most medical emergencies. Call the Maryland Medical Assistance Help Lines at 800-456-8900. Or visit http://www.dhr.state.md.us/blog/?page_id=805 to get the address for your local Department of Social Services’ office.
  • Your immigration status does not matter.
  • You must live in Maryland and meet all other Medicaid requirements.

HELPFUL PHONE NUMBERS

Visit www.dhmh.state.md.us/gethealthcare for a list of public programs.

For legal help:

  • Call Maryland Legal Aid at 888-215-5316.
  • Call Prince George’s County Community Legal Services at 301-864-8353.
  • If you do not qualify for legal aid help, call Montgomery County Lawyer Referral Service at 301-279-9100 or Prince George’s County Lawyer Referral Service at 301-952-1440. The lawyers they refer you to may charge a fee. Tell them that you have a low income or ask for a reduced fee.

For help with Medicare or other programs for seniors:

  • Call the Maryland State Health Insurance Assistance Program at 301-590-2819 for Montgomery County or301-265-8450 for Prince George’s County.

If you or a family member has HIV or AIDS:

  • Call the Whitman-Walker Health Legal Services at 202-939-7627.

If you have a disability:

  • Call the Maryland Disability Law Center at 800-233-7201 for information on the health care rights of people with disabilities.