Medicaid

Medicaid is a joint federal/state program that provides health coverage to eligible low-income elderly adults, and other eligible groups. Medicaid provides health coverage but is not Medicare.

As a joint federal/state program, federal law and policies lay out basic requirements allowing state flexibility to develop their programs. Key facts about Medicaid.

1. Medicaid provides basic health care coverage.
2. Medicaid coverage is available to persons who otherwise cannot afford coverage.
3. Separate eligibility rules apply to most home and community-based services (HCBS) and to nursing facility services.
4. Special financial rules protect couples when determining eligibility for HCBS and nursing facility coverage.
5. Medicare Savings Programs (QMB/SLMB) are administered through Medicaid and help to make Medicare more affordable.

What Medicaid Covers

Required Medicaid Benefits

• Physician services
• Hospital services (inpatient & outpatient)
• Nursing facility services
• Laboratory & x-ray services
• Home health services
• Transportation to medical services

Optional Medicaid Benefits

• Physical, occupational, speech therapy
• Dental
• Vision
• Hospice
• Home and Community-based services (HCBS)

Maryland Medicaid Eligibility for Residents 65+

Medicaid eligibility depends on financial need, as well as these additional requirements.

• Maryland resident
• U.S. Citizen or non-citizen who meets immigration status requirements
• Provide a Social Security Number (SSN) (if you have one and are applying for coverage for yourself).
• Meet financial requirements
  • Income limits. If you are 65 and older, the Maryland income limit is $350/month.
  • Asset limits. Only applies to certain groups including individuals who need long term care or are applying based on being aged, blind, or disabled.

  Different Eligibility Rules for Long Term Services and Supports

  Medicare eligibility requirements for nursing home (long term care—LTC) and HCBS are complex and are different from regular Medicaid. Eligibility is based on medical necessity determined by your doctor and meet both income and asset requirements.

  For information about any aspect of Medicaid eligibility, contact:
  Division of Eligibility Policy/MCHP
  OOEP Department of Health and Mental Hygiene
  201 W. Preston Street Baltimore, MD 21201
  Telephone: (410) 767-1463
  Toll Free: (800) 492-5231, extension 1463

  If you have questions about Medicaid covered services or other Medicaid issues, you may call: (410) 767-5800 or 1 (800) 492-5231.

  Home and Community-Based Services (HCBS)

  Maryland Medicaid offers certain Home and Community-Based Services (HCBS) waiver programs that afford individuals LTC services assistance so that they can remain living independently—in their homes and communities—instead of in nursing homes. Each have slightly different eligibility rules.

  3 Maryland HBCS programs

  • Community Options Waiver
  • Community First Choice
  • Community Personal Assistance Services

  For more information, contact the Montgomery County LTC Program

  Apply for Medicaid

  For Maryland seniors who are age 65 or older, you may be eligible for Medicaid based on your age, and if you meet Medicaid eligibility requirements and financial criteria. To determine your eligibility, you should apply for Medicaid through your local Department of Health and Human Services (DHHS).

  You can apply for Medicaid in the following ways:

  • Online through myMDTHINK
  • Download the application to mail or take in-person

  Or through your local DHHS

  • Mail the completed application
  • In-person

  If you are disabled or over age 65 and receive Supplemental Security Income (SSI) as well as Medicare:

  You are entitled to full Medicaid benefits, which are provided as a wrap-around to Medicare once Medicare coverage begins. You may also be eligible for assistance with Medicare premiums, co-pays, and deductibles through the QMB/SLMB program.

  Montgomery County Department of Health and Human Services

  Main Office (No Public Service)
  401 Hungerford Drive, 5th Floor
  Rockville, Maryland 20850

  DHHS Silver Spring Center
  8818 Georgia Ave.
  Silver Spring, MD 20910

  DHHS Offices
  1401 Rockville Pike
  Rockville, MD 20852

  Up-County Regional Services Center
  2nd Floor, 12900 Middlebrook Rd.
  Germantown, MD 20874

  Phone: 240-777-4513
  Within Montgomery County: 311
  Outside Montgomery County: 240-777-0311
  Fax: 240-777-1494
  TTY: Use MD Relay 711

  Contact us 301-255-4250 https://medicareabcd.org/contact-us/
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