Key takeaways
- Eligibility for Medicaid in Maryland
- How to enroll in Medicaid in Maryland
- Maryland expanded Medicaid under the ACA, starting in 2014
- Maryland’s post-pandemic Medicaid disenrollments resume at the end of May 2023
- As of 2023, Maryland Medicaid includes adult dental benefits
- Nearly 1.7 million people are enrolled in Medicaid/CHIP in Maryland
Who is eligible for Medicaid in Maryland?
Maryland’s Medicaid program, which is also called Medical Assistance, has higher income limits than many other states when it comes to Medicaid eligibility for children and people who are pregnant. Individuals with family income up to the following levels are eligible for Medicaid (note that these limits include the build-in 5% income disregard that’s used for MAGI-based Medicaid eligibility):
- 322% of the federal poverty level (FPL) for children ages 0-18
- 264% of FPL for someone who is pregnant (coverage continues for 12 months after the baby is born)
- 138% of FPL for parents and other adults
- Aged, blind, and disabled (ABD) individuals may also qualify for Medicaid; see the income and asset guidelines in the FAQs of the Maryland Department of Health and Mental Hygiene website.
- Maryland helps pay for long-term care for qualifying individuals; see the eligibility criteria and application information.
For ease of reference, the Maryland Health Connection website shows the monthly income limits in terms of dollar amounts rather than percentage of FPL.
How does Medicaid provide assistance to Medicare beneficiaries in Maryland?
Many people with Medicare receive help through Medicaid with Medicare premium costs, prescription drug expenses, and expenses that Medicare doesn’t cover — such as long-term care.
Our guide to financial resources for Medicare enrollees in Maryland provides an overview of those programs, including Medicare Savings Programs, nursing home benefits, and income guidelines for assistance.
How do I enroll in Medicaid in Maryland?
In general, you can enroll for Maryland Medicaid online or in person. See below for specifics, which vary for different eligible groups.
- If you are under 65 and don’t have Medicare, apply online through SAIL (Service Access and Information Link) or at www.MarylandHealthConnection.gov.
- Seniors and people who have Medicare can apply for Medicaid using this website.
- Get an application or apply in person at a local health department or social services office. Call 1-800-456-8900 and have an application mailed to you.
- For help applying, call 1-855-642-8572 (1-855-642-8573 for individuals who have hearing difficulty)
- People who are pregnant are encouraged to apply at a local health department. Call 1-800-456-8900 for information
Did Maryland expand Medicaid under the ACA?
Yes, Maryland expanded Medicaid under the ACA. The state’s Medicaid expansion was authorized in May 2013 for a Jan. 1, 2014, start date. Medicaid expansion, which makes Medicaid available to low-income, non-elderly adults, is one of the Affordable Care Act’s main tenets to reduce the nation’s uninsured rate.
Maryland has accepted federal Medicaid expansion
- 1,673,179 – Number of Marylanders covered by Medicaid/CHIP as of November 2022
- 816,882 – Increase in the number of Marylanders covered by Medicaid/CHIP fall 2013 to November 2022
- 47% – Reduction in the uninsured rate from 2010 to 2019
- 95% – Increase in total Medicaid/CHIP enrollment in Maryland since Medicaid expansion took effect
How is Maryland handling Medicaid renewals after the pandemic?
From March 2020 through March 2023, states have been receiving additional federal Medicaid funding, but have been prohibited from disenrolling people from Medicaid, even if they no longer met the eligibility requirements. That rule ends March 31, 2023, and states can once again disenroll people from Medicaid starting as early as April 1, 2023.
Maryland will start sending out Medicaid renewal packets in April 2023, and the first round of disenrollments will come at the end of May. So some enrollees will need to find new coverage as soon as June 2023. But renewals will be spread over a 12-month period, so some Maryland Medicaid (Medical Assistance) enrollees will not receive a renewal packet until late 2023 or early 2024. Until that point, their coverage will continue, even if they no longer meet the eligibility guidelines. But once a member’s renewal is due, they can only continue to receive Medical Assistance coverage if they still meet the eligibility guidelines and also provide the state with requested renewal information (unless the state is able to renew the coverage automatically, in which case the member will be notified that their coverage has been renewed).
People who are no longer eligible for Medicaid will be able to transition to a plan offered by an employer (if available) or a plan offered through Maryland Health Connection. In either case, the loss of Medicaid will provide a special enrollment period during which the person will be able to enroll (in both cases, the special enrollment period ends 60 days after the loss of Medicaid, so it’s important to act quickly; it’s also important to note that if you enroll in a new plan after Medicaid ends, there will be a gap in coverage, as employer-sponsored plans and private individual/family plans do not have retroactive effective dates). There is also a special enrollment period during which people can transition from Medicaid to Medicare, if they became eligible for Medicare during the pandemic and didn’t enroll because their Medicaid wasn’t terminated.
Does Maryland Medicaid provide dental benefits for adults?
Yes, as of 2023, Maryland Medicaid includes adult dental benefits. Prior to 2023, since the early 1990s, Maryland had not provided coverage for adult dental care through its Medicaid program (most states provide at least limited or emergency dental coverage for adults enrolled in Medicaid; Maryland was one of just three states that provided no coverage at all). But legislation (HB6 and SB150) was enacted in 2022 to add an adult dental benefit to the state’s Medicaid program as of 2023.
Children with Medicaid already had coverage for dental care in Maryland, as is the case nationwide. And Maryland did implement a program in 2019 to provide dental benefits to Maryland residents age 21-64 who were dually enrolled in Medicaid and Medicare (ie, they are disabled and have low incomes and low assets). But the state estimated that fewer than 39,000 people would be eligible for benefits under that program. Under HB6/SB150, a far larger population of low-income residents gained access to dental care starting in 2023.
Maryland Medicaid enrollment
Medicaid enrollment in Maryland has grown significantly in the last few years. From late 2013 to late 2022, total enrollment in Maryland’s Medicaid/CHIP grew by 95%. Total Medicaid/CHIP enrollment was 1,673,179 as of November 2022.
Maryland has used Medicaid managed care since 1991. As of 2022, Medicaid Managed Care Organizations (MCOs) covered about 90% of Maryland’s Medicaid population, while the other 10% were covered under the Medicaid Fee for Service program (the Medicaid FFS program includes elderly enrollees who are also eligible for Medicare, and those who are in long-term care facilities).
There are currently nine health insurance carriers that participate in Maryland’s Medicaid Managed Care program:
- Aetna Better Health
- CareFirst BlueCross Blue Shield Community Health Plan
- Jai Medical Systems
- Kaiser Permanente
- Maryland Physicians Care
- MedStar Family Choice
- Priority Partners
- UnitedHealthcare
- Wellpoint Maryland (formerly Amerigroup Community Care)
Maryland’s leadership and Medicaid expansion
Republican Larry Hogan took over as Maryland’s governor in January 2015, replacing Democrat Martin O’Malley. O’Malley faced a term limit and was not running for re-election; Lt. Gov. Anthony Brown vied with Hogan.
While Hogan frequently criticized O’Malley and Brown over Maryland’s state-run health insurance exchange, Medicaid expansion was not a campaign issue. In fact, Hogan acknowledged that significant changes to Medicaid were unlikely given Democrats’ dominance in the Maryland General Assembly.
Maryland gathered much information about the potential impacts of the ACA’s Medicaid expansion before proceeding with implementation, and the findings were summarized in a Health Affairs blog by an official with the Maryland Department of Health and Mental Hygiene. Maryland estimated that 190,000 Marylanders would gain Medicaid coverage through the expansion by 2020 and took note of a New England Journal of Medicine research showing a 6.1% reduction in mortality for low-income adults covered by expanded Medicaid. Maryland also learned that Medicaid expansion would have a significant positive effect on the state economy, including an estimated $25 billion in federal Medicaid funding and 27,000 new jobs by 2020.
(Medicaid enrollment nationwide is much higher as of 2023 than had been projected, due to the COVID pandemic. So the number of people with Medicaid expansion coverage is higher in nearly every state than official had projected initially, although that will decline somewhat in 2023 and 2024 as states resume disenrollments.)
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.