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Program Description

Medical Assistance, also called MA or Medicaid, is a joint federal and state program, authorized under Title XIX of the Social Security Act, which provides health care benefits, including long- term care coverage, to low-income individuals who qualify. It is administered by the state and pays most medical bills with both federal and state funds. The Maryland Department of Health and Mental Hygiene (DHMH) provide Medicaid coverage to individuals determined to be categorically needy or medically needy. Medicaid coverage is automatically granted to individuals receiving other public assistance, including Supplemental Security Income (SSI), Temporary Cash Assistance (TCA), and Foster Care. These individuals are said to be “categorically needy eligible.” Low-income families, children, persons younger than 21, caretaker relatives other than parents, pregnant women, and aged, blind, or disabled adults may also qualify for Medicaid. An individual can have private health insurance and still be eligible for Medicaid. Medicaid is payer of last resort. The eligibility rules vary for different groups of persons and the kinds of medical care covered may vary from group to group. If a person needs help paying for his/her own or family member‟s medical bills, he/she should fill an application on-line or at the LDSS to find out about his/her MA eligibility.

Benefits and eligibility requirements are the same across the state. General Program Requirements In order to qualify for this benefit program, you must be a resident of the State of Maryland and meet federal citizenship requirements. Automatic Medical Assistance as a State Option The Personal Responsibility and Work Opportunity Act of 1996 (PRWORA) eliminated the requirement for automatic “categorical” MA eligibility for recipients of TCA. Instead, states were given the option of providing automatic MA Eligibility to recipients of TCA. Maryland has chosen this option. This means that TCA recipients will continue to automatically receive MA, by state option rather than Federal requirement.