The Health Department can assist qualified Caroline County residents with obtaining health insurance through the Maryland Medicaid/Medical Assistance program and the Maryland Children’s Health Insurance Program. Our team can answer questions about eligibility, assist you with the application process, and help you understand your benefits.
Eligibility
Many different groups of people may be eligible for Medicaid in Maryland. Maryland has expanded Medicaid to nearly all adults under age 65 with incomes at or below 138% of the Federal Poverty Level.
To be eligible for Medicaid, applicants must meet Medicaid eligibility requirements. Medicaid requirements are based on state and federal law. Some requirements, such as income limits, vary for different groups of people and household sizes. Children and pregnant women, for example, may be eligible at higher household income limits.
For more information about Medicaid eligibility, visit the Maryland Medicaid Administration. Our Health Department staff can also answer questions about eligibility. Call (410) 479-8004 or dial 7-1-1 to place a call through Maryland Relay. However, the only way to know for sure if you are eligible for Medicaid is to apply.
Services Provided
If you have Medicaid, you will be required to choose a Managed Care Organization (MCO). If you fail to select one, the State will assign you to one. This process is known as Maryland HealthChoice.
Through their agreements with the State of Maryland, MCOs are required to provide a wide variety of basic health care benefits, including:
- Doctor visits and regular checkups
- Healthy kid checkups and immunizations (shots)
- Prescription drugs
- Urgent care and emergency services
- Hospital services, and more.
Visit the Maryland HealthChoice website for more information on covered services.
Some Medicaid recipients are not eligible to enroll in an MCO, including those on Medicare. Visit the website for more complete information. Our staff can also answer questions about eligibility to enroll with an MCO. Call (410) 479-8004 or dial 7-1-1 to place a call through Maryland Relay.
How to Apply
There are several programs under Maryland Medicaid. Each program provides one of three types of medical assistance – health coverage, long term services, or supports or assistance with Medicare premiums, deductibles and cost-sharing – to serve the health needs of different eligible groups of people.
You can apply for Medicaid at any time. If you are eligible, you can enroll year-round. Individuals who receive Supplemental Security Income (SSI) are automatically eligible and do not need to apply.
For information about how to apply for the Medicaid program that best meets your needs, visit the Maryland Medicaid Administration.
There are multiple ways to apply:
- By contacting or visiting us at the Health Department. Call (410) 479-8004 or the deaf and hard of hearing can dial 7-1-1 to place a call through Maryland Relay.
- Online at www.marylandhealthconnection.gov
- By visiting a local connector entity or the Caroline County Department of Social Services.
- Download the free mobile app, Enroll MHC.
Choosing a Provider
You can select which of Maryland’s Managed Care Organizations (MCOs) you would like to have as your insurance provider through Maryland HealthChoice. Different MCOs may vary in access to providers based on location.
Our Health Department staff can help you review your option and select an MCO. Call (410) 479-8004 or dial 7-1-1 to place a call through Maryland Relay.
The Maryland Children’s Health Program (MCHP) gives full health benefits for income qualified children up to age 19. MCHP enrollees obtain care from a variety of Managed Care Organizations (MCOs) through the Maryland HealthChoice Program.
Eligibility
MCHP enrollment is available to uninsured children under age 19, whose household modified adjusted gross income (MAGI) is at or below 211% of the federal poverty level (FPL) for their family size.
Uninsured children under age 19 may qualify for MCHP Premium if their household income is above the MCHP income guidelines but is at or below 322% of the federal poverty level for their family size. MCHP Premium requires a small monthly premium per family. The premium is based on family income, but generally ranges between $61 and $80.
For more complete information on eligibility and the most recent income guides, visit the State MCHP website. Our Health Department staff can also answer questions and help you determine eligibility for MCHP. Call (410) 479-8004 or dial 7-1-1 to place a call through Maryland Relay.
Services Provided
Receiving regular medical care has a huge positive impact on children’s health. Healthier children also perform better in school and have better long-term outcomes than those who do not receive regular and routine medical care and health screenings.
MCHP covers the necessary health services children need, including:
- Doctor visits (both well and sick care)
- Immunizations (shots)
- Lab work and tests
- Mental health services
- Hospital care
- Dental care
- Vision care
For a full list of benefits provided, visit the State MCHP website.
How to Apply
There are multiple ways to apply:
- By contacting or visiting us at the Health Department. Call (410) 479-8004 or the deaf and hard of hearing can dial 7-1-1 to place a call through Maryland Relay.
- Online at www.marylandhealthconnection.gov
- By visiting a local connector entity or the Caroline County Department of Social Services.
- Download the free mobile app, Enroll MHC.
Choosing a Provider
You can select which of Maryland’s Managed Care Organizations (MCOs) you would like to have as your insurance provider through Maryland HealthChoice. Different MCOs may vary in access to providers based on location.
Our Health Department staff can help you review your option and select an MCO. Call (410) 479-8004 or the deaf or hard of hearing can dial 7-1-1 to place a call through Maryland Relay.
All participants in Maryland HealthChoice programs – including both Medicaid/Medical Assistance and Maryland Children’s Health Insurance Program (MCHP) – are eligible for two free services to help them navigate issues with their healthcare coverage: Administrative Care Coordination and Ombudsman Services.
Administrative Care Coordination
An Administrative Care Coordinator is a local resource that can help HealthChoice members by:
- Helping you understand your benefits and how to access services
- Explaining your health insurance provider choices (evaluating and selecting a Managed Care Organization (MCO))
- Helping you find a primary care doctor or specialist in your MCO network, or a dentist for your child
- Linking you to transportation services for eligible Medicaid medical appointments
- Help you get your prescriptions filled
- Explaining healthcare services you can get out of network and without a referral, such as prenatal care and family planning services
- Explaining your annual right to change MCOs
- Explaining how to renew your benefits through the Maryland Health Connection
- Helping you keep your information updated and how to get a new Medicaid card if yours is lost or stolen
- Assistance resolving billing issues
- Explaining your grievance and appeals rights
You can access Administrative Care Coordination services by calling us at (410) 479-8189. Dial 7-1-1 to place a call through Maryland Relay.
Ombudsman Services
A local Ombudsman is an advocate for your healthcare needs. There are several ways an Ombudsman can help you.
- They may contact you when there are complex medical issues involving care coordination with your MCO.
- They may also contact you to ensure that any complaints that you have about your healthcare or MCO have been resolved.
- The Ombudsman investigates disputes referred by the Division of Complaint Resolution between recipients and MCOs.
To contact your local Ombudsman, call our office at (410) 479-8189. Dial 7-1-1 to place a call through Maryland Relay.
Medical Assistance, Medicaid, and Maryland Children’s Health Insurance Program
Phone: (410) 479-8004
Administrative Care Coordination
Phone: (410) 479-8189
Dial 7-1-1 to place a call through Maryland Relay.
Hours
Monday – Friday
8:00 a.m. to 4:30 p.m.
Location
Caroline Health and Public Services Building
First Floor, Community Clinic
403 S. 7th Street
Denton, Maryland 21629