Medicaid Costs and Coverage in Maryland

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Medicaid coverage in Maryland is intended to help low-income families obtain affordable health care.

As such, MD Medicaid cost estimates will always be nominal for enrolled beneficiaries. Many applicants wonder how much does Medicaid cost since there may be associated fees for services and treatments for which the patient would be responsible. Maryland offers different types of Medicaid insurance options, each with unique costs and covered services. An important part of applying for Medicaid involves gaining as much knowledge about the program as possible. This means that applicants should understand what services are covered by Medicaid in Maryland as well as what does Medicaid not cover for approved applicants. Further knowledge about Medicaid coverages and costs can go a long way for potential applicants. For instance, in addition to the federally mandated services covered by Maryland Medicaid, there are also optional benefits specifically elected by the state. To find out more about how much is Medicaid in Maryland and the services covered by the health insurance assistance program, continue reading the information outlined below.

What services are covered by Medicaid in Maryland?

Understanding Medicaid coverage in Maryland involves finding out all the health services Medicaid covers as well as the services Medicaid does not cover. MD Medicaid coverage includes many different treatments and procedures free of charge. Petitioner who meet the eligibility requirements of Medicaid will receive coverage on preventative and medically necessary services like hospital inpatient and outpatient care. Medicaid coverages can be specific to the beneficiary such as services for diabetes, dialysis and physical therapy. While there are many types of insurance options for Medicaid offered, the services that can accompany those options can vary. Some of the covered services through Medicaid in Maryland includes but are not limited to:

  • Emergency ambulance and non-emergency transportation
  • Laboratory and X-ray services
  • Family planning services
  • Medical equipment and supplies
  • Private duty nursing, hospice and home health care

It is important to note that services covered by Medicaid can also have stipulations attached, such as exclusive to age or number of visits. For instance, hearing aids, eye glasses and dental services are only available for enrollees younger than 21 years of age. Likewise, vision care for adults is limited one eye examination every two years. Any services or procedures that are extra, may not be covered or may carry extra out-of-pocket expenses. For a full scope of services Medicaid will cover in Maryland, applicants can contact their local Medicaid care provider.

Discover the health care services Medicaid must cover according to federal law within our comprehensive guide.

What services are not covered by Medicaid in Maryland?

Knowing what services Maryland Medicaid will not cover is important to avoid surprise charges. With different types of Medicaid insurance options, health services covered by Medicaid can vary from beneficiary to beneficiary. A good way to rule out questions surrounding Medicaid coverage is to determine if the doctor is a Medicaid provider. Even if the treatment or procedure rendered is medically necessary, the state will only cover services from the Medicaid network. Patients will be responsible for Medicaid covered service costs from out-of-network health care professionals without prior authorization. Health care services Medicaid will not cover include:

  • Experimental services and treatments
  • Cosmetic surgeries and services
  • Acupuncture
  • Medical equipment not prescribed
  • Eye glasses and hearing aids for adults
  • Certain dental coverages for adults

While Medicaid coverages can vary for different reasons, there may be exceptions to the rules. For instance, if a doctor finds a particular service or treatment medically necessary but Medicaid does not cover it, the physician may be able to receive prior authorization from Medicaid for costs to be covered.

How much does Medicaid cost in Maryland?

Medicaid cost estimates in Maryland are always on the low side, especially for petitioners within a certain age range. Petitioners younger than 21 years of age generally have all services completely covered by Medicaid and have little to no out-of-pocket expenses. As long as the applicants meet the income requirements for Medicaid, they should receive care at very low cost. If there are any costs for Medicaid coverage, it usually involves copays, deductibles or premiums. Copayments are the most common out-of-pocket expenses for which approved applicants will be responsible.

Copayments can vary depending on the type of Medicaid insurance options an applicant has, as well as the medical procedure necessary. However, copayments are always low and oftentimes can be billed to an applicant after the procedure has been completed. Medicaid costs estimates can rely on different factors, which is why answering, “How much is Medicaid in Maryland?” is difficult. One of the few ways an applicant can understand what types of costs are associated with Medicaid is by being approved into the program and receiving further information that is tailored to his or her needs. If an applicant has children or seniors in the household, he or she will likely find the majority of Medicaid costs to be covered.

For comprehensive information about Medicaid coverage and applying for health insurance assistance, download our free guide.