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Learn About Requirements for Medicaid in Maryland

Learning how to qualify for Medicaid in Maryland is an important first step for all residents seeking Medicaid coverage and benefits. “Who is eligible for Medicaid?” is a common question that applicants ask. Medicaid benefits eligibility guidelines ensure that the program fulfills its goal of providing coverage to low-income and very low-income individuals, as well as other needy people. Medicaid eligibility requirements involve meeting income limits, which vary according to the petitioner’s particular Medicaid program. Applicants will also have to meet basic eligibility requirements, as well as any special requirements needed to participate in a specified Medicaid program. To learn more about eligibility for Medicaid in MD, review the informative sections below.

What are the requirements for Medicaid in Maryland?

Essentially, to be eligible for Medicaid in Maryland, a candidate must be a resident of Maryland who is a U.S. citizen or qualifying non-citizen and meets the financial qualifications. Traditionally, eligibility guidelines for Medicaid benefits required beneficiaries to qualify on the basis of income, while also requiring participants to meet special qualifying circumstances. These groups included families with children, pregnant women and people with disabilities. While these groups can still qualify for MD Medicaid programs, the state’s Medicaid eligibility expansion has increased the number of residents who qualify to receive Medicaid coverage. This primarily includes low-income adults between 19 and 64 years of age who do not have children.

Medical eligibility requirements for Medicaid will apply to some specific programs. Eligibility for Medicaid programs in Maryland based on a disability determination must be proved with official documentation. To determine how a candidate may qualify for Medicaid, Maryland uses a system of coverage group codes. Applicants must meet all financial and technical MD Medicaid eligibility requirements in accordance with their coverage group code. For example, infants belong to one coverage group code and children between one and six years of age qualify for another coverage group code. Currently, Maryland had 68 coverage group codes. To learn more about requirements for Medicaid programs, download our free guide today.

What are the income requirements for Medicaid in Maryland?

The Maryland Medicaid eligibility expansion allowed the program to cover adults younger than 65 years of age with incomes at or below 138% of the Federal Poverty Level (FPL). Otherwise, Medicaid income limits and rules differ depending on the circumstances of the candidate. For instance, Medicaid income requirements for children and parents/caregiver relatives are different than the income limits used to determine eligibility for applicants older than 65 years of age or applicants who are blind. To qualify for Medicaid in MD as an individual who falls under a coverage group and is considered a medically needy person, an applicant’s household income must meet a very low income requirement.

To determine income eligibility for Maryland Medicaid, the state carefully reviews an applicant’s earned household income. This includes the income that petitioners receive from being self-employed. Applicants must provide the state with information on all earned salaries, tips, commissions, bonuses and severance pay. To prove they meet income requirements for Medicaid, petitioners can include pay stubs or other forms of income verification in their Maryland Medicaid application. When filing for Medicaid in MD, petitioners will be required to provide any unearned income they receive. Unearned income is income received from different sources like Veterans benefits, pensions, child support, alimony and annuities.

What are the Medicaid application guidelines in Maryland?

Applicants can apply for Medicaid in Maryland at any time. Applications are rolling, meaning petitioners can be approved for benefits at any time. Applicants have the choice of applying for Medicaid online, by phone or in person. While applying online is convenient, applicants may apply in person if they need assistance filling out their application. Medicaid application guidelines will differ slightly depending on the applicant’s category of Medicaid program. For example, application procedures for Adults, Children, Pregnant Women and some other groups will have different requirements than People With Disabilities and Seniors Age 65 or Older. To learn more about Medicaid application requirements, download our free guide today.