![[photo, Johns Hopkins Hospital, 600 North Wolfe St., Baltimore, Maryland]](/msa/mdmanual/01glance/health/images/1198-1-2708.jpg)
![[photo, Medical and Chirugical Faculty of Maryland, 1211 Cathedral St., Baltimore, Maryland]](/msa/mdmanual/16dhmh/images/1198-1-1279.jpg)
![[photo, Wilmer Dome, Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe St., Baltimore, Maryland]](/msa/mdmanual/36loc/bcity/images/1198-1-1535.jpg)
The Medical Assistance Program, known as Medicaid, is a joint federal and state program that provides health and long-term care coverage to low-income people. The program is overseen in Maryland by the Medical Assistance Program of the Department of Health and Mental Hygiene, and on the federal level by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services. In FY2006, some 709,000 people were enrolled in Medicaid at a cost of $5.2 billion. Of this total, 115,000 people received partial benefits at a cost of $136 million.
Eligibility for Medicaid is determined by local departments of social services. To apply for Medicaid assistance, Maryland residents visit their county or city department of social services. There, they are interviewed and submit an application. Generally, those who are either older than age 65, under age 21, disabled, blind, or caring for a child whose parent is unemployed, sick, or deceased are eligible for benefits.
As of March 2000, approximately 70% of qualifying Medicaid recipients are required to join one of eight State-regulated managed care organizations. Exceptions are made for those who receive long-term care, certain mentally fragile children, or for the mentally handicapped, among others.
HealthChoice is the program that places Medicaid recipients into Managed Care Organizations (MCOs). These organizations provide group insurance that covers medical services at select hospitals and clinics participating in HealthChoice and are responsible for meeting nearly all of the recipients' medical needs, except for mental health services and other specific care. Mental health services are provided by the Specialty Mental Health System, which is administered by the Mental Hygiene Administration.
A variety of major programs are offered through HealthChoice. Local health departments identify and enroll Medicaid recipients with special needs or disabilities (such as diabetes, homelessness, alcoholism, or drug addiction) into appropriate programs. One-on-one assistance is available for those who require it.
Additional State-sponsored services include infant and reproductive care through the Center for Maternal and Child Health, nutritional assistance offered by Women, Infants and Children (WIC) Program, and medical care for children through the Maryland Children's Health Program.
To investigate and mediate disputes, health departments act through the Ombudsmen Program to handle enrollees' complaints. Concerns also may be addressed through the HealthChoice Enrollee Action Line at 1-800-284-4510.
The Rare and Expensive Case Management Program and the Stop Loss Case Management Program focus on patient needs and expenses that are not covered by Managed Care Organizations.
Initiated in 1978, the Pharmacy Assistance Program helped pay for prescriptions, insulin, and certain medical supplies for low-income individuals who were not eligible for Medicaid.
HEALTHCHOICE
MEDICARE
PRIMARY ADULT CARE PROGRAM (includes PHARMACY ASSISTANCE)
![[photo, Pavilion, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., Baltimore, Maryland]](/msa/mdmanual/36loc/bcity/images/1198-1-2516.jpg)
RENOWNED HEALTH-CARE INSTITUTIONS
Pavilion, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., Baltimore, Maryland, October 2007. Photo by Diane F. Evartt.
? Copyright Maryland State Archives