Medicaid is a program that pays the medical bills of the people who have low income, cannot afford medical care, and meet other eligibility requirements. It is run by the State and pays the medical bills with State and federal tax money.

Medicare is an insurance program that pays medical bills for people who are at least 65 years old, or who are disabled. It is available to people who receive Social Security benefits regardless of how much money they have. It pays medical bills with money from the Social Security Trust Fund, which most people pay into while they work. Retired and disabled people pay a monthly insurance premium for Medicare Part B. This is usually taken out of their Social Security check before they get the check.

Yes. Both programs can work together. If you receive Medicare and qualify for Medicaid, the Medicaid program will pay your monthly Medicare Part B premiums for you (this is called “Buy-In”). Medicaid will also pay your Medicare co-payments and deductibles. If you are 65 or over and have not worked long enough to receive free Medicare Part A (hospital insurance), the Medicaid program will also pay the Medicare Part A premium. When you apply for Medicare, it is important to let the Social Security Administration representative know that you have Medicaid and may be eligible to have the State pay your Medicare Part A premium.

Whenever you have both Medicare and Medicaid, you should show both cards to your medical care provider each time you receive services.

Yes. If you have private health insurance available to you or a member of your family, your eligibility for Medicaid will not be affected. Any service not covered or only partially covered by a private health insurance plan and listed as a Medicaid covered service will be paid by Medicaid. Medicaid will pay up to the maximum Medicaid is allowed to pay.

Whenever you have both private health insurance and Medicaid, you should show both your Medicaid card and your health insurance card to your medical provider each time you receive services.

All people who receive money through Supplemental Security Income (SSI) or Temporary Cash Assistance (TCA) automatically receive Medicaid.

If you do not get SSI or TCA, you must file an application to find out if you are eligible for Medicaid. To do this, you must go to the Local Department of Social Services in the city or county where you live.

If you are interested in applying for the Maryland’s Children’s Health Program (MCHP), you may obtain an application from your Local Health Department. The completed application can be returned by mail or in person.

You will be interviewed by an eligibility worker who will ask for information about your income, assets, and private health insurance coverage. You will be asked to prove what you say is true.

If you are too sick to come to the Local Department of Social Services office to apply, you may send someone to the interview for you who is knowledgeable about your money situation and other circumstances.

MCHP does not have an interview requirement.

First, the eligibility worker will decide if you belong to one of the groups of people covered by Medicaid. You will also need to show that you are a resident of Maryland and a U.S. citizen, or an alien admitted for permanent residency who has lived in the United States as a qualified alien for at least 5 years or who otherwise qualifies. You must meet one of the conditions listed below. Your eligibility will be determined differently depending on the group you fall into. You must be…

Some people meet more than one of the conditions above. If that is so, the person may choose for which eligibility group to apply. The rules are different for different groups and the kinds of medical care covered are different for different groups.

After the eligibility worker determines that you meet one of these eligibility conditions, the value of all your assets will be added up. Assets are cash, money in checking or savings accounts, credit union accounts, stocks, savings bonds, trusts, annuities, or any other money that you have saved or invested. Assets also include things like boats, trailers, real estate, and life insurance policies or other expensive items you may own. Medicaid does not count as assets the home you live in or personal property (e.g., clothing, furnishings, car).

The amount of assets you may have depends on the size of your family and the eligibility group for which you are applying. This will be determined at the time of application.

Income is money that you get from working, or money that someone gives you, or checks that you get, like Social Security, unemployment or disability benefits, child support, retirement benefits, or sick pay. The amount of income you may have depends on the size of your family and the eligibility group for which you are applying.

If you have too much in assets, you are not eligible for Medicaid. However, if you spend your assets on your daily living expenses, medical care, or bills, you may reapply when your assets are lower.

If you have too much income, you may qualify under a “spend-down,” or you may decide to apply in a different eligibility group. This information and your eligibility worker will help you to decide which group is best for you and your family.

When a person’s income is more than the amount allowed by Medicaid, the eligibility worker will figure out exactly how much greater the income is than the amount allowed. This is called “Excess Income.” If the person can show that his/her medical bills are equal to or greater than the excess income, the person can still get Medicaid. This is called “Spend-down.”

Persons who become eligible under a spend-down are only eligible for a limited time, and they will still have to pay some of their own medical bills.

Medicaid is for people in two broad categories, “Families and Children” or “Aged, Blind or Disabled”.

Families and Children (FAC) is for children under 21 years old. Parents and other relatives who are providing care for unmarried children living with them may also qualify in this category. The income limits are very low, but families with too much income may qualify under spend-down. Families with too much assets cannot qualify until assets are reduced to the amount allowed. For more information about FAC, please click the link for the Medical Assistance for Families Initiative at http://www.dhmh.state.md.us/ma4families/index.html

Aged, Blind or Disabled (ABD) is for people 65 years old or older, blind, disabled or with an illness that is expected to result in death. The income limits are the same as for the FAC category, and people with too much income can qualify under a spend-down. People with too much assets cannot qualify until the assets are reduced to the amount allowed.