Maryland Children’s Health Program



The Maryland Children’s Health Program (MHCP) provides comprehensive health benefits for children up to age 19 and pregnant women of all ages. In order to qualify you must meet the income guidelines and other eligibility criteria. A variety of services are covered through the program, which is available to children whose income is over the Medicaid limit. Some families may receive MCHP for no additional fee, while others with a higher income can pay a premium for coverage.

Those enrolled in MHCP can receive care through a number of Maryland managed care organizations (MCOs) through the Maryland HealthChoice Program. Eligibility is determined by residency in the state of Maryland, income, and U.S. citizenship or legal residency. Health is not a consideration to qualify, as children with special physical or mental health needs are welcome to additional benefits through MHCP. Additionally, certain individuals may have some source of health insurance and still qualify for MHCP, though it is used my most members as their primary coverage.

 

Income Guidelines

The Maryland Children’s Health Program accepts children whose income is too high to qualify for Medicaid, yet is at or below 200 percent of the Federal Poverty Level. Pregnant women are accepted for MHCP benefits if they have income less than or equal to 250 percent of FPL. Families who wish to receive MHCP coverage with income over the limit of 200 percent FPL must have an income between 200 and 300 percent FPL, and are subject to premiums. The current figures for annual and monthly earnings are listed below according to family size.

*Note: For each family member over “8”, add as indicated:
P02, P06 & P13 ADD $611 per person for monthly/$7,326 for annual.

P07 ADD $439 per person for monthly/$5,266 for annual.

P08 ADD $330 per person for monthly/$3,960 for annual.

P11 ADD $825 per person for monthly/$9,900 for annual.

P14 ADD $660 per person for monthly/$7,920 for annual.

 

MHCP Premium

Monthly premiums apply to higher income members, whose total earnings are between 200 and 300 percent of the Federal Poverty Level. The MHCP Premium program provides health benefits through employer-sponsored coverage or one of the state’s various MCO health plans participating in the HealthChoice Program, as mentioned above.

Monthly rates for those with a qualifying income will be either $56, for those with income up to 250 percent FPL, or $69, for families who earn between 251 percent and 300 percent FPL. No additional fees are charged for services.

 

Covered Benefits

For children, free services offered through MHCP providers include the following:

  • Doctor’s office visits
  • Preventative care
  • Inpatient hospital services
  • Outpatient hospital care
  • Immunizations
  • Lab work and testing
  • Dental care
  • Vision care
  • Prescription medications
  • Transportation to medical appointments
  • Mental health care
  • Substance abuse treatment
  • Emergency room visits
  • Ambulance services

 

The benefits available to pregnant women in Maryland through MHCP include:

  • Prenatal and postnatal doctor’s office visits
  • Labor and delivery costs
  • Doctor visits not related to pregnancy
  • Lab work, diagnostic testing, and X-rays
  • Dental care
  • Vision care
  • Prescription medications, including vitamins
  • Medical transport
  • Mental health services
  • Substance abuse treatment
  • Family planning services after delivery

 

How to Apply

Maryland residents have various ways to apply for MHCP coverage, and it can be accomplished quite simply and efficiently. You may choose to download a copy at home and send or drop off the form at your Local Department of Social Services, or call your LDSS and request they send you a form. Applications are also available at Local Health Departments, WIC Centers, and local hospitals and schools.

If you need additional help, your local health department will be staffed with case managers who can assist with your application. When you are found eligible for benefits, you and your family will receive a packet in the mail for official enrollment and in order to choose your MCO for care administration.

Applications ask for a few pieces of information including your general contact information, if you have any health insurance currently or in the past, and information about family members, such as names and birth dates. Social Security numbers of those who are applying are also required. Income sources and amounts are necessary to record for eligibility purposes.

 

Resources

Maryland Children’s Health Program

Apply for MHCP

Department of Health and Mental Hygeine MHCP: 800-456-8900

TDD Contact: 800-735-2258