Sections
- How It Works
- Eligibility
- New Work Requirement
- Income Limits
- Immigrant Families
- Eligibility Renewal
- Step-by-Step Application Process
Medicaid, also known as Medical Assistance, is a government health insurance program run by both the federal and state governments for individuals with limited income and resources. Because the federal government only sets general rules and regulations for Medicaid, each state government may establish its own specific eligibility criteria for individuals to qualify for the program. Medicaid can be used to cover a wide range of services from doctors visits to hospital services to laboratory and x-ray services. The federal government requires Medicaid to have certain mandatory benefits which can be found here, however certain states’ Medicaid programs may provide additional option benefits. A list of services that Medicaid covers can be found here.
In this article, we will walk you through how Medicaid enrollment works and its benefits. If you found this article helpful, let us know by leaving a comment or following our Instagram. Take a look at our other articles, including Applying for Medicare Savings Programs and Applying for Part D “Extra Help”! Lastly if you have any questions, comments, or concerns, feel free to email us at bmorebenefits@gmail.com.
How it Works
Medicaid is a free or low-cost health insurance for individuals with limited income or resources. As mentioned above, you can see the services that Medicaid covers by navigating here. Medicaid in Maryland operates through HealthChoice, the state’s managed care program. HealthChoice contracts with Managed Care Organizations (MCOs), which partner with Medicaid to provide healthcare services to enrolled recipients. When enrolling in Medicaid, they will ask you to enroll with an MCO of your choice. As of June 2025, there are 9 MCOs in the HealthChoice program to choose from:
- Aetna Better Health
- CareFirst
- Jai Medical Systems
- Kaiser Permanente
- Maryland Physicians Care
- MedStar Family Choice
- Priority Partners*
- UnitedHealthcare
- Wellpoint Maryland
*Priority Partners had its accreditation suspended in early 2025 and was closed to new enrollments. Check Department of Health’s website or Maryland Health Connection for latest information regarding Priority Partners new enrollment status.
You can learn more about the different MCOs here. Furthermore, Maryland Health Connection has organized a comparison table to understand the differences, eligibility, and scope of each MCO which can be accessed here. Choosing your MCO is a very important and consequential part in the Medicaid enrollment process. For example, if you are currently receiving services from a doctor and want to continue to see that doctor, enrolling in the “wrong” MCO could make it difficult for you to be seen by that doctor if they are not part of the MCO Network Providers. Ensure that the MCO you choose is the best one for you!
Eligibility
To be eligible for Medicaid, you must be a Maryland resident and a U.S. citizen or qualified non‑citizen. Maryland has expanded Medicaid, which means more people qualify than in some other states. You may be eligible if you fall into one of these categories:
- Low income adults ages 19–64 without dependent children
- Parents or caretakers of minor children
- Children under 19
- Pregnant individuals
- People with disabilities
- Seniors (65+)
- Low-income, lawfully present immigrant with at least 5 years of residency unless you’re pregnant or under 19
New* Work Requirement (Ages 19-64)
Due to the recent One Big Beautiful Bill Act (also known as the Big Beautiful Bill Act) passing, there is now a new work requirement as of July 4th, 2025. According to AP News, experts estimate the passing of OBBBA will put upwards of 10 million adults and children at risk of losing health insurance.
If you are an able-bodied adult (not pregnant, not disabled, no children under 14 in your care), you must now complete at least 80 hours/month of work, job training, school, or community service. You must report your hours regularly to maintain coverage.
Who is exempt?
- Pregnant individuals
- Full-time students under 23
- People with a disability
- Parents of young children (under 14)
- Seniors (65+)
- People with serious health conditions
Missing work reports may result in losing your coverage, even if your income qualifies.
Income Limits
Your eligibility depends largely on your household size and income. These limits regarding assets and income are updated every year and are subject to various exceptions, so you are encouraged to apply even if you exceed the limit listed. Here are the monthly income limits for 2025:
Monthly Income Limit Effective January 1, 2025. Found here.
| Household Size | Adults | Children | Pregnant |
| 1 | $1,801 | $4,202 | N/A |
| 2 | $2,433 | $5,677 | $4,654 |
| 3 | $3,065 | $7,152 | $5,863 |
| 4 | $3,698 | $8,630 | $7,075 |
| 5 | $4,330 | $10,104 | $8,284 |
| 6 | $4,962 | $11,579 | $9,493 |
| 7 | $5,596 | $13,057 | $10,705 |
| 8 | $6,228 | $14,532 | $11,914 |
| + Each additional person cost | $632 | $1,475 | $1,209 |
For Seniors (65+), blind or disabled individuals, or individuals that are in a Home and Community-Based Service program, the following limits apply.
| Household Size | Income Limit | Asset Limit |
| 1 | $350 | $2,500 |
| 2 | $392 | $3,000 |
For those in the Employed Individuals with Disabilities (EID) Program, there are no income limits. There is a single household asset limit of $10,000. For more information, please see the Employed Individuals with Disabilities Program.
Even if you’re slightly over the limit, don’t give up, some programs still allow for partial coverage or medical spend-down.
Immigrant Families
As of July 4th, 2025, Lawfully present immigrants must now wait 5 years after the date of legal entry before being eligible for full Medicaid.
Exceptions:
- Pregnant individuals and children under 19 can still access limited or emergency Medicaid services immediately
Eligibility Renewal
You must renew every 6 months even if nothing has changed. You’ll receive a notice when it’s time to renew, and missing a deadline can result in automatic loss of coverage. You can sign up for text/email alerts through your Maryland Health Connection account to avoid missing deadlines.
Step-by-Step Application Process
There are various options for applying for Medicaid, including online, over the phone, or by working with a navigator in-person.
Applying online:
Step 1: Gather the necessary documentation/information
- Proof of household income
- Medical Assistance Card
- Pay stubs, Social Security award letter, unemployment letter
- Birthdates
- Social security numbers. Alternatively, if you are a legal immigrant, you can provide your document numbers
- Citizenship/immigration status
- Tax returns from recent years
- Employer and income information (W-2 form, pay stubs, etc.)
- If you currently have health insurance, be prepared to provide your policy number
- Employer-sponsored coverage that members of the household are currently eligible for
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