What is MCHP?
The Maryland Children’s Health Program (MCHP) gives full health benefits for children up to age 19. MCHP enrollees obtain care from a variety of Managed Care Organizations (MCOs) through the Maryland HealthChoice Program.
Who is eligible for MCHP?
Those eligible for MCHP are uninsured children under age 19, whose household modified adjusted gross income (MAGI) is at or below 211% of the federal poverty level (FPL) for their family size. In 2020, this was about $4,608/month for a family of four).
Uninsured children under age 19 may qualify for MCHP Premium if their household income is above the MCHP income guidelines but is at or below 322% of the federal poverty level for their family size. In 2020, this was about $7,032 for a family of four. MCHP Premium requires a small monthly premium per family. Effective 2020, the premium is either $57 or $71, depending on your household income.
For questions about your premium payment, please contact the MCHP Premium Unit at 410-767-6883 or 1-866-269-5576.
To find the income level for your family size, see the MCHP income guidelines.
Benefits for children include:
- Doctor Visits (well and sick care)
- Hospital Care
- Lab Work and Tests
- Dental Care
- Vision Care
- Immunizations (shots)
- Prescription Medicines
- Transportation to Medical Appointments
- Mental Health Services
- Substance Abuse Treatment
For a full listing of benefits, see the HealthChoice MCO comparison chart.
How do I apply?
You can apply for MCHP in the following ways:
Those found eligible for MCHP will receive an enrollment packet in the mail to select an MCO for health care.
Can I apply for my grandchild (or niece, brother, etc.), if they live with me?
Yes, if neither of the applicant’s parents live with the child. Your income would not be counted toward determining the applicant’s eligibility unless you have adopted the child.
When can I see a doctor?
If you are eligible for MCHP:
- Within 14 days, you will receive a red and white Medical Assistance card. You may use this card to get health care until you enroll in the HealthChoice program and select a MCO. Do not throw away this card, it will allow you to obtain additional services even when you receive your MCO card.
- Within 5 days, you will receive your enrollment packet to select your MCO. If you do not receive your enrollment packet within two weeks, contact your case manager immediately.
When you receive your enrollment packet in the mail, you will:
- Find out from your doctor which MCO plans they accept;
- Pick a MCO and primary care doctor to provide your care. If you do not pick a MCO, the state will pick one for you;
- Inform HealthChoice which MCO and doctor you have selected;
- Contact the doctor for an appointment.
How can I obtain more information?
For more information, call Maryland Health Connection at 1-855-642-8572 (Deaf & Hard of Hearing Use Relay Service).
Information For Medical Providers
What can providers do to help patients who might qualify for MCHP?
- Inform your patients about MCHP and encourage them to apply if they think they may be eligible, or if there are older siblings in the family who may qualify;
- Make available brochures and fact sheets to anyone who needs health insurance. These materials can be obtained from the Local Health Departments;
- Tell your patients all of the MCOs with which you participate. Explain to your patients that they need to choose an MCO and you as their primary care provider when they enroll.
- Urge your patients to keep their addresses up to date with you and their Local Health Department; and
- Primary Care Providers should always check the Eligibility Verification System (EVS) to obtain their patients’ MCO and eligibility status at the time of appointment. The number to call is 1-866-710-1447