![[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, Center for Autism, Kennedy Krieger Institute, 3901 Greenspring Ave., Baltimore, Maryland]](/msa/mdmanual/36loc/bcity/images/1198-1-4397b.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.
Since 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) Food 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 had helped to pay for prescriptions, insulin, and certain medical supplies for low-income individuals who were not eligible for Medicaid.
HEALTHCHOICE
MEDICARE
Medicare is the federal government's health insurance program for Americans 65-years old or older and for those with certain disabilties.
PRIMARY ADULT CARE PROGRAM (includes PHARMACY ASSISTANCE)
Effective July 1, 2006, the Maryland PrimaryCare Program combined with the Maryland Pharmacy Assistance Program to create the Primary Adult Care Program. The new program provides primary care and outpatient mental health services in addition to prescription drugs to Maryland residents aged 19 to 64. Eligibility for the Program is limited to residents not eligible for Medicare, and for those whose annual income falls at or below the federal poverty level. Enrollees receive primary care and most of their prescriptions through managed care organizations (MCOs). Those formerly enrolled in the Maryland Pharmacy Assistance Program or the Maryland PrimaryCare Program, automatically were enrolled in the Primary Adult Care Program.
![[photo, Robert H. & Clarice Smith Building, Wilmer Eye Institute, Johns Hopkins Hospital, North Broadway, Baltimore, Maryland]](/msa/mdmanual/01glance/health/images/1198-1-4611.jpg)
RENOWNED HEALTH-CARE INSTITUTIONS
In Baltimore are The Johns Hopkins Hospital and The Johns Hopkins University School of Medicine; the University of Maryland Schools of Dentistry, Medicine, Nursing, and Pharmacy; and the private University of Maryland Medical System, which serves as the primary teaching hospital for the University of Maryland School of Medicine and includes the R Adams Cowley Shock Trauma Center, a regional facility for trauma management.
Robert H. & Clarice Smith Building, Wilmer Eye Institute, Johns Hopkins Hospital, North Broadway, Baltimore, Maryland, September 2010. Photo by Diane F. Evartt.
![[photo, Pavilion, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., Baltimore, Maryland]](/msa/mdmanual/36loc/bcity/images/1198-1-2516.jpg)
In Bethesda is the National Institutes of Health of the U.S. Department of Health and Human Services.
Pavilion, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., Baltimore, Maryland, October 2007. Photo by Diane F. Evartt.
© Copyright May 25, 2011 Maryland State Archives