Maryland Children's Health Program (MCHP)
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. The Maryland Children’s Health Program (MCHP) began in July 1998. MCHP uses federal and state funds to provide health care coverage to low-income children.
Who is eligible for MCHP?
Those eligible for MCHP are children under age 19, who are not eligible for Medicaid, whose modified adjust gross income is at or below 200% of the federal poverty level (FPL); and who are uninsured.
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
How do I apply?
Starting October 1, 2013, you can apply for MCHP through Maryland Health Connection. If you or your child is found eligible for MCHP, you can select an MCO right away. Coverage will go into effect on January 1, 2014.
You can also call 1-855-MHC-8572 (1-855-642-8572) to apply over the phone. You can also visit your Local Health Department, Local Department of Social Services, or Connector Entity to get help with applying for coverage.
If you need coverage before January 1, 2014, you should fill out this application. The application is brief and the process is simple. The application asks for:
- General Information (such as Name, Address, Telephone Number),
- Any health insurance coverage,
- Information about family members (such as names and birth dates)
- Social Security numbers of applicants,
- Sources and amounts of family income.
Local Health Departments will mail applications on request. Also, applications are available at:
- Local Departments of Social Services
- WIC Centers
- Local hospitals and schools
Applications can be completed at home and mailed in or dropped off at any local health department. Case managers are available to assist you there. Those found eligible for MCHP will receive an enrollment packet in the mail to select a 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?
You can get more information at your Local Health Department. You can also call the DHMH MCHP Hotline at (800) 456-8900 or TDD for the Disabled (800) 735-2258.
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, fact sheets and the application form 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 a 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