Medical Assistance for Families Program, MCHP and PAC Darlene Toms, Supervisor-Grant Manager FCHD-MA Eligibility Unit

New Health Care for More Families! o Working Families and Small Business Health Coverage Act – Senate Bill 6 Expanded Medical Assistance eligibility to parents and caregiver relatives with dependent children Medical Assistance for Families (MAF) Program will cover parents and caregiver relatives with incomes up to 116% of the FPL (this limit was 30% FPL) For a family of 4, the income limit is $2131 monthly Assets are not counted

Who’s Covered? o Parents and relative caregivers of children Must be taking care of children in their household under age 21 Relative caregiver by relative, marriage, or adoption o Adults aged 19 and up o Adults on Medicare or other Employee Based Program Will be considered a secondary health insurance and can be applied for premiums, co-payments, and deductibles (will not cover prescriptions for recipients of Medicare Part D)

What Application Should Be Used?  A new, shorter MA only application will be available – the application will be combined with MCHP  A person should use the MCHP/MA application if they are: A parent(s) or child(ren) applying for Medicaid A relative caregiver A child applying for Medicaid only A pregnant woman applying for Medicaid only

Who Should Not Use the New Application? An Aged, Blind, or Disabled (ABD) individual(s) applying for Medicaid (use the 9702 application) A person who wants to apply for Medicaid as well as additional programs such as TCA, Food Stamps, etc. (use the 9701 application) A person applying for PAC (use the PAC application)

How Do I Apply For MAF/MCHP?  Visit us at 350 Montevue Lane – Entrance B Monday, Wednesday, Friday – 8:00 am-4:30 pm Tuesday – 9:00 am – 12:00 pm or Thursday – 2:00 pm – 4:30 pm  Call or the MA Eligibility Unit at FCHD at to have an application mailed & fax back to us at  On-Line through the FCHD website, State website or SAIL (Service Access Information Link) website at:   

How Do I Apply For PAC? o Call for an application o On-line through the State website at: o Call or visit the Frederick Community Action Agency 100 S. Market Street –

How Long Does it Take?  Eligibility Processing Time FCHD has 10 working days from the date of application LDSS has 30 calendar days from the date of application Face-to-Face interview is no longer mandatory

What Information Is Needed To Apply? oInformation about family members (such as names and birth dates), oProof of Citizenship and Identity for all family members applying, For a list of ways to prove citizenship and identity, see: oSocial Security numbers of all family members applying for health care, oSources and amounts of family income – Declaratory (do not need proof) but may be asked to provide if there is a discrepancy Information on assets is not needed for MCHP or the MAF Program

Additional Information Needed to Apply? oInformation on any other health insurance coverage that you or your family might have A person can have health insurance and still apply, however, if their income is at 185% or above the children will not be eligible for the MCHP. oChild care/day care expenses - declaratory oIf found over income for MAF the case is forwarded to LDSS for Spenddown and this information will then be required Verification of assets Verification of any medical bills for spend down

What Is Covered? PAC vs Medical Assistance for Families PAC benefits include (yellow & white card):  Free outpatient visits to a mental health provider  Lower-priced or no-cost prescription drugs  Once they become active in an MCO they will get an MCO card, then they are able to access their PCP for routine care  They can receive all of the services that are covered by the Maryland Family Planning Program except sterilization (tubal-ligation)  Some MCO’s offer more services than others, such as dental services and eye exams ***PAC does not pay for hospital stays, emergency room visits, or specialty care.

What Is Covered? PAC vs Medical Assistance for Families Medical Assistance for Families offers PAC benefits and:  Specialty care  X-ray and lab services  Hospital services  Emergency Services  Physical Therapy  OB/GYN care for women  Outpatient treatment for drug and alcohol abuse  Targeted case management for HIV-infected individuals  Home health services  Hospice services  Transportation services  Eye exams (Eye Glasses for beneficiaries under 21)  Dental services for beneficiaries under 21

What If Someone Already Has PAC?  Previous PAC recipients with children will be redetermined to see if they qualify under MAF  Clients will remain on the same MCO and have the same doctor. Families can be united in one MCO.  If a client does not have a dependent child on MCHP/Medicaid, they will stay on PAC  If a client has a dependent child, but not enrolled in MCHP/Medicaid, they will need to apply for the child

What Is A Family Unit?  A natural or adoptive parent must be included in the Family Unit with his/her own child unless: The parent is a minor living with his/her own parent or parents. The parent is the spouse of a caregiver stepparent and the stepparent is excluded. The parent is a SSI recipient  Child(ren) may be excluded from the family unit as long as at least one child remains in the unit with the parent.  A caregiver relative may be included with other family members.  In a three generation family, the grandparent(s) or minor parent should be included in the family unit and both must sign.  Married persons under 21 who are living with their parents or caregiver relative are a separate family unit.

What If We Make Too Much Money For The Free Program?  If the total household income exceeds 200% of the FPL the child(ren) can still be eligible in the MCHP Premium Program  When applying for MCHP they must indicate on the application that they are willing to pay a premium each month  The child(ren) can not have any other health insurance  The child(ren) will have the same medical benefits as the child(ren) in the free program

Family Income Guidelines Family Size Maximum Family Income Limit, Effective March 1, 2009 Children Pregnant Women (Family Size includes Unborn Child) 1$ 21,660 2$ 29,140$ 36,425 3$ 36,620$ 45,775 4$ 44,100$ 55,125 5$ 51,580$ 64,475 For each additional family member add  $ 7,480$ 9,350 MCHP Premium Family Size Maximum Family Income Limit, Effective March 1, 2009 Children above 200% through 250% FPL Children above 250% through 300% FPL 1$ 27,075$ 32,490 2$ 36,425$ 43,710 3$ 45,775$ 54,930 4$ 55,125$ 66,150 5$ 64,475$ 77,370 For each additional family member add  $9,350$ 11,220 You Pay  $48$60

Questions?  Call the Medical Assistance Hotline: (800) or TDD for the Disabled: (800) or visit the website at:  Call FCHD – MA Eligibility Unit at or ACCU – (with questions about providers and benefits) o Visit our website at

Informational Handouts  Selected Health Coverage Initiatives At a Glance  Monthly Income and Asset Guidelines for Maryland Medical Care Programs