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Medicaid
What
is Medicaid?
Medicaid, also known as Medical Assistance is a joint
federal-state health insurance program administered
by the state. It is designed to assist people with low
incomes and people with disabilities. It pays for a
wide variety of health care services and prescriptions.
Who
is eligible?
You will usually qualify for Medicaid if you qualify
for Supplemental Security Income (SSI). You can also
qualify if you have a low income or if you are an adult
with a disability that significantly limits your ability
to work. Children are eligible for Medicaid based on
the family’s income.
How
do I obtain services?
To apply for Medicaid, contact the Prince George’s
Department of Social Services at (301) 909-2000 or www.dhr.state.md.us/pgcounty.htm.
What
types of services does Medicaid provide?
Medicaid will pay for most health services that are
deemed medically necessary by your primary physician,
who must be a Medicaid vendor. He or she will refer
you to other vendors. Medicaid will pay for prescriptions,
diapers for older children and adults, transportation
to medical appointments, a personal care aide to assist
with hygiene skills at home, and some day treatment
programs.
What
is the Medicaid Waiver Program?
Medicaid Home and Community-Based Service Waivers provide
a community-based alternative to institutional care
for people who are Medicaid-eligible. The waivers serve
adults and children with developmental disabilities
who qualify for Medical Assistance. Under the waivers,
Medicaid eligibility is based exclusively on the applicant’s
income and assets, not the family’s. There are
often limits to the number of people each program can
serve, so even if you are eligible, you may be put on
a waiting list. For answers to frequently asked questions
about the waiver go to: http://www.ddamaryland.org/waiver.htm#waiver.
What are the different Waiver Programs in Maryland?
Community
Pathways
Community Pathways allows the state of Maryland to use
Medicaid dollars to pay for services for people with
developmental disabilities outside institutions. This
waiver covers services such as residential,
day services,
supported
employment services, and Community
Supported Living Arrangements (CSLA). Call the DDA
at 301-362-5100.
The
Model Waiver
The Model Waiver for Medically
Fragile Children allows the state of Maryland to
pay for extensive medical services in a child’s
home rather than in a hospital. Call the Coordinating
Center at 410-987-1048.
The
Autism Waiver
The Autism Waiver
is designed to help children with autism spectrum disorder
receive specialized services, such as intensive individual
support services, therapeutic integration and residential
habilitation. Call the Autism Waiver office at 301-925-7050.
New
Directions Waiver
The New Directions Waiver allows families to take their
funds from an existing program, such as Community
Supported Living Arrangement or Individual Support
Services, and use these funds more creatively. Families
have much more autonomy in determining how the funds
should be spent to benefit the person with a disability.
Families must develop an intensive person-centered plan,
utilize a support broker and a fiscal intermediary.
For more information call 410-767-5636 or go to http://www.ddamaryland.org/waiver.htm#newdirections.
What
other information is available?
The
Maryland Disability Law Center publishes guides on medicaid.
Click
here to read about Accessing Services through Medical
Assistance/Medicaid.
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