Medicaid (Medical Assistance)

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

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.

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 residentialday servicessupported 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 Arrangementor 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.

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