Eligibility Requirements for MHIP Plans
MHIP
An individual is eligible to enroll in MHIP if the individual is a resident of Maryland and meets one of the following requirements:
- has a medical or health condition that is included on a list of conditions adopted by the Board of Directors for MHIP by regulation;
- has been denied health insurance coverage for medical reasons within the last six months;
- is enrolled in, or has been offered, individual health insurance that:
- limits, restricts or blocks coverage for a specific medical condition; or
- has benefits similar to MHIP’s benefits but costs more due to a health condition;
- has federal guaranteed-issue rights under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 due to loss of group coverage;
- is eligible for the 65 percent Health Care Tax Credit under §35 of the Internal Revenue Code;
- is transferring from a high-risk pool in another state; or
- is a dependent of an individual who is eligible for coverage.
MHIP Federal
An individual is eligible to enroll in MHIP Federal if the individual is a resident of Maryland and meets the following requirements:
- is a citizen or national of the United States or lawfully present in the United States;
- has not had health insurance for a continuous six-month period of time immediately prior to the date of application to the federal high risk pool program; and
- meets one of the following criteria:
- has a medical or health condition that is included on a list of conditions adopted by the Board of Directors for MHIP by regulation;
- has been denied health insurance coverage for medical reasons within the last six months;
- is enrolled in, or has been offered, individual health insurance that:
- limits, restricts or blocks coverage for a specific medical condition; or
- has benefits similar to MHIP’s benefits but costs more due to a health condition.
MHIP+
MHIP+ provides discounted premiums and, in some cases, cost sharing to individuals with limited income. An individual is eligible for MHIP+ if the individual meets both of the following requirements:
- is eligible for MHIP; and
- has annual household income that meets the guidelines shown on the MHIP+ application form.
Resources:
A summary of each of the benefit options is contained in the MHIP Application Booklet. A detailed explanation of MHIP's coverage is contained in the Certificate of Coverage.
To apply for:
- MHIP, you must complete the MHIP Enrollment Application.
- MHIP Federal, you must complete the MHIP Enrollment Application and the MHIP Federal Application.
- MHIP+, you must complete the MHIP Enrollment Application and the MHIP+ Application.
Resources
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MHIP is administered by CareFirst BlueCross BlueShield and CareFirst BlueChoice, independent licensees of the BlueCross BlueShield Association.
