Medical Benefit Questions

  1. How long must I be a resident of Maryland to qualify for Maryland Health Insurance Plan (MHIP)?
  2. What benefits are provided under Maryland Health Insurance Plan?
  3. As a new member how long will it take to receive an MHIP ID card?
  4. How do I notify MHIP to end my coverage and when will my MHIP coverage stop?
  5. Is a referral required to see a specialist?
  6. How do members change their Primary Care Provider (PCP)?
  7. How does a member get pre-authorization for services?
  8. What medical services require pre-authorization?
  1. How long must I be a resident of Maryland to qualify for the Maryland Health Insurance Plan (MHIP)?
    You must be a resident for at least six months to qualify for MHIP. However, the six-month residency requirement will not be applied to Maryland residents who qualify for MHIP because they have recently exhausted group coverage or to Maryland residents who apply for MHIP within 63 days of losing coverage under another state's (other than Maryland) high-risk pool.
  2. What benefits are provided under MHIP?
    For a summary of benefits offered through MHIP click here. For a list of benefits offered through MHIP+ click here.
  3. As a new member how long will it take to receive an MHIP ID card?
    An MHIP ID card and a package of information will be sent to new members within 10 days of receiving enrollment information. If access to services is needed before receiving your MHIP ID card, please call Member Services at 443-725-1010 or 1-888-456-2024.
  4. How do I notify MHIP to end my coverage and when will my MHIP coverage stop?
    You must notify MHIP in writing of your intent to stop your MHIP coverage. If you notify MHIP in writing of your intent to terminate or cancel your MHIP coverage on or before the 15th of the month, then the cancellation will become effective at the end of that month. If you notify MHIP in writing of your intent to cancel coverage after the 15th of the month, then the cancellation is effective at the end of the next month. Please remember that MHIP WILL NOT provide premium refunds for voluntary terminations where coverage was provided.
  5. Is a referral required to see a specialist?
    If you selected the MHIP Preferred Provider Organization (PPO) coverage, specialists can be seen without a referral. If a member selected the MHIP HMO plan, a Primary Care Provider (PCP) is required to provide a referral before the member can see a specialist.
  6. How do members change their Primary Care Provider (PCP)?
    A new PCP can be selected by calling Member Services at 443-725-1010 or 1-888-456-2024.
  7. How does a member get pre-authorization for services?
    For information on pre-authorization, call member services at 443-725-1010 or 1-888-456-2024. Remember, the member is responsible for making sure that any necessary pre-authorization for service is obtained before receiving that service.
  8. What medical services require pre-authorization?
    If you have any questions about pre-authorization, please contact Member Services at 443-725-1010 or 1-888-456-2024 so that we can discuss the specifics of your situation.

Resources

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CareFirst BlueCross BlueShield CareFirst BlueChoice

MHIP is administered by CareFirst BlueCross BlueShield and CareFirst BlueChoice, independent licensees of the BlueCross BlueShield Association.