Baltimore City Fire Department personnel assisting injured football player, Patterson Park, Baltimore, Maryland, September 2014. Photo by Diane F. Evartt.
Johns Hopkins Hospital, 600 North Wolfe St. (view from Broadway), Baltimore, Maryland, April 2008. Photo by Diane F. Evartt.
Pavilion, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., Baltimore, Maryland, October 2007. Photo by Diane F. Evartt.
Center for Autism, Kennedy Krieger Institute, 3901 Greenspring Ave., Baltimore, Maryland, May 2010. Photo by Diane F. Evartt.
Wilmer Dome, Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe St., Baltimore, Maryland, September 2006. Photo by Diane F. Evartt.
Calvert County Health Department, 975 Solomon's Island Road North, Prince Frederick, Maryland, July 2008. Photo by Diane F. Evartt.
To allow instantaneous sharing of patient records between hospitals and the patient’s primary care physician, the federal government awarded grants to all states and territories in an effort to create a medical information-sharing digital network. In February 2012, Maryland became the first state to connect all acute-care hospitals within its borders under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.
To provide Marylanders with high quality, affordable private health plans at competitive prices, the Maryland Health Benefit Exchange administers the State-based health insurance marketplace called Maryland Health Connection. Opened to enroll individuals on October 1, 2013, Maryland Health Connection helps individuals purchase qualified health plans in the individual insurance market.
Open enrollment began on November 1, 2019 and ended December 15, 2019 for individual coverage starting January 1, 2020. During the open enrollment period, consumers evaluated their health insurance options, including an estimate of financial assistance, on the Exchange website (www.marylandhealthconnection.gov). The next open enrollment period will begin Nov. 1, 2020 and will end on Dec. 15, 2020 for individual coverage starting January 1, 2021.
Since April 1, 2014, small business owners also have been able to enroll their employees in health insurance plans certified under the Small Business Options Program (SHOP). Employers with from one to fifty employees may purchase insurance plans directly from a carrier, a third-party administrator, or a broker, and, for those who are eligible, receive federal small business tax credits.
The Exchange provides comprehensive information on qualified health plans, and an electronic calculator to compute the actual cost of coverage, factoring in all variables, such as tax credits and cost-sharing. To assist consumers seeking to enroll in Medicaid or other health insurance plans, the Exchange maintains a network of certified navigators who help enrollees find and purchase a suitable plan.
Robert H. & Clarice Smith Building, Wilmer Eye Institute, Johns Hopkins Hospital, North Broadway, Baltimore, Maryland, September 2010. Photo by Diane F. Evartt.
Within the Maryland Deparment of Health are health-care institutions for those with developmental disabilities, the chronically ill and elderly, and the mentally ill.
The Medical Assistance Program, known as Medicaid, is a joint federal and state program that provides health and long-term care coverage to low-income people. In Maryland, Medicaid is overseen by the Medical Assistance Program of the Maryland Deparment of Health, and on the federal level by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services.
Eligibility for Medicaid is determined by local departments of social services. To apply for Medicaid, Maryland residents visit their county or city department of social services. There, they are interviewed and submit an application. Generally, those who are either older than age 65, under age 21, disabled, blind, or caring for a child whose parent is unemployed, sick, or deceased are eligible for benefits.
Since March 2000, approximately 85% of qualifying Medicaid recipients are required to join one of eight State-regulated Managed Care Organizations (MCOs). Exceptions are made for those who receive long-term care, certain mentally fragile children, or for the mentally handicapped, among others.
As of December 2018, some 1.14 million people were enrolled in Medicaid and 156,666 children were in the Maryland Children's Health Program (MCHP). About one in five of Maryland's residents were enrolled in Medicaid and MCHP.
MARYLAND MEDICAID PHARMACY PROGRAM
A variety of major programs are offered through HealthChoice. Local health departments identify and enroll Medicaid recipients with special needs or disabilities (such as diabetes, homelessness, alcoholism, or drug addiction) into appropriate programs. One-on-one assistance is available for those who require it.
Additional State-sponsored services include infant and reproductive care through the Maternal and Child Health Bureau, nutritional assistance offered by the Women, Infants and Children (WIC) Food Program, and medical care for children through the Maryland Children's Health Program.
To investigate and mediate disputes, health departments act through the Ombudsmen Program to handle enrollees' complaints. Concerns also may be addressed through the HealthChoice Enrollee Action Line at 1-800-284-4510 (toll free).
The Rare and Expensive Case Management Program and the Stop Loss Case Management Program focus on patient needs and expenses that are not covered by Managed Care Organizations.
Initiated in 1978 as the Pharmacy Assistance Program, the Maryland Medicaid Pharmacy Program helps to pay for prescriptions, insulin, and certain medical supplies for low-income individuals who are not eligible for Medicaid. The Program is assisted by the Medicaid Pharmacy and Therapeutics Committee.
HEALTHCHOICE
Created in 1997, HealthChoice is the program that places Medicaid recipients into Managed Care Organizations (MCOs). These organizations provide group insurance that covers medical services at select hospitals and clinics participating in HealthChoice and are responsible for meeting nearly all of the recipients' medical needs, except for mental health services and other specific care. Mental health services are provided by the Specialty Mental Health System, which is administered by the Behavioral Health Administration.
MEDICARE
Authorized in 1966, Medicare is the federal government's health insurance program for Americans age 65-years old or older, and for those with certain disabilties, or with permanent kidney failure (end-stage renal disease), requiring dialysis or kidney transplant. Application for Medicare is made through the federal Social Security Administration.
Johns Hopkins Hospital main entrance, Orleans St., Baltimore, Maryland, March 2019. Photo by Diane F. Evartt.
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