If you qualify for Medicaid because you receive payments from either Supplemental Security Income (SSI) or Temporary Cash Assistance (TCA), or as a result of the Medicaid application process, you would likely be eligible for HealthChoice. HealthChoice enrollment is administered by the DHMH’s contracted Enrollment Broker.  The Enrollment Broker handles outreach, education and the enrollment of all eligible beneficiaries.  If eligible for HealthChoice, you will be sent materials regarding each MCO available in your county of residence so that you can choose your own provider. The information packet that you receive will include:

• the names and addresses of participating providers;
• a schedule of the benefits offered, including any benefits offered beyond the basic required package;
• a narrative description of the clinical expertise and experience of the MCO’s network for special needs populations;
• any forms necessary to select an MCO (including a health risk assessment form);
• and the toll-free telephone number of the enrollment unit.

The Enrollment Broker is available to assist you with any aspect of the enrollment process. You may enroll by mail, telephone, and face-to-face meeting, if requested, or if medically necessary. For assistance in making an application for HealthChoice, please contact the HealthChoice Enrollment Line at (800) 977-7388.  You may call Monday-Friday 7:00 a.m.- 7:00 p.m.

If you are an MCO eligible beneficiary, you have 21 days to select an MCO from the day the Department mails its eligibility notification and information packet to you. If the recipient is a child in foster care or kinship, you have 60 days. If you do not pick an MCO, the State will pick one for you. If you select a specific primary care provider when you choose your MCO, the MCO is advised of this choice. Within 10 days of the effective date of enrollment, an MCO will notify the enrollee of their Primary Care Provider (PCP) assignment.

If you are new to the Program, you will be issued a fee-for-service Medical Assistance card to use until you are actually enrolled in the MCO that you select and you receive your HealthChoice card with a new member enrollment packet.

The Health Risk Assessment is a series of questions which is used as part of the HealthChoice enrollment process to identify people who may need immediate care because of their health problems. The health risk assessment is completed at the time of enrollment or within 5 days of enrollment. The information is transmitted to your MCO within 5 business days. The MCO is responsible for ensuring that if you are a new enrollee who needs special or immediate health care services, you receive them in a timely manner.                       

An MCO enrollee may elect to change MCOs annually, on the anniversary date of initial enrollment in an MCO.

Enrollee-initiated Dis-Enrollment for Cause occurs:

• when an enrollee moves to another county;
• to maintain the family unit;
• when special provisions involving children in State-supervised care or children in foster care need to be made; or
• to maintain continuity of care with their PCP when the PCP’s contract with the enrollee’s MCO, MCO’s management group or it’s subcontractor is terminating for reasons specified in COMAR 10.09.63.06.

 Department-initiated Dis-Enrollment occurs when an enrollee

• becomes institutionalized for more than 30 successive days in a LTC facility or an IMD institution;
• is institutionalized for more than a total of 60 days in a calendar year in an IMD;
• is admitted to an ICF-MR;
• is determined eligible for the REM program;
• or loses Medicaid eligibility. 

HealthChoice Enrollment Forms

-HealthChoice Enrollment Form
-HealthChoice Enrollment Form (Spanish)
-HealthChoice Enrollment Agreement
-HealthChoice Enrollment Agreement (Spanish)
-HealthChoice Health Services Need Form
-HealthChoice Health Services Need Form (Spanish Version)