The Maryland Health Insurance Plan, commonly called MHIP, is a health insurance option for individuals considered uninsurable, primarily due to a pre-existing condition. A state-managed program, MHIP administration is through CareFirst BlueCross BlueShield and CareFirst Blue Choice. MHIP plans provide medical coverage, prescription and behavioral health benefits. The goal of MHIP is to provide an affordable insurance option to a high-risk pool, thereby reducing the number of uninsured. According to the Maryland Department of Budget and Management's 2009 fiscal-year-end report, MHIP enrollment is 21,740 individuals.
Eligibility Requirements
Individuals must be Maryland residents to qualify for MHIP. In addition, you must meet at least one other criterion. Examples of criteria include: inability to obtain health insurance because of a pre-existing condition; current insurance disallows coverage or costs more due to a specific condition; moving from another state where you were covered under a high-risk pool; or you meet eligibility for the 65 percent Health Care Tax Credit. The MHIP+ plan is available to individuals with low or moderate income, offering lower premiums and out-of-pocket costs than MHIP.
Plan Options
There are four basic MHIP plans. Each plan provides different premiums and out-of-pocket costs. MHIP offers a Health Maintenance Organization (HMO), a Preferred Provider Plan (PPO) with a $500 deductible, a PPO with a $1,000 deductible and a High Deductible Health Plan (HDHP) with a $2,600 deductible. There is also the HDHP MHIP Federal plan with a $1,500 deductible. Lastly, there are three MHIP+ plans: an HMO, a PPO with a $200 deductible and a PPO with a $500 deductible.
Plan Premiums
Monthly premiums, the amount you are billed for MHIP coverage, are based on the benefit options you select and the age of the oldest individual covered, according to the MHIP website. A board of directors sets the premiums and they have the right to change those amounts during the plan year. MHIP will notify you in writing of any changes. Premium payment is due by the first of each month and can be automatically withdrawn from your checking account if you choose.
Apply
You can apply for MHIP through an insurance agent or by obtaining the enrollment application from the MHIP website. The website allows you to print the application and provides information about premiums and plan types. Once you decide which plan to apply for, complete the enrollment form and attach proof of Maryland residency and any other eligibility verification as specified in the application and mail it to the address listed on the application. MHIP will not accept faxed or emailed applications. Enrollment is on the first of each month and determined by the approval date of your application.
Pre-Existing Condition
MHIP accepts individuals with pre-existing conditions into the plan; however, there is a six-month waiting period before services related to that condition will be paid. According the MHIP 2010 Plan Year Certificate of Coverage, pre-existing conditions encompass diagnosis, advisement of or care received for a medical condition within a six-month period prior to the effective date of MHIP coverage. Exceptions include newborn baby, newly adopted child, individual with three months of prior creditable coverage and an individual covered under HIPAA rules who applied for coverage within 63 days of losing prior insurance. MHIP will notify you in writing if they deem you to have a pre-existing condition. At the time of applying, you may purchase an endorsement to waive the pre-existing condition waiting period.
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