Program Benefits

Dental care ER visits Healthcare provider visits Hospital delivery Immunizations Lab work / tests Mental health OB / GYN visits

Physical therapy Pregnancy related medical bills from 3 months prior Prescriptions Program benefits Specialist care Substance abuse Vision care

Also enrolled in Family Planning Program after delivery:

Birth control choices HIV and STD tests

Pap tests Pelvic exams

Qualifications
Must be:
U.S. Citizen, permanent resident, or refugee / asylee

Must meet income requirements:(Income Guidelines Effective March 1, 2012)

Income Limit	2-Person Family	3-Person Family	4-Person Family	5-Person Family	6-Person Family
Yearly	$37,825	$47,725	$57,625	$67,525	$77,425

How to Apply

• Print an MCHP Application Form 

                     In English

                  En Espanol

• Call (800) 456-8900 or (301) 600-8888. Ask for a MCHP application form; or
• Apply online at www.marylandsail.org
• Make sure to put your phone number on your form so someone can contact you if they have questions.
• Mail in your completed application form to the Frederick County Health Department:
• Frederick County Health Department
• The Health Care Connection
• 350 Montevue Lane
• Frederick, MD 21702

Information needed to Apply

• Names, birth dates, social security numbers of family members (Guardians and their dependents)
• Proof of US citizenship or residence (Birth certificate; passport; naturalization papers; affidavits)
• Sources and amount of income
• State-issued photo identity card (Driver's license or MVA ID)

Once You Have Been Approved
Review the letter provided to recipients of MA

For more information, visit the Maryland Department of Health and Mental Hygiene website or call The Health Care Connection at FCHD at (301) 600-8888.