MedicaidAdministrativeMedium impact
Amendment to the HealthChoice Regulations Regarding Automatic Disenrollment of MCO Enrollees at age 65 or Older
Maryland Medicaid·MD·General Provider
Effective date
Jan 1, 2001
We identified it
Jun 20, 2026
Summary
Maryland Medicaid will automatically disenroll all members age 65 and older from managed care organizations (MCOs) and place them in fee-for-service Medicaid until they become Medicare eligible. Providers must be prepared to bill Medicaid directly for these transitioning members and eventually coordinate Medicare crossover billing.
Action Required
Immediately: Billing team must verify Maryland Medicaid members age 65+ are no longer enrolled in MCOs and bill Medicaid fee-for-service directly using red and white Medical Assistance cards. Contact Ms. Cheryl Gresham at (410) 767-6033 to link to Medicare crossover file for automatic claim processing once patients become Medicare eligible. Monitor for Medicare eligibility changes and bill Medicare first when patients receive Medicare cards.