Background

In 2005, states were given the option to establish health benefit packages (known as alternative benefit plans - ABPs) for specific groups of Medicaid enrollees, as long as those alternative benefit plans met certain coverage requirements and were actuarially equivalent to a benchmark plan selected by the state. This allowed states to bypass certain Medicaid requirements like freedom of choice or statewideness for a subset of Medicaid enrollees. 

In 2010, the Affordable Care Act (ACA) required states who participated in the expansion to establish an ABP for the ACA expansion population. Additionally,  the ACA further expanded requirements for ABPs by requiring them to cover ten essential health benefits (EHBs). Although states could have multiple ABPs, Maryland only has one, for the ACA expansion population. 

Some states, including Maryland, have expanded this required ABP to encompass all benefits available under the Medicaid State Plan. Each year, the Maryland Department of Health (the Department) must update the ABP to include all new and updated benefits available, and demonstrate that the state ABP meets all Centers for Medicare and Medicaid Services (CMS) requirements. 

This site serves to provide information and updates regarding Maryland's ABP.​ 

To review the current ABP, go to Attachment 3.1L of the Maryland Medicaid State Plan here.

For more information on Alternative Benefit Plans click here.​

​Current Alternative Benefit Plan Updates

2026 - The Department is updating the State’s approved ABP to align with the authorized Maryland Medicaid State Plan, and will provide the same amount, scope and duration of the benefits therein, with the exception of habilitative services. The ABP coverage will be updated to include newly covered services as well as updates to existing services authorized in Maryland's Medicaid State Plan. This includes:

• Adult Hearing Aids and Cochlear Implants
• Community First Choice
• Community Violence Prevention services
• Doula Services
• Home Visiting Services
• Home and Community Based Services
• Lead Paint Risk Assessor
• Medication-Assisted Treatment (MAT)
• Mobile Crisis Intervention
• Behavioral Health Crisis Stabilization Center Services
• Pharmacy billing for Medication Therapy Management
• Substance Use Disorder Certified Peer Support Services
• Targeted Case Management Services: Care Coordination for Children & Youth
• Routine Patient Costs for Qualifying Clinical Trials
• School Based Services
• Targeted Case Management Services For People with Intellectual and Developmental Disabilities on DDA Waiting List
  

The public comment period for this update ended January 16, 2026. The proposed udpated pages have been submitted to CMS for approval.