ANNAPOLIS, Md. – Governor Wes Moore announced that the Maryland Insurance Administration launched a new resource to help Marylanders navigate health care coverage challenges that impact access to care. The new Health Coverage Assistance Team, known as H-CAT, will “walk with the consumer” to navigate health coverage questions or challenges, in addition to coordinating closely with other state agencies and organizations to use resources wisely and avoid duplicated efforts.
“Health care access is about much more than eligibility. We must move in partnership to ensure that Marylanders understand all of the resources available to them — and have the tools and guidance necessary to make informed decisions,” said Gov. Moore. “I am thrilled that we are launching this new initiative, which has the potential to set the standard for making health care more accessible in communities across the country.”
Through H-CAT, a trained staff member will provide direct, consistent and personal assistance, following the consumer’s case from initial in-take through resolution by H-CAT or other partners. H-CAT is available to provide information, assistance, and advocacy, if needed. The approach is designed to help consumers understand health coverage plans; how they work, what is covered, and how to use the benefits and health plan processes such as care authorizations, appeals, and complaints.
“The H-CAT team is dedicated to helping people navigate health care coverage issues, particularly with respect to mental health and substance use disorders,” said Maryland Insurance Commissioner Kathleen A. Birrane. “Too often, coverage challenges become barriers to compensated care for people who need it the most. H-CAT team members are there to help Marylanders work through those challenges and access the compensated care that is available to them.”
H-CAT will respond to consumer inquiries within one business day and will follow internal step-by-step protocols specific to different types of health coverage – whether or not the specific health plan is regulated by the Maryland Insurance Administration. H-CAT assistance includes:
- Providing a general understanding of how health plans works and what is covered— especially considering mental health parity and network adequacy requirements;
- Explaining the health plan’s role, resources and steps when consumers are unable to access a provider or treatment, or when it is too far away or the wait too long;
- Helping consumers work with their healthcare provider and health plan to get necessary referrals and authorizations for services or treatment, including behavioral health;
- Helping consumers understand and take the necessary steps when coverage or payment for health services—including medication prescribed—is denied;
- Coordinating seamlessly with other Maryland Insurance Administration units that provide consumer assistance regarding health coverage, including handling of complaints and appeals and, where appropriate, informing market conduct interactions between the Insurance Administration and health carriers;
- Informing consumers who lack legal documentation of available health coverage and connection to community health care resources that offer affordable care or other services; and
- Working cooperatively with other units of state government, such as the Maryland Health Benefit Exchange and the Health Education and Advocacy Unit of the Office of the Attorney General, that provide specific forms of relevant assistance.
“I am pleased to see the coordination between government agencies and consumer advocacy groups in an effort to assist consumers in gaining access to coverage of all of their health care needs, while providing a focused emphasis on behavioral health,” said Maryland Senate President Pro Tempore Malcolm Augustine. “H-CAT, which ‘walks alongside the consumer,’ provides the type of assistance and support — specifically, explaining the process — that many Marylanders have requested.”
“I am truly excited about the launch of H-CAT and the assistance the team will provide to Marylanders with their health coverage issues and concerns,” said Maryland House of Delegates Health and Government Operations Committee Vice Chair Delegate Bonnie Cullison. “Over the years, we have all heard the stories from individuals that need help navigating the health coverage system, H-CAT will provide the expertise so that they don’t have to navigate it alone.”
Marylanders may contact H-CAT directly by visiting the H-CAT webpage, via email at hcat.mia@maryland.gov or by calling 410-468-2442.
