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Full Answer
When do I become eligible for Medicaid in Maine?
Once one has met his or her spend-down, sometimes called a deductible, one becomes eligible for Medicaid for the remainder of the spend down period, which in Maine is a period of 6 months. Make note, the Medically Needy Pathway does not assist one in spending down extra assets for Medicaid qualification.
How do I know if I am enrolled in MaineCare?
After you submit your application, you will be contacted if any additional documents or information is needed. You will then receive a written notice indicating whether you have been enrolled in the MaineCare program. Note: The Office for Family Independence is responsible for processing MaineCare applications and determining eligibility.
How do I Look Up my Medicare eligibility information?
Each MAC offers its own Medicare online provider portal so that you can access real time information, anytime. You can look up eligibility information by entering the following information: Medicare Beneficiary Identifier (MBI) First and last name
How do I contact Maine State health insurance assistance program?
To see exactly what Maine law says on this issue, check out: Bureau of Insurance Rule 275 Section 11. For other questions about Medicare or Medicare Supplement policies, contact the Maine State Health Insurance Assistance Program at 1-800-262-2232 (within the state).
How do I find out if I still have MaineCare?
Talk with your health care provider or call MaineCare Member Services at 1-800-977-6740. TTY users, dial 711 (Maine Relay). To see if your medication is covered, call the Pharmacy Help Desk at -866-796-2463, TTY: 711.
What is the difference between MaineCare and Medicare?
In Maine, Medicaid is now called “MaineCare.” The situation is particularly confusing because the two programs have almost identical names. The distinguishing features of the two programs may help you understand the difference. Medicare is an entitlement program, while Medicaid is a welfare program.
What is the income limit for MaineCare?
You may be eligible for MaineCare if your monthly income (before you pay taxes) is up to:Your household sizeChildrenYoung Adults (19-20)1$2,413$1,8242$3,251$2,4573$4,088$3,0904$4,926$3,7241 more row
Is Maine Medicaid the same as MaineCare?
In Maine, Medicaid is called MaineCare. Medicaid is a health insurance program that provides insurance to people who have limited income and assets.
Can I have MaineCare and Medicare?
Elderly and disabled adults can have private insurance, Medicare, or Supplemental Insurance AND MaineCare.
How do I apply for Medicare in Maine?
You can enroll in Medicare Part A and/or Medicare Part B in the following ways:Online at www.ssa.gov/medicare.By calling Social Security at 1-800-772-1213 (TTY users 1-800-0778), Monday through Friday, from 7AM to 7PM.In-person at your local Social Security office.More items...•
What are the qualifications to get MaineCare?
Who is eligible for Maine MaineCare?Pregnant, or.Be responsible for a child 18 years of age or younger, or.Blind, or.Have a disability or a family member in your household with a disability, or.Be 65 years of age or older.
How much is MaineCare a month?
There is a monthly fee of $8-$64 depending on income and family size. Children remain eligible for coverage for 12 months. Full MaineCare Benefit 105% of FPL 1: $1,093 2: $1,480 3: $1,867 4: $2,254 Each additional person: $387 Must be residing with and caring for a dependent child under the age of 18.
Does Social Security count as income for MaineCare?
Income: Includes household money from sources such as Social Security, pensions, wages, alimony, self-employment, etc.
Do assets count for MaineCare?
Assets: Assets are only looked at for people who are 65 and older, or who have Medicare. Many assets will not count against you. You can own a home, land that the home is on, cars and many other assets and still get MaineCare coverage. Remember: Assets do not count for most people.
Does Maine have free healthcare?
MaineCare (Medicaid) MaineCare provides free and low-cost health insurance and other help affording health care for people who meet certain requirements, such as income, age, or medical condition. Learn more about MaineCare.
What is the income limit for MaineCare 2022?
This may include Medicare premiums, eyeglasses, dental services, and doctor visits. In 2022, the medically needy income limit (MNIL), also called a protected income level in ME, is $315 / month for an individual and $341 / month for a couple.
Does Maine have free healthcare?
MaineCare (Medicaid) MaineCare provides free and low-cost health insurance and other help affording health care for people who meet certain requirements, such as income, age, or medical condition. Learn more about MaineCare.
What is the difference between Medicare and Medicaid?
The difference between Medicaid and Medicare is that Medicaid is managed by states and is based on income. Medicare is managed by the federal government and is mainly based on age. But there are special circumstances, like certain disabilities, that may allow younger people to get Medicare.
Can I get Medicare Part B for free?
While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.
Can MaineCare take my house?
The Department of Health and Human Services (DHHS) can pursue recovery against not just the probate estate but against any legal interest the MaineCare recipient held at the time of death. Currently, the only exception is a joint tenancy interest in real estate.
What happens after you submit your MaineCare application?
After you submit your application, you will be contacted if any additional documents or information is needed. You will then receive a written notice indicating whether you have been enrolled in the MaineCare program.
When will the new premium payment portal go live?
The Portal went live on Monday, August 31st, 2020. The payment portal provides an efficient and secure way for premium payments to be made online, instead of having to send payment by mail each month. This portal serves as another option to make these payments and is not mandatory; payments will still be accepted by mail.
How much is the Medicaid exemption in Maine?
These exemptions are in addition to the Medicaid asset limit of $2,000 for a single individual and $3,000 for a married couple.
What income is counted for Medicaid?
Examples include employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends.
How much can a spouse retain for Medicaid?
For married couples, with one spouse as a Medicaid nursing home applicant or Medicaid waiver applicant, the community spouse (the non-applicant spouse) can retain up to a maximum of $130,380 (in 2021) of the couple’s joint assets, as the chart indicates above.
What are some examples of Medicaid?
Examples include paying for home modifications, like the addition of wheelchair ramps or stair lifts, prepaying funeral and burial expense s, and paying off debt. 2) Medicaid Planning – the majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care.
Does the Medically Needy Pathway help with Medicaid?
The Medically Needy Pathway does not assist one in spending down extra assets for Medicaid qualification. Said another way, if one meets the income requirements for Medicaid eligibility, but not the asset requirement, the above program cannot assist one in reducing their countable assets.
Apply for MaineCare
Ready to apply? Applications for MaineCare are processed by the Office for Family Independence. Learn how to apply today.
Contact MaineCare
If you have questions or need help, the Contact Us page can help you find the right person at MaineCare.
I will be turning 65 in a few weeks. Can you please explain the open enrollment for Medicare supplement (Medigap) insurance policies?
If you are turning 65, your first priority is to make sure you are enrolled in Medicare Part B (contact the Social Security Administration at 1-800-772-1213 or www.ssa.gov/ for information on enrollment procedures).
Are there any alternatives to original Medicare (Parts A and B) available in Maine?
Yes, Medicare Advantage HMO, PPO, and Medicare Advantage private fee-for-service plans, with or without prescription drug coverage, are currently available in Maine. See your current edition of "Medicare and You" for a list of plans available in Maine, or call 1 -800 Medicare.
Can I change from one Medicare supplement plan to another?
If you have had a Medicare supplement plan since you turned 65, in most cases you can change to the same or a lower plan (e.g., from plan "G" to plan "A") at the same or another company without having to wait for open enrollment. However, you must obtain your new plan within 90 days of leaving the old plan.
I am currently enrolled in a Medicare Advantage plan. Can I switch to original Medicare? If I switch to original Medicare, will I be able to enroll in a Medicare supplement plan?
You cannot purchase a Medicare supplement plan if you are enrolled in Medicare Advantage. If you are enrolled in a Medicare Advantage plan you may have a right under Maine law to enroll in a Medicare supplement plan if you switch back to original Medicare, but only under certain limited circumstances.
What Is MaineCare?
What Does It Cover?
- MaineCare covers: 1. doctor visits, 2. emergencies, 3. substance use disorder treatment, 4. prescription drugs, and more.
Who Is Eligible?
- You may be eligible for MaineCare if your monthly income (before you pay taxes) is up to:
*Add 1 to household size for each baby expected. You may still qualify even if you are over the income limits. Please refer to the eligibility guidelines (PDF)for detailed information about income limits for different MaineCare coverage categories. Even if you do not qualify for MaineCare, yo…
Next Steps
- After you submit your application, you will be contacted if any additional documents or information is needed. You will then receive a written notice indicating whether you have been enrolled in the MaineCare program. Note: The Office for Family Independence is responsible for processing MaineCare applications and determining eligibility. Once enro...
MaineCare Information For Members
- If you have question about MaineCare benefits, need help finding a provider, or have other questions, please visit the Office of MaineCare Servicesfor assistance.
Paying Premiums Online
- OFI has a new Online Payment Portal for individuals to make online payments for their MaineCare Premiums. The Portal went live on Monday, August 31st, 2020. The payment portal provides an efficient and secure way for premium payments to be made online, instead of having to send payment by mail each month. This portal serves as another option to make these payments and …
Summary
Healthcare
- There are several different Medicaid long-term care programs for which Maine seniors may be eligible. These programs have medical and functional eligibility requirements, although the exact requirements differ, as do the programs benefits. Further complicating eligibility are the facts that the criteria vary with marital status and that Maine offers multiple pathways towards eligibility.
Participants
- 2) Medicaid Waivers / Home and Community Based Services Limited number of participants. Provided at home, adult day care, or in assisted living.
Programs
- 3) Regular Medicaid / Aged Blind and Disabled is an entitlement (meeting the eligibility requirements guarantees one will receive services) and is provided at home or adult day care. Eligibility for these programs is complicated by the facts that the criteria vary with marital status and that Maine offers multiple pathways towards eligibility. The table below provides a quick ref…
Funding
- For Medicaid eligibility purposes, any income that a Medicaid applicant receives is counted. To clarify, this income can come from any source. Examples include employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. However, when only one spouse of a marr...
Components
- Countable assets include cash, stocks, bonds, investments, credit union, savings, and checking accounts, and real estate in which one does not reside. However, for Medicaid eligibility, there are many assets that are considered exempt (non-countable). Exemptions include personal belongings, household furnishings, two automobiles (one must be needed for a specific purpose…
Examples
- Make note, Maine is unique in that the state allows a single individual an exemption of $8,000 in liquid assets and married couples an exemption of $12,000. (Liquid assets include checking and savings accounts). These amounts are in addition to the Medicaid asset limit of $2,000 for a single individual and $3,000 for a married couple. Hence, the $10,000 asset limit shown above f…
Qualification
- For Maine residents, 65 and over who do not meet the eligibility requirements in the table above, there are other ways to qualify for Medicaid.
Issues
- 2) Medicaid Planning the majority of persons considering Medicaid are over-income or over-asset or both, but still cannot afford their cost of care. For persons in this situation, Medicaid planning exists. By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible. Read more or connect with a Medicaid planner.
Benefits
- Another non-nursing home program relevant to seniors is a benefit called Consumer Directed Attendant Services or CDAS. Under CDAS, beneficiaries can receive assistance with their activities of daily living (attendant care) in their home. Beneficiaries are also given the option to consumer direct their care provider. Stated another way, beneficiaries can choose their care provider and c…