For an individual to meet Medicaid benefits eligibility requirements, he or she must first and foremost be a current resident in Maine. Other requirements for Medicaid in Maine include being a U.S. national, citizen, permanent resident or legal alien. MaineCare
Medicaid
Medicaid in the United States is a federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and personal care services. The Health Insurance As…
Full Answer
How do I apply for Medicaid in Maine?
Persons can apply for Medicaid benefits online at My Maine Connection or in person at their district OFI office. Click here to find the office nearest you. In addition, persons can download an application here.
Who is eligible to receive Medicaid in Maine?
Pregnant Women - You are pregnant, or you had a pregnancy that ended within the last 60 days. Former Foster Care Children - You are under 26 years old, were in foster care in the State of Maine and were enrolled in Medicaid through the State of Maine at age 18, and are not otherwise eligible for, or enrolled in, other Medicaid coverage.
How can I learn more about Medicare and MaineCare?
Learn more about MaineCare. Medicare is a federal program that covers most seniors and many people with disabilities. For help choosing a plan or understanding your Medicare benefits visit the State Health Insurance Assistance Program ("SHIP”)
How do I get health insurance as a veteran in Maine?
The Maine Bureau of Veterans' Services provides information about health coverage for veterans. If you do not qualify for MaineCare you may still be eligible to receive financial assistance paying for your health insurance through CoverME.gov, Maine’s official health insurance Marketplace.
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 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
How much money can you have in the bank and still get MaineCare?
For children (18 and under) and pregnant women,MaineCare will not count assets. For parents of children (18 and under), and for 19 and 20 year olds, there is a $2,000 asset limit. For other adultcouples with no minor children at home, there is a $3,000 asset limit.
How long does it take to get approved for MaineCare?
within 45 daysDHHS will also send you a notice letting you know whether you are approved for MaineCare or denied. How long will it take to get a decision from DHHS? DHHS is supposed to make a decision about whether or not you can get MaineCare within 45 days of receiving your complete application.
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.
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.
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 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.
How do I apply for MaineCare insurance?
To apply for MaineCare, you need to fill out an application form that you can get from your local DHHS office or by calling the Member Services of OMS at 1-800-977-6740. You may also download it by clicking here. After you have completed the application, you should return it to your local DHHS office.
Can I have MaineCare and Medicare at the same time?
Elderly and disabled adults can have private insurance, Medicare, or Supplemental Insurance AND MaineCare.
What happens if I don't qualify for MaineCare?
If you do not qualify for MaineCare or Marketplace discounts and cannot afford other private insurance, call our HelpLine (1-800-965-7476) or check out our Guide to Maine Health Care to identify programs that may help with cost for prescriptions drugs, primary and preventive care, emergency care and more.
When do you have to apply for Medicare?
Initial Enrollment Period: You may sign up for Medicare during your 7-month Initial Enrollment Period, which begins 3 months before the month of your 65th birthday.
How many Maine seniors will receive Medicare in 2020?
Maine residents who meet federal eligibility requirements may be qualified to receive health insurance coverage through Medicare. In fact, in 2020, 345,205 Maine seniors received benefits through the program, with 210,664 beneficiaries enrolled in Original Medicare and 134,541 beneficiaries enrolled in Medicare Advantage.
What is Medicare Supplement Insurance?
Medicare Supplement Insurance (Medigap) Medigap plans, which are also known as Medicare Supplement Insurance, are policies you can purchase from private insurers to work alongside your Medicare plan. They’re designed to cover out-of-pocket costs associated with Original Medicare such as: Copays. Co-insurance.
What is Medicare Part A?
Medicare Part A covers expenses related to inpatient care, which includes medical services, room and board. Coverage includes but is not limited to the following categories: Hospitalization. Hospice. Home health care. Inpatient psychiatric care.
What is original Medicare?
Original Medicare. Original Medicare is a federally governed program that provides comprehensive healthcare benefits to seniors and other qualifying individuals. The program consists of two components — Part A and Part B — each offering a different suite of benefits.
When is the second enrollment period for Medicare?
If you have Original Medicare and haven’t signed up for a Part D plan, you may also do so at this time. A second enrollment period runs from January 1 to March 31. During this period, enrollees may switch from one plan to another or return to Original Medicare.
When is the enrollment period for Medicare Advantage?
For beneficiaries who want to enroll at a later time, or who wish to switch between Original Medicare and Medicare Advantage, the program has an Annual Enrollment Period between October 15 and December 7. If you have Original Medicare and haven’t signed up for a Part D plan, you may also do so at this time.
How long does it take to get Medicare in Maine?
Medigap insurers in Maine must allow a Medicare beneficiary to enroll in a Medigap plan if they apply within 90 days of losing coverage under an individual market plan (not counting a short-term health plan or fixed indemnity plan ), an employer-sponsored plan, or MaineCare (Medicaid).
How long does it take to switch to Medicare Advantage in Maine?
But Maine law extends that trial right period to three years.
What is a Medigap plan?
Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that people would otherwise incur if they only had Original Medicare on its own.
How many Medicare beneficiaries are there in Maine in 2020?
As of July 2020, there were 125,831 Medicare beneficiaries in Maine enrolled in stand-alone Medicare Part D prescription drug plans. In addition to those with stand-alone Part D plans, more than 140,000 Maine residents had Part D coverage integrated with the Medicare Advantage plans as of mid-2020. As of late 2018, about 43 percent ...
How long is the open enrollment period for Medicare in Maine?
People under age 65 in Maine are granted the same six-month open enrollment period for guaranteed-issue Medigap plans (starting when they’re enrolled in Medicare Part B) as people who are 65 and enrolling in Medicare due to their age.
What percentage of Maine Medicare beneficiaries are in Medicare Advantage?
As of late 2018, about 43 percent of Maine’s Medicare beneficiaries had been enrolled in stand-alone Medicare Part D plans, but that has dropped as Medicare Advantage enrollment had increased. By mid-2020, about 36 percent of the Maine Medicare beneficiaries were enrolled in stand-alone Medicare Part D plans.
What percentage of Medicare beneficiaries are under 65?
Nationwide, about 15 percent of Medicare beneficiaries are under the age of 65, but this is also higher in Maine, where 18 percent of Medicare beneficiaries are under 65.
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.
Medicare
Medicare is a federal program that covers most seniors and many people with disabilities.
Health Insurance for Veterans
The Maine Bureau of Veterans' Services provides information about health coverage for veterans.
Individual Marketplace Coverage
If you do not qualify for MaineCare you may still be eligible to receive financial assistance paying for your health insurance through CoverME.gov, Maine’s official health insurance Marketplace.
Small Businesses Health Plans
Although businesses with 1-49 employees are not required to offer insurance coverage, many small business owners want to provide their employees with health benefits.
Children
Learn more about the affordable health coverage options available to kids under age 21.
Adults
Learn more about affordable health coverage options available to Adults 19-64 years old.
Older Adults and Adults with Disabilities
Learn about the Medicare Savings Program (Buy-in), the Spenddown program for individuals who are medically needy, programs for individuals with a disability, long term care, and more.
Limited Benefits
Learn about pharmacy coverage, discount drug programs, adult dental coverage, the Private Health Insurance Premium (PHIP) program, and limited benefit packages.
Ready to Apply?
Learn about your options for applying online, by mail, and in person. Applications for MaineCare are processed by DHHS’s Office for Family Independence.
How old do you have to be to be in foster care in Maine?
Former Foster Care Children - You are under 26 years old, were in foster care in the State of Maine and were enrolled in Medicaid through the State of Maine at age 18, and are not otherwise eligible for, or enrolled in, other Medicaid coverage. If you are an adult who is age 65 and older or eligible for Medicare, ...
How to check if MaineCare is covered?
To see if a service you need is covered, call MaineCare Member Services at 1-800-977-6740. TTY users, dial 711. Make sure MaineCare covers the service you need before you get care. There are limits or special rules for most covered services.
What are some examples of services that may be covered by MaineCare?
Some examples of services that may be covered: Visits to your doctor. Medications. Behavioral health services. Inpatient and outpatient hospital visits. X-rays and labs. The services covered depends on your MaineCare eligibility category. MaineCare may not cover all services listed.
How to get help with quit smoking in Maine?
If your ready to quit, you can call: The Maine Tobacco Helpline at 1-800-207-1230 to get free help with your quit plan. Your doctor for help finding services and determining which products might be best for you. See the Tobacco Cessation (PDF) for more information about how we can help.
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.
What Is MaineCare?
- MaineCare provides free and low-costhealth insurance to Mainers who meet certain requirements, based on household composition and income. There are also additional options for people with disabilities and certain health conditions, young adults who have been in foster care, and those who need long-term care.
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 enrolled, the Office of Main…
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 …