MaineCare provides healthcare coverage for eligible individuals and families. There are two coverage categories:
– “Non-categorical” coverage: Provides partial MaineCare benefits to individuals and couples who meet certain income guidelines. Currently “non-categorical” coverage is frozen (not open to new applicants) but it is recommended that you still apply to get on the waiting list.
– “Categorical” coverage: Provides full MaineCare benefits to individuals and families who fall under a specific coverage group. Some of the coverage groups include: children 18 and under, children age 19-20, parents or guardians, pregnant women, adults who are medically eligible for nursing care or living in residential care facilities, women who have breast or cervical cancer, seniors age 65 and older, and adults with disabilities. For a full list click here. (http://www.mejp.org/PDF/mainecare_guide.pdf).
How to apply:
To get a MaineCare application you can call the DHHS statewide toll-free number 1-877-543-7669 or the Consumers for Affordable Health Care Helpline 1-800-965-7476, visit your local DHHS office, or print an application from the internet for adults :(http://www.maine.gov/dhhs/ofi/services/mainecare/mainecareapplication.pdf) or families with children (http://www.maine.gov/dhhs/ofi/public-assistance/pdf/On-Line-CubCare-Application.pdf). Once you fill out an application it must be mailed to or dropped off at a local DHHS office. DHHS must make a decision within 45 calendar days from the date they get the application (if the application is complete) or they must send the family a short-term medical card to use until a decision is made. You may also do a pre-screening, open an account or renew on-line. (https://www1.maine.gov/benefits/account/login.html?issueNum=111012140034096).
Things to Remember:
- If your request is denied at first, it is crucial to ask for reconsideration immediately by calling the regional DHHS office and asking for a fair hearing. Eligibility decision appeals must be sent within 30 calendar days of the date of the DHHS written opinion.
- Make sure to complete an annual review each year and promptly notify DHHS of address changes or changes in income or assets. These are two common reasons that people lose their MaineCare coverage.
- If you have a problem or complaint you can call DHHS and talk to a MaineCare Eligibility Specialist to see if your issue can be worked out.
For more information on applying for MaineCare check out the resources below:
– Maine Equal Justice Partners – Tips for the Applicant (http://www.mejp.org/mainecaretips.htm)
– Consumers for Affordable Health Care website (http://www.mainecahc.org/guide_disabled.htm#can) and HelpLine – 1-800-965-7476
– MaineCare Services website (http://www.maine.gov/dhhs/oms/member/index.shtml#new_mbr)