Health Care Assistance

What is MaineCare?

MaineCare provides free and low-cost health 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:

• doctor visits,
• emergencies,
• substance use disorder treatment,
• prescription drugs, and more.

Who is eligible?

You may be eligible for MaineCare if your monthly income (before you pay taxes) is up to:

Your household size	Children	Young Adults (19-20)	Adults (21-64)	Pregnant Individuals*
1	$3,828	$3,828	$1,733	N/A
2	$5,196	$5,196	$2,352	$3,646
3	$6,563	$6,563	$2,970	$4,605
4	$7,930	$7,930	$3,588	$5,564
Each additional family member	Add $1,345	Add $1,345	Add $597	$938

*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, you may be able eligible to receive financial help paying for health insurance when you purchase coverage through the individual marketplace. Learn more at CoverME.gov.

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 MaineCare Services administers the program and handles all billing and claims.

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 Services for 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 is not mandatory; payments will still be accepted by mail.  Please note that there is a $2 fee that will be assessed for each payment made on this Online Payment Portal.  To make an online payment click here, www.maine.gov/dhhs/paymentportal.

Expansion of Maine's Medicare Savings Program

If you have Medicare, you may qualify for a Medicare Savings Plan (MSP). Depending on your income and the program you qualify for, MaineCare may pay for your Part A premiums, Part B premiums, Medicare deductibles, coinsurance, and copayments. Effective July 1, 2024, people with higher income levels now qualify for MSP. The new monthly income limits are:

• Qualified Medicare Beneficiaries (QMB): 185% of the Federal Poverty Level (FPL) or $2,322 (individuals)/$3,152 (couples) per month
• Qualifying Individual (QI): 250% of the FPL or $3,158 (individuals)/$4,259 (couples) per month

There are no asset tests or estate recovery requirements for MSP. The Specialized Low-Income Medicare Beneficiary (SLMB) program will be replaced by QMB, which provides more benefits, on July 1, 2024. For more information about what's covered under MSP, visit this Medicare website. 

Individuals currently enrolled in either the Specified Low Income Medicare Beneficiary (SLMB) or Qualifying Individual (QI) groups will be automatically converted to the Qualified Medicare Beneficiary (QMB) program, starting July 1, 2024. An application is not necessary and no further action by the individual is needed for this to occur. Individuals will receive a notice from OFI explaining the change.