For MaineCare Members

 

News

Changes in MaineCare Benefits

  • April 1, 2012 Benefit Changes: Notice to members (.pdf)
  • Community Support Services for Adults with Intellectual Disabilities or Autistic Disorder - effective July 1, 2011 (.doc)

Memos and Notices

  • Durable Medical Equipment Nutritional Providers 4/06/2012 (.pdf)
  • Update on Transportation Project 5/25/2011 (.doc)

MaineCare Member Newsletter

Patient Centered Medical Home (PCMH)

  • Brochure about Patient Centered Medical Home (.pdf)
  • Letter from MaineCare to members served by PCMH practices May 2010 (.doc)

HealthInfoNet, a health data exchange available to MaineCare members

HealthInfoNet Flyer and Opt-out Form (.pdf )

 

For current MaineCare Members . . .

Co-pay schedule (.doc) lists how much members pay for their care or prescription drugs.

Covered service changes visit the Policies/Rules - Proposed, Recently Adopted, Emergency and Other Rules pages.

MaineCare Benefits Manual External site disclaimer is the legal document explaining covered services.

MaineCare Member Handbook (.doc) (.pdf) explains the basics of the MaineCare Program in easy-to-understand terms.

Name, address and other changes, you should report to your eligibility specialist at the Department of Health and Human Services local office.

Prescription drug benefits For questions about prescription drug benefits, mail order options, and generic drugs, contact the DHHS Pharmacy Unit Member Help Desk at: 1-866-796-2463, TTY: 1-800-423-4331. You can also look at MaineCare's Preferred Drug List (PDL). Information about Medicare Part D plans can be found on the Office of Elder Services webpage.

 

Becoming a MaineCare Member

To apply for MaineCare, call or visit the Department of Health and Human Services local office closest to where you live. Ask to talk to an eligibility specialist.

Applications for MaineCare and other assistance programs are also available online.

MaineCare is available to people who meet the income guidelines and who are:

  • newborn through age 20
  • age 21 and over who have dependent children living in the home (See also, Medicaid Expansion for Parents)
  • are between age 21 and 64 who
    • have no dependent children living in the home,
    • have not been determined to be disabled and
    • do not meet qualifications for another MaineCare benefit package.
  • age 18 and over and disabled
  • age 18 and over and have mental retardation or autism
  • under age 19 who
    • have mental retardation, autism, or other developmental disabilities;
    • need care generally provided in medical or psychiatric hospital, nursing home, or intermediate care facility; and
    • are living at home.
  • pregnant
  • elderly
  • living with HIV/AIDS
  • inmates in jails
  • undocumented residents
  • living in a Nursing Home
  • living in a Residential Care Facility

There are also programs for children who have special needs and for adults who have low income. For different kinds of members, MaineCare has different benefits. See the MaineCare Member Handbook (.doc | .pdf) for more info.