Maine Medicaid Eligibility and Enrollment
- MaineCare is Maine's version of Medicaid. Find out whether you might qualify for this state health insurance program that helps low-income individuals and families.
MaineCare — formerly Medicaid in Maine — is a joint federal and state government program that provides free and low-cost healthcare insurance to eligible people who have limited resources to pay for it. MaineCare provides healthcare support for an estimated 238,900 state residents who are aged, blind, disabled, pregnant, in foster care and those who need long-term care.
To be eligible for MaineCare, applicants must be a state resident, in need of healthcare and insurance and lack the financial resources to pay for it.
What Benefits Does MaineCare Cover?
MaineCare services cover a wide array of medically necessary healthcare services, including doctor visits, prescription medications, X-rays and labs.
Healthcare and insurance services are based on an applicant’s coverage group, which is determined by income and assets, age and medical needs. These services are also determined by whether an individual needs help with Activities of Daily Living (ADLs).
Some examples of other services that may be covered include:
- Emergency and hospital visits
- Substance use disorder treatment
- Mental health services
- Eye exams and eyeglasses
Some examples of services that are not covered by MaineCare include acupuncture, cosmetic surgery, health club memberships, such as the YMCA, and massage therapy. You can call MaineCare Member Services at (800) 977-6740 to see if a particular health service is included. To see if a certain medication is covered, call the Pharmacy Help Desk at (866) 796-2463.
Who Is Eligible for Medicaid in Maine?
Maine residents are eligible for MaineCare if they meet all of the federal requirements, including income and asset limits that are adjusted for the state. MaineCare factors in medical need, age and whether the applicant is pregnant or disabled as part of its enrollment determination process.
Eligibility is categorized by the following criteria:
- Children under the age of 18
- Individuals 19 and 20 years old living with their parents
- Parents and caretaker relatives residing and caring for a dependent child under the age of 18
- Pregnant women
- Adults between 19 and 64 years old who are not pregnant or eligible for another medical plan
- Applicants who are blind, over the age of 65 or disabled
In order to federally qualify for Medicaid, individuals must not earn more than $12,800 annually, and families of four must not earn more than $26,500.
In the state, the maximum qualifying income for individual adults under 65 is $16,971.
How Do I Enroll in Medicaid in Maine?
If you are eligible for MaineCare, you can enroll in several ways. Applications are available online through the State of Maine’s Department of Health and Human Services and are processed by the Office for Family Independence.
Office for Family Independence
114 Corn Shop Lane
Farmington, ME 04938
Applicants can email an application to Farmington.DHHS@Maine.gov or fax it to (207) 778-8429. You can also visit one of the district offices and apply in person.
Contact Information for Maine Medicaid
For more information on MaineCare and to print out an application or learn more about Medicaid in Maine, please visit Maine.gov or call (207) 624-4168.
General correspondence and questions can be sent to:
Department of Health and Human Services
109 Capitol Street
11 State House Station
Augusta, ME 04333