MaineCare Eligibility
Introduction

Contents

Introduction

This guide is about MaineCare, which is Maine's Medicaid program. MaineCare also includes Maine's State Children's Health Insurance Program (CHIP), which provides the same MaineCare coverage benefits to children in families with a higher income range; this program used to be called Cub Care. MaineCare provides health insurance benefits to specific groups, or categories, of low-income people: children, their parents, 19- and 20-year-olds, pregnant women, adults with disabilities, seniors age 65 and older, and "non-categorical" adults (who do not fit into any of the categories of coverage-they are adults age 21 to 64 who do not have dependent children living in their household and who are not disabled). For a brief overview of all covered groups, see:   Maine's Medical Assistance Programs:  Who's Covered and Who's Not.

This guide was created by the Covering Kids and Families Coalition (CKF) and has been adapted and maintained by Consumers for Affordable Health Care and Maine Equal Justice Partners. The CKF Coalition consisted of the Maine Department of Health and Human Services, Consumers for Affordable Health Care, Maine Equal Justice Partners, Maine Primary Care Association, and Maine Children's Alliance.

This guide focuses on MaineCare for the categories above as well as the Medicare Savings Program, which is a partial-benefit MaineCare program.

Easy to get help and information.

• Consumers for Affordable Health Care HelpLine: The HelpLine will answer questions about MaineCare and help eligible people enroll. The HelpLine is answered by Consumers for Affordable Health Care, a non-profit agency, not by DHHS. Any information given to the HelpLine staff is confidential and will not be shared with DHHS, without permission. The HelpLine toll-free number is 1-800-965-7476. If you are deaf or hard of hearing and have a TTY machine, the number is the same.
• MaineCare Member Services: 1-800-977-6740 (TTY 1-800-977-6741), for coverage questions or for help getting bills paid or finding a provider.
• MaineCare Provider Services: 1-800-321-5557 (option 9), for assistance for MaineCare providers.
• Department of Health and Human Services (DHHS) regional offices: Call or visit a local DHHS office to apply to MaineCare or to ask questions about eligibility. Statewide toll-free number: 1-877-543-7669.
• Maine Equal Justice: 626-7058; 1-866-626-7059 (TTY is the same). Maine Equal Justice, a non-profit agency, provides a range of health care information on this website. Staff is also available to help with problems or concerns regarding MaineCare or other public benefit programs.
• Pine Tree Legal Assistance (PTLA): PTLA can assist with MaineCare denials, terminations, and appeals, both in terms of eligibility for MaineCare and also for covered services (e.g., they handle cases when MaineCare denies coverage of a drug or denies a service, such as orthodontics). Find a local PTLA office. PTLA does not help with cases related to MaineCare long-term care for seniors age 60 and older; Legal Services for the Elderly (LSE) will help with this (LSE HelpLine: 1-800-750-5353).
• Disability Rights Center: provides information about rights and service systems, referrals to appropriate services, representation of individuals at meetings and hearings and legal representation of individuals or groups. Call 1-800-452-1948.
• Legal Services for the Elderly (LSE) Helpline: 1-800-750-5353
• Further information about options for dental care:
  List of free and low-cost dental service providers
  Map of Federally Qualified Health Centers that offer dental care
  

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