It is called the "non-categoricals" group because the enrollees do not fit into a usual MaineCare group; they are not disabled, 65 or over, a parent with minor children at home or a child. There is a waiting list for the programUnlike other benefit programs, this program has a waiting list. Sometimes the waiting list moves fast and at other times it moves very slowly. It is important to get your name on the waiting list. People get on the program on a first-come, first served basis. As of March 2009 there are close to 13,000 people on the list so it may be a while before people can get help from the program. It is still important to apply so that you get your name on the list, however. Do people in the non-categorical group get the same services as everyone else who gets MaineCare?No. Most medical services are covered. However, some services are not covered or there are limits on the service. What can I do if I need services that are not covered for this group?You may still get full MaineCare benefits if you fit into another MaineCare group. The first step is to see if you fit into one of these groups:
Get chart of all covered groups, the basic financial eligibility
requirements and coverage for each. Also, if you were ever in AMHI and are a consent decree class member, you should get any service that is in your Individualized Support Plan (ISP). Contact your case worker if you need help with this. If you think DHHS has you listed in the non-categorical group when you belong in a different group with full MaineCare benefits, contact your local DHHS office about switching MaineCare groups.If you think you may fit the disability category, but have not yet been determined disabled by either Social Security or DHHS, ask the DHHS case worker for the "disability" packet. Fill it out and send it to your local DHHS office. I provide health and/or social services to people in the non-categorical group. How can I help them get the services that they need?You can screen the people that you see to be sure that they are not mistakenly in the non-categorical group. You can also help those who are likely to be considered disabled apply for a DHHS disability determination (see above). MEJP has a written screening tool, with instructions, to help you decide whether a person should be in a different MaineCare category. How to make sure that you keep your MaineCare coverageIf you are in the MaineCare non-categorical group now, it's important that you fill out the annual review form (recertification) and get it in to DHHS on time. If you get your review form in on time and you are still eligible for non-categorical services, your MaineCare coverage will continue. Be sure to let your DHHS worker know if your address changes, so you will get the review form. If your review form is more than 30 days late, your case will be closed and you will lose MaineCare coverage (unless you are eligible for another group). If this happens you may have to apply again to find out if your name can be put on the waiting list for non-categorical coverage.
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||