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Learn About Requirements for Medicaid in Maine

Residents wondering how to qualify for Medicaid in Maine can benefit from health care coverage if they meet the requirements. What are the requirements for Medicaid coverage? Medicaid eligibility requirements in ME are structured around income and types of groups in need. Medicaid is a comprehensive health care program funded by both the federal and state government. Nevada must adhere to federal requirements but have the authority to determine who is eligible for Medicaid in the state. The Medicaid program in the state is called MaineCare. Candidates considering applying to MaineCare should verify they meet the prerequisites of the program by reading the outlined information below.

What are the requirements for Medicaid in Maine?

For an individual to meet Medicaid benefits eligibility requirements, he or she must first and foremost be a current resident in Maine. Other requirements for Medicaid in Maine include being a U.S. national, citizen, permanent resident or legal alien. MaineCare requires residents to provide proof of their citizenship or immigration status. Individuals must provide copies of needed documentation with Medicaid applications to show what their status is.

In addition, applicants must also be one of the following:

  • Pregnant
  • A parent or relative caretaker of dependent children younger than 19 years of age
  • Blind
  • Disabled or have a family member in the household who is disabled
  • 65 years of age or older

Most individuals who participate in MaineCare have limited resources and need help with health care payments. In order to participate in MaineCare individuals must have a financial situation that would be referred to as low or very low income.

What are the income requirements for Medicaid in Maine?

The federal government has Medicaid eligibility requirements for states to participate in Medicaid and receive funding. Included in these eligibility requirements for Medicaid funding are conditions to cover certain groups of individuals based on income and medical need. MaineCare is intended to provide health care coverage for low-income individuals, families and other needy people. A MaineCare application will ask candidates how much each month they pay for housing (rent, mortgage, property taxes, mobile home loan payments and homeowner’s insurance) and utilities (heat, electricity, water, gas, sewer and trash removal). Medicaid eligibility requirements also take into consideration any expenses a petitioner spends on pay for someone else’s care (like day care for children). Petitioners must include how much they pay and who provides the care in order for it to be accepted.

MaineCare petitioners are also required to list all of their assets, things like bank accounts, stocks, bonds, trust funds, money that is owed, certificates of deposits, retirement accounts, vehicles, homes and other real estate, life insurance policies, personal property, real estate, cemetery plots, annuities, vehicles, burial trusts and other items for burial. As all off these will count towards income requirements for Medicaid enrollment, every asset included in a candidate’s Medicaid application must list the value of each separate asset. The value and how much is still owe should be included for assets like vehicles and real estate. Applicants must include the name, address and account number for the bank or institution where the asset is being held and whether the asset is a joint asset. These figures may influence medical costs for Medicaid participants.

The Modified Adjusted Gross Income (MAGI) is used to determine MaineCare eligibility for most children, parents, adults and pregnant women. The MAGI-based process takes into consideration an applicant’s taxable income and tax filing relationships to decide an applicant’s financial eligibility. Generally, elderly and disabled adults must earn less than the federal poverty level (FPL). Children younger than 21 years of age may have incomes up to 150 percent of the FPL, whereas parents of minors and pregnant women can have household earnings up to 200 percent of the FPL. Those with certain diagnosis, such as HIV and cervical cancer, are eligible with incomes up to 250 percent of the FPL.

Discover more about the requirements to receive health care coverage from the Medicaid program in our free guide.

What are the Medicaid application guidelines in Maine?

To determine who is eligible for Medicaid, petitioners must complete MaineCare application. Those who meet the Maine Medicaid benefits eligibility requirements will receive coverage as soon as they are approved. Applicants can receive a MaineCare application anywhere in the state by visiting their local Department of Health and Human Services (DHHS) office. Individuals can apply online, in-person, by mail and by phone. Medicaid benefits do not have a deadline and petitioners can apply at any time.

Find out how to properly submit a Medicaid application by reading our free guide.