Even if you haven’t qualified for coverage before, it’s time to check it out again: more Mainers are now eligible for free or low-cost plans.

MaineCare: Free or Low-Cost Coverage for Mainers

If you qualify for MaineCare, it is your best option. And if you’ve lost all or most of your regular income due to the pandemic, even if only temporarily, you probably qualify. Don’t hesitate to apply. MaineCare is here for the people of Maine when they need it.

Do I qualify for MaineCare?

Mainers are eligible for MaineCare coverage if they meet certain requirements, including having a household income below certain limits. Different income limits apply to people with different circumstances, and depending on your situation, some people in your household may qualify but not others.

Maximum Monthly Household Income

Household Size Adults
Ages 21-64
Young Adults
Ages 19-20
Children
Ages 1-18
Pregnant Women
Include expected babies in household size
1 $1,482 $1,729 $2,287 -
2 $2,004 $2,338 $3,093 $3,107
3 $2,526 $2,947 $3,898 $3,917
4 $3,048 $3,556 $4,704 $4,726
Each additional person +$523 +$610 +$796 +$810

What counts as monthly income for MaineCare?

Do include Current income earned by you, your spouse, and anyone else counted in your household
Do include Severance benefits (in the month received)
Do include Base unemployment benefits
Do not include Supplemental $600/week
unemployment benefits from CARES act
Do not include Tax rebates, including the recent $1,200/
person stimulus payment
Do not include Expected future earnings
Do not include SNAP benefits

People with disabilities and those with certain health conditions can qualify for MaineCare even at higher household income levels. You can find more detailed income limits in this 2020 summary of eligibility guidelines (PDF). Not sure if you or your family qualifies? Call (800) 965-7476 for free, local help from Consumers for Affordable Health Care.

What services does MaineCare cover?

MaineCare covers essential health care needs. This includes: visits to your doctor, prescription drugs, treatment for mental health needs and substance abuse disorder, surgery, emergency care, and more. Learn more about what’s covered in the MaineCare Member Handbook (PDF).

For applicants age 55 or older

If you are 55 or older, you may have heard that signing up for MaineCare could put your home or savings at risk if you need long term services and supports like nursing home care. Although in some cases federal law does require Maine to try to recover costs of care from a beneficiary’s estate, the State only pursues this option in certain circumstances and has policies in place to protect family members and individuals experiencing hardship. Learn more about estate recovery (PDF).

For applicants who are immigrants

Recently, the federal government attempted to make changes to the rules they use to decide whether some people applying for green cards and certain visas are likely to depend on government resources in the United States. These new “public charge” rules meant that, in some specific cases, enrolling in MaineCare might make it more difficult to have an immigration application approved. On November 2nd, 2020, a federal district court overturned the new rule, and in March 2021, the federal Department of Homeland Security announced it would no longer attempt to defend the rule change in court. This means that enrolling in MaineCare, except in some very limited circumstances, will not be considered in public charge determinations during the immigration application process.

The information provided here is not intended as legal advice. If you aren’t, or a person you are helping to apply for MaineCare is not, a citizen or lawful permanent resident of the United States and you have questions about public charge rules, contact Consumers for Affordable Health Care at 1-800-965-7476.

 

HealthCare.gov: Marketplace Health Insurance

Most Mainers who don’t have affordable coverage through their job, and who don’t qualify for other insurance (like MaineCare, Medicare, or Military or Veterans coverage) can apply for quality coverage through the Health Insurance Marketplace at HealthCare.gov.

Open enrollment for HealthCare.gov coverage for 2021 is now closed, but you may still be able to apply through a special enrollment period if you’ve experience a life change like getting married or divorced, having a baby, changing jobs, or losing your current source of insurance. Use the screener on HealthCare.gov to see if you qualify. 

The American Rescue Plan has expanded financial assistance in the Marketplace to help people afford insurance. Thanks to the new law:

  • More people than ever before qualify for help paying for health coverage, even those who weren’t eligible in the past.
  • Most people currently enrolled in a Marketplace plan may qualify for more tax credits.
  • Health insurance premiums after these new savings will go down.

For help understanding your choices or filling out your application, call 1-800-965-7476.

Why get covered?

Listen to why these real Maine people are glad they signed up for their health plans:

“I have emphysema, and it was tough paying for my oxygen without health insurance. I’m ecstatic to be covered—and to get the word out to others. I can breathe again!”

“Like most home health aides, I’m not covered through my job. When I needed surgery after my car accident, I realized how important health insurance is. I got excellent help signing up, close to home.”

“I lost my health insurance because of a job change. It was a relief to find out I had options. With a genetic risk for breast cancer, I need to be tested often. I’m so grateful to be covered.”