Choosing and enrolling in a health care plan can be confusing, but it’s worth it to be covered.
|Need help? Call (800) 965-7476|
for free, local help from Consumers for Affordable Health Care.
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.
Open Enrollment for HealthCare.gov ended December 15th, but if you’ve experienced certain life changes you may still be able to sign up. If you qualify for MaineCare (based on your income and family size) you can apply any time.
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
Include expected babies in household size
|Each additional person||+$523||+$610||+$796||+$810|
Scroll/swipe sideways to view the full table if necessary
What counts as monthly income for MaineCare?
|Current income earned by you, your spouse, and anyone else counted in your household|
|Severance benefits (in the month received)|
|Base unemployment benefits|
unemployment benefits from CARES act
|Tax rebates, including the recent $1,200/
person stimulus payment
|Expected future earnings|
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. 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.
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.
For applicants who are immigrants
As of February 24, 2020, the federal government has changed 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 mean that, in some specific cases, enrolling in MaineCare might make it more difficult to have an immigration application approved.
It is important that anyone who might be impacted understand when these rules do – and do not – apply. The new rules only impact people applying for family-based green cards and certain visas, and do not apply to refugees, asylees, asylum seekers, and people with other humanitarian statuses. Only the applicant individual’s use of benefits is considered under this rule, and it does not apply to enrollment in benefit programs by their family members. The organization Protecting Immigrant Families has a guide with more information if you’re wondering who is impacted by this change.
In April 2020, the federal government announced that testing, treatment, and preventive care (including a vaccine if one becomes available) for COVID-19 will not be considered in the public charge test. These services will have no negative impact, even if such treatment is provided or paid for by MaineCare. Learn more on the U.S. Customs and Immigration Control website.
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 this rule change, 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.
The HealthCare.gov Open Enrollment Period ended December 15, 2020, but if you’ve experienced certain life changes, like losing coverage through your job, getting married or divorced, or having a baby, you may still be able to apply for 2021 coverage. Find out more what changes qualify at HealthCare.gov.
Depending on your income, you may also receive financial assistance from the federal government to make your plan more affordable. Last year, 86% of Mainers who enrolled through HealthCare.gov got a tax credit to reduce their monthly premium, and many received extra help with out-of-pocket costs.
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.”