Me Medicaid is Maine's name for its Medicaid program

Me Medicaid is the official name of Maine's Medicaid program. It covers hospital care, doctor visits, prescription drugs, mental health services, and long-term care for people who meet income and resource limits. The program is run by the Maine Department of Health and Human Services, and it operates under both federal Medicaid rules and Maine-specific policies that differ from how Medicaid works in other states.

If you live in Maine and have been told you might be covered by Medicaid, you are being referred to Me Medicaid. The name itself is simply Maine's branding for the program — it is the same Medicaid system that exists in every state, but with Maine's own rules about who gets in and what is covered.

Key Takeaways

  • Me Medicaid is Maine's Medicaid program, run by the Department of Health and Human Services, and covers medical care for people below certain income and resource limits.
  • You can learn whether you may be covered by contacting Maine's Department of Health and Human Services directly or by calling 211 for a referral to local resources.
  • Me Medicaid covers different services than other states' Medicaid programs, so what is covered depends on which category of coverage you fall into.
  • Income limits and what counts as a resource vary by household size and the type of coverage you are seeking, and they change each year.
  • Once you understand the rules that apply to your situation, you will need to gather documents like proof of income and residency to provide to the program.

Who can get Me Medicaid coverage

Me Medicaid covers several groups of people: children and parents in low-income households, pregnant people, people over 65, people who are blind or disabled, and people in long-term care facilities. Each group has different income and resource limits. For example, a parent with one child has a different income limit than a single adult, and someone seeking long-term care coverage has different rules than someone seeking regular medical coverage.

Maine also covers some people who earn slightly more than the standard limits if they have high medical expenses. This is called a "spend-down" — you can use your medical bills to reduce your countable income and become covered. The exact income limits change each year, so the Department of Health and Human Services website or a 211 call can tell you the current numbers for your household size and situation.

You must also be a U.S. citizen or may have access to immigrant, a Maine resident, and a Social Security number holder (or have applied for one). If you do not meet all three of these requirements, you will not be covered, even if your income is low enough.

How to learn about you may be covered

The fastest way to learn whether you may be covered is to call the Maine Department of Health and Human Services at 207-287-2886, or to call 211 and ask for a referral to your local MaineCare office. MaineCare is the name Maine uses for its Medicaid program in some contexts, so you may hear both names used interchangeably. Either call can tell you the current income limits for your household and whether your situation fits one of the covered groups.

You can also visit the Maine Department of Health and Human Services website directly. They publish the income limits for each category of coverage, and they have a list of local MaineCare offices by county. Calling is usually faster than visiting in person, because staff can answer questions about your specific situation without you having to travel.

When you call, have your household size, monthly income, and the names and ages of anyone in your household ready. This information helps the staff person tell you whether you are likely to be covered and what documents you will need to gather.

What documents you will need

To move forward with Me Medicaid, you will need to show proof of income (such as recent pay stubs, tax returns, or a letter from your employer), proof of Maine residency (such as a utility bill or lease), and proof of your Social Security number or evidence that you have applied for one. If you are over 65 or disabled, you may also need medical records or a doctor's statement.

If your income changes or you have medical expenses that might may have access to you for a spend-down, keep records of those expenses. Hospital bills, prescription receipts, and doctor visit statements all count. The MaineCare office can tell you which expenses they will accept.

You do not need to have all documents before you contact the program. Many people gather them after they call and learn what is required for their specific situation. The MaineCare office will tell you exactly what to bring and where to send it.

How Me Medicaid coverage works once you are covered

If you are covered by Me Medicaid, you will receive a card in the mail. You use this card when you go to the doctor, the hospital, or the pharmacy. The card shows your member ID number and the phone number to call if you have questions about your coverage.

Me Medicaid covers a wide range of services: doctor visits, hospital stays, emergency care, prescription drugs, mental health and substance use treatment, dental care (for children and some adults), vision care, and hearing aids. Long-term care coverage includes nursing home care and home and community-based services. The exact services covered depend on which category of Me Medicaid you are in, so ask the MaineCare office which services apply to you.

You may have a small copay for some services, but Me Medicaid does not charge copays for preventive care like annual checkups or cancer screenings. If you cannot afford a copay, tell the provider — they can sometimes waive it or work out a payment plan.

What happens if your income or situation changes

You must report changes to the MaineCare office within 30 days. Changes that matter include a new job, a job loss, a change in household size (like a birth or someone moving in or out), or a change in your address. If you do not report changes, your coverage could be canceled or you could be asked to repay benefits you were not supposed to receive.

If your income goes up, you may lose coverage. If it goes down, you may become covered or your coverage category may change. The MaineCare office will tell you what happens to your specific coverage based on the change you report. You can report changes by phone, by mail, or through the Maine Department of Health and Human Services website.

How Me Medicaid is different from other states' Medicaid programs

Every state runs Medicaid slightly differently. Maine's income limits, covered services, and rules about what counts as a resource are specific to Maine. For example, Maine covers some services that other states do not, and Maine's income limits may be higher or lower than neighboring states.

If you have moved to Maine from another state and were covered by Medicaid there, your coverage does not automatically transfer. You will need to contact the Maine MaineCare office to see whether you are covered under Me Medicaid. Your income and resources may may have access to you in Maine even if they did not in your previous state, or vice versa.

If you are planning to move out of Maine, your Me Medicaid coverage will end on your last day in the state. You will need to contact the Medicaid program in your new state to see what coverage is available there.

Frequently Asked Questions

What is the difference between Me Medicaid and MaineCare?

They are the same program. MaineCare is the name Maine used for its Medicaid program for many years, and some people and offices still use that name. Me Medicaid is the newer official name. If you hear either name, they refer to the same coverage.

Can I get Me Medicaid if I am not a U.S. citizen?

You may be covered if you are a may have access to immigrant — this includes people with a green card, refugees, asylees, and some other immigration statuses. Call the MaineCare office or 211 to find out whether your immigration status qualifies you. Undocumented immigrants are not covered by Me Medicaid, though Maine may have emergency-only coverage in some situations.

How long does it take to learn about I am covered?

If you call the MaineCare office with your income and household information, they can often tell you on the phone whether you are likely to be covered. The formal process of gathering documents and submitting them usually takes one to two weeks. Urgent cases may be processed faster.

What if I disagree with a decision about my coverage?

You have the right to request a hearing. The MaineCare office will send you a letter explaining the decision and telling you how to request a hearing. You must request it within a certain time frame, so read the letter carefully and follow the instructions.

Does Me Medicaid cover dental and vision care?

Me Medicaid covers dental care for children and some adults, and it covers vision care including eye exams and glasses. Coverage varies by age and category, so ask the MaineCare office what is covered for you.