Mainecare Eligibility Manual

MaineCare Eligibility Manual: Your Complete Guide to Navigating the System

Navigating the complexities of MaineCare, Maine's Medicaid program, can feel overwhelming. Understanding eligibility requirements and the application process is crucial for securing vital healthcare coverage. This comprehensive guide serves as your personal MaineCare eligibility manual, providing clear, concise information to help you determine your eligibility and successfully navigate the application process. We'll break down the key requirements, address common questions, and offer resources to simplify your journey. This in-depth resource will save you time and frustration, empowering you to access the healthcare you deserve.

Understanding MaineCare Eligibility: Key Factors

MaineCare eligibility hinges on several key factors, primarily income and resource limits. These limits are adjusted periodically, so it's essential to consult the most up-to-date information from the official MaineCare website.

Income Requirements

MaineCare uses both gross and net income to determine eligibility. Gross income includes all earnings before taxes and deductions, while net income is the amount remaining after taxes and deductions. The allowable income limits vary depending on household size, age, and other factors. For example, a single adult might have a lower income limit than a family with multiple children. It's crucial to accurately report all income sources, including wages, salaries, self-employment income, Social Security benefits, and any other sources of income.

Resource Limits

Beyond income, MaineCare considers resource limits. Resources generally include assets like bank accounts, stocks, bonds, and real estate. These limits also vary depending on the applicant's circumstances. Certain assets, such as a primary residence and a vehicle, may be exempt, depending on their value.

Age and Disability

Specific eligibility criteria exist for different age groups and individuals with disabilities. Children, pregnant women, seniors, and individuals with disabilities often have different income and resource limits or may qualify under specific programs within MaineCare.

Citizenship and Residency

You must be a U.S. citizen, a legal alien, or a qualified non-citizen to be eligible for MaineCare. You must also meet Maine residency requirements.

The Application Process: A Step-by-Step Guide

Applying for MaineCare involves several steps. While the process can seem daunting, breaking it down into manageable steps can make it less overwhelming.

Gathering Necessary Documents

Before beginning the application, gather all necessary documents. These typically include proof of income, proof of residency, social security numbers for all household members, and birth certificates. Having these documents ready will streamline the application process.

Completing the Application

The MaineCare application can be completed online, by mail, or through assistance from a local MaineCare office. The online application is generally the most convenient option. Ensure you accurately complete all sections of the application to avoid delays.

Submitting the Application

Once completed, submit your application through the chosen method. After submission, you'll receive confirmation and an estimated processing time.

Follow-Up and Appeals

If your application is denied, you have the right to appeal the decision. The MaineCare website provides information on the appeals process and the necessary steps to take.

Understanding Different MaineCare Programs

MaineCare isn't a single program; it encompasses several different programs designed to cater to specific populations and needs. Understanding these programs is essential for determining which one you may qualify for.

MaineCare for Children

This program provides comprehensive health coverage for children under 19 who meet specific income and resource limits.

MaineCare for Adults

MaineCare for adults offers coverage to adults who meet certain income and resource criteria. Specific programs within this category exist for pregnant women and parents with dependent children.

MaineCare for Seniors and People with Disabilities

This program offers coverage to individuals 65 and older and those with disabilities who meet specific eligibility requirements.

MaineCare Long-Term Care

This program provides long-term care services for eligible individuals who require assistance with daily living.

Navigating the System: Helpful Resources

Several resources can assist you in navigating the MaineCare system:

The official MaineCare website: This is your primary source for the most up-to-date information, application forms, and contact details.
Local MaineCare offices: These offices provide in-person assistance with the application process.
Community health centers: Many community health centers offer assistance with MaineCare applications.

Conclusion

Successfully navigating MaineCare eligibility requires understanding the various requirements and the application process. This guide provides a comprehensive overview, empowering you to take control of your healthcare access. Remember to utilize the available resources, and don't hesitate to seek assistance if needed. Securing MaineCare coverage can significantly impact your health and well-being.

FAQs

Q1: What happens if my income changes after I apply for MaineCare? A: You must report any changes in your income or resources immediately. Failure to do so can result in penalties or loss of coverage.

Q2: Can I still be eligible for MaineCare if I have some savings? A: Yes, but the amount of savings you can have depends on your specific circumstances and the program you are applying for. Consult the resource limits outlined on the official MaineCare website.

Q3: How long does the MaineCare application process typically take? A: Processing times vary, but it's generally advisable to allow several weeks for your application to be processed.

Q4: What if my application is denied? A: If your application is denied, you have the right to appeal the decision. The denial letter will explain the appeals process.

Q5: Are there any penalties for providing false information on the application? A: Yes, providing false information on your application can lead to penalties, including loss of coverage and potential legal repercussions. Accuracy is crucial.


  mainecare eligibility manual: Elder Law Nina Kohn, 2024-09-15 Revised with teachers and learners in mind, the Third Edition of Elder Law: Practice, Policy, and Problemscomprehensively updates this market-leading casebook. It combines a client-focused approach with in-depth discussions of elder law related policy issues. Designed to be both practical and theoretical, it provides students with specific legal knowledge and a conceptual framework for understanding key issues confronting older adults and the attorneys who represent them. The author’s narrative frames a series of primary materials including cases, statutes, regulations, and sample documents, as well as excerpts from articles designed to stimulate student thinking and discussion. Problems and exercises are numerous. Many relate to client counseling and ask students to imagine themselves in the role of the elder law attorney, and to describe how they would handle various scenarios, such as a client meeting. In addition, questions in each section prompt students to critique key policies, or consider policy changes, and thereby allow students to test their understanding of policies and more deeply think through their consequences. Key Features of the Third Edition: The new edition maintains the book’s status as the most up-to-date and cutting-edge elder law casebook with the following key features: Updates to statutory and regulatory materials New demographic and economic information Updates to eligibility criteria for public benefits Greater emphasis on intersectionality Lessons learned (and legal changes resulting from) the COVID-19 pandemic More excerpts of scholarly articles on key legal, policy, and philosophical dilemmas, designed to help support professors who wish to foster juicy, “big picture” discussions of old age policy Coverage of additional topics including, intergenerational justice, ageism and elderspeak, and family formation in later life Adds a handful of new cases to reflect legal developments and enhance the teaching experience while also moving several longer cases to notes Professors and students will benefit from: Very clearly organized content A client-centered approach Integrated discussion of policy and current issues Relevant cases, statutes, regulations, sample documents, and commentaries that are fully integrated into the casebook All relevant statutory material being in the casebook; no need to require a separate statutory supplement Practice problems of varying difficulty that encourage students to apply what they are learning to realistic client-focused hypothetical scenarios Questions throughout the text that prompt critical thinking and prepare students to engage in classroom discussion ● Exercises that can be used for either independent or in-class assignments
  mainecare eligibility manual: Making Eye Health a Population Health Imperative National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on Public Health Approaches to Reduce Vision Impairment and Promote Eye Health, 2017-01-15 The ability to see deeply affects how human beings perceive and interpret the world around them. For most people, eyesight is part of everyday communication, social activities, educational and professional pursuits, the care of others, and the maintenance of personal health, independence, and mobility. Functioning eyes and vision system can reduce an adult's risk of chronic health conditions, death, falls and injuries, social isolation, depression, and other psychological problems. In children, properly maintained eye and vision health contributes to a child's social development, academic achievement, and better health across the lifespan. The public generally recognizes its reliance on sight and fears its loss, but emphasis on eye and vision health, in general, has not been integrated into daily life to the same extent as other health promotion activities, such as teeth brushing; hand washing; physical and mental exercise; and various injury prevention behaviors. A larger population health approach is needed to engage a wide range of stakeholders in coordinated efforts that can sustain the scope of behavior change. The shaping of socioeconomic environments can eventually lead to new social norms that promote eye and vision health. Making Eye Health a Population Health Imperative: Vision for Tomorrow proposes a new population-centered framework to guide action and coordination among various, and sometimes competing, stakeholders in pursuit of improved eye and vision health and health equity in the United States. Building on the momentum of previous public health efforts, this report also introduces a model for action that highlights different levels of prevention activities across a range of stakeholders and provides specific examples of how population health strategies can be translated into cohesive areas for action at federal, state, and local levels.
  mainecare eligibility manual: Strategies for Improving Homeless People's Access to Mainstream Benefits and Services Martha R. Burt, 2010 In 2000, HUD, in recognition that any solution to homelessness must emphasize housing, targeted its McKinney-Vento Act homeless competitive programs towards housing activities. This policy decision presumed that programs such as Medicaid, TANF and General Assistance could pick up the slack produced by the change. This study examines how 7 communities sought to improve homeless people¿s access to mainstream services following this shift away from funding services through the Supportive Housing Program. Provides communities with models and strategies that they can use. Highlights the limits of what even the most resourceful of communities can do to enhance service and benefit access by homeless families and individuals.
  mainecare eligibility manual: Functional Family Therapy Thomas L. Sexton, 2000
  mainecare eligibility manual: Telemedicine Dee W. Ford, Shawn R. Valenta, 2021-03-03 This book provides an overview of key issues with regards to implementing telemedicine services as well as an in depth overview of telemedicine in pulmonary, critical care, and sleep medicine. Topics range from specific practices to program development. Telemedicine has experienced explosive growth in recent years and yet, implementing telemedicine solutions is complex with substantial regulatory, legal, financial, logistical, and intra-organization/intra-personal barriers that must be overcome. This book provides the necessary information and guidance to address those complex issues. This book is broadly divided into two parts 1) a primer on requisite steps before embarking on telemedicine service development and 2) specific applications and examples where telemedicine is successfully utilized to improve quality of care in pulmonary, critical care, and sleep medicine. The first part includes coverage of telemedicine and finance, regulatory and legal issues, and program development. The second part delves into specifics with information on ambulatory telemedicine programs, inpatient consultations, and tele-ICU programs. All chapters are written by interprofessional authors that are leaders in the field of telemedicine with extensive knowledge of diverse telemedicine programs and robust real-world experience on the topic. This is an ideal guide for telehealth program managers, and pulmonary, critical care, and sleep medicine professionals interested in improving their telehealth practice.
  mainecare eligibility manual: SSI Annual Statistical Report ... United States. Social Security Administration. Division of SSI Statistics and Analysis, 2002
  mainecare eligibility manual: Critical Care Transport American Academy of Orthopaedic Surgeons (AAOS),, American College of Emergency Physicians (ACEP),, 2009-11-09 Welcome to the new gold standard in critical care transport training. Published in conjunction with the American Academy of Orthopaedic Surgeons (AAOS) and the American College of Emergency Physicians (ACEP), Critical Care Transport offers cutting edge content relevant to any healthcare provider training in critical care transport. Like no other textbook in this market, Critical Care Transport thoroughly prepares medical professionals to function as competent members of a critical care team by covering the material that everyone—paramedics, nurses, physicians, and specialty crew—needs to know to operate effectively in the prehospital critical care environment. This book meets the curricula of major critical care training programs, including University of Maryland, Baltimore County (UMBC). It covers both ground and flight transport, and meets the objectives of critical care transport certification exams such as the Certified Flight Paramedic (FP-C) exam administered by the Board for Critical Care Transport Paramedic Certification. Content includes information specific to prehospital critical care transport, such as flight physiology, lab analysis, hemodynamic monitoring, and specialized devices such as the intra-aortic balloon pump. Standard topics such as airway management, trauma, and pharmacology are covered in the context of critical care. Chapters have been authored by leading critical care professionals across the country and represent the most current, state-of-the-art information on management of critical care patients.
  mainecare eligibility manual: SSI Recipients by State and County , 1992
  mainecare eligibility manual: Fiduciaries and Trust Paul B. Miller, Matthew Harding, 2020-04-02 Explores the interactions of fiduciary law and personal and political trust in private, public and international law.
  mainecare eligibility manual: Recommendations to the Congress United States. Congress. Pepper Commission, 1990
  mainecare eligibility manual: Guidelines for Perinatal Care American Academy of Pediatrics, American College of Obstetricians and Gynecologists, 1997 This guide has been developed jointly by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, and is designed for use by all personnel involved in the care of pregnant women, their foetuses, and their neonates.
  mainecare eligibility manual: Bayley Scales of Infant and Toddler Development Nancy Bayley, 2006
  mainecare eligibility manual: Older Workers Benefit Protection Act United States, 1990
  mainecare eligibility manual: Autism Spectrum Disorders Eric Hollander, Randi J. Hagerman, Deborah Fein, 2018-04-30 In DSM-5, published in 2013, the classification of autism spectrum disorder (ASD) was created, subsuming several diagnoses and representing a significant evolution from its first appearance in the DSM-III three decades earlier. Autism Spectrum Disorders reflects this evolution, offering clinicians and families a succinct, definitive, and up-to-date guide to current research in the field and its impact on assessment and treatment. The book begins with the epidemiology of ASDs, which have increased in prevalence, and explores genetic heritability and environmental risk factors. It then explains the roles of the psychiatrist, neurologist and pediatrician in assessing the patient, examines assessment tools and processes, and describes the latest advances in a variety of treatments and interventions. The text's focus is on educating and empowering families and health care providers to determine whether appropriate genetic testing and counseling have been undertaken, whether the individual has had the relevant assessment, and whether skilled behavioral treatment and additional medical assessment or treatment are required. Specifically, the text: Reviews existing prevalence estimates for ASDs since 2000 and discusses methodological factors impacting the estimation of prevalence and the interpretation of changes in prevalence estimates over time. Evaluates genomic and epigenomic research over the last decade in the context of translating findings to practice, in terms of testing (e.g., copy number variants and whole-exome sequencing) and counseling. Examines the role of environmental toxicity in immune dysregulation, which has now been noted among individuals with ASD and their family members by numerous studies. Reviews medical and cognitive assessments that may be needed. Reviews targeted treatments that have the potential to reverse neurobiological abnormalities in ASD Reviews behavioral treatments that are effective in promoting development and improving behavior. Describes the Developmental, Individual Difference, Relationship-based (DIR) model, a comprehensive developmental theory with relevance across the lifespan, which targets the core deficits of ASD identified in DSM-5. Provides an overview of school-based interventions for students with autism, exploring the rationale for conducting school-based research and examining existing teacher-, paraprofessional-, and peer-mediated interventions school-based interventions. Explores other approaches to ASDs, such as complementary and integrative approaches and non-invasive brain stimulation technologies, including transcranial magnetic stimulation. The push for early screening is resulting in earlier diagnosis of ASDs and the provision of evidence-based interventions that have a positive impact on outcomes. Autism Spectrum Disorders provides a bench-to-bedside guide that is essential reading for health care providers and families facing the challenges inherent in these complex disorders.
  mainecare eligibility manual: A Desktop Guide to SSI Eligibility Requirements , 1991
  mainecare eligibility manual: Medicaid Eligibility Quality Control United States. Social and Rehabilitation Service, 1975
  mainecare eligibility manual: The Social Determinants of Mental Health Michael T. Compton, Ruth S. Shim, 2015-04-01 The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the take-away messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a Call to Action, offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.
  mainecare eligibility manual: Conditions of Participation for Hospitals United States. Social Security Administration, 1966
  mainecare eligibility manual: D C, 0-3 Alicia F. Lieberman, Serena Wieder, Emily Schrag Fenichel, 1997 Helps professionals from various disciplines to put DC:0-3's diagnostic system into practice. Twenty-four detailed case reports, documenting work with children, ages 6 months to 4-1/2 years, and their families, show how highly experienced practitioners from a range of disciplines use Zero to Three's DC:0-3.
  mainecare eligibility manual: Domestic Service Employees United States. Employment Standards Administration, 1979
  mainecare eligibility manual: The Social Security Definition of Disability , 2003
  mainecare eligibility manual: Pediatric Voice Lisa N. Kelchner, Susan Baker Brehm, Barbara Weinrich, 2014-01-10
  mainecare eligibility manual: Wilderness EMS Seth C. Hawkins, 2017-10-16 Wilderness EMS is designed for EMS providers and leaders who deliver medical care in the wilderness, and those practicing wilderness medicine as part of a formal team. The textbook is a comprehensive, expertly-written reference ideal for this fast-changing and multidisciplinary specialty. This first-of-its-kind text provides specialized instruction and best practices for wilderness EMS practitioners and students – crucial information for the success of today’s rescue missions. A strong foundation in evidence-based medicine, clinical experience, and field applicability makes it especially useful for any EMS provider in a wilderness environment.
  mainecare eligibility manual: The Fundamentals of Legal Drafting Reed Dickerson, 1986 This book gives the practitioner a detailed treatment of the principles and applications of effective legal drafting. New material on drafting strategy, verbal sexism, and the use of computers for word processing of legal documents is included in the work.
  mainecare eligibility manual: The CMS Hospital Conditions of Participation and Interpretive Guidelines , 2017-11-27 In addition to reprinting the PDF of the CMS CoPs and Interpretive Guidelines, we include key Survey and Certification memos that CMS has issued to announced changes to the emergency preparedness final rule, fire and smoke door annual testing requirements, survey team composition and investigation of complaints, infection control screenings, and legionella risk reduction.
  mainecare eligibility manual: Competitive Employment Paul Wehman, 1981 Ce livre comprend un profil du mouvement de l'intégration au travail et du Supported employment avec une perspective historique, une déclaration des orientations nécessaires à l'intégration sociale, des stratégies d'iontervention reliées à une approche behavioriste sur l'enseignement professionnel et des recommandations pour l'application de programme d'intégration au travail.
  mainecare eligibility manual: Senate and House Journals Kansas. Legislature. Senate, 1959
  mainecare eligibility manual: Cases in Health Services Management Jonathon S. Rakich, Beaufort B. Longest, Kurt Darr, 1987
  mainecare eligibility manual: What Every Special Educator Must Know Council for Exceptional Children, 2000 This document presents revised comprehensive standards and guidelines for the preparation and certification of special educators and for practice as special educators, developed by the Council for Exceptional Children (CEC). Section 1 provides CEC's Code of Ethics and Standards for Professional Practice for Special Education. Section 2 presents CEC's International Standards for Entry into Professional Practice and for Continuing Professional Growth. It contains a curriculum-referenced licensing and program accreditation framework recommended for licensing of entry-level professionals in special education. Guidelines for mentoring and for continuing practice in the profession are also included. Section 3 contains the knowledge and skill standards that special education preparation programs use for developing and evaluating their programs and that CEC uses for the national accreditation process. The last section contains the profession's Knowledge and Skill Standards. Skill standards are also included for paraeducators, career/transition specialists, educational diagnosticians, and special education administrators. Appendices include summaries of the history of special education and professional standards, and a self-evaluation instrument designed for use by students of special education to evaluate their progress in learning knowledge and skills. (CR)
  mainecare eligibility manual: Kinship Navigators Gerard Wallace, Liliana Hernandez, Julie Treinen, 2015
  mainecare eligibility manual: Government Reports Announcements & Index , 1996-06
MaineCare
What is MaineCare? MaineCare, Maine’s Medicaid program, is free or very low-cost health insurance for eligible people who live in Maine. MaineCare covers well and sick care ofice visits, …

MaineCare Eligibility Guide - maineequaljustice.org
Nov 7, 2019 · This Guide contains user-friendly explanations about how eligibility works for some common MaineCare programs. Although MaineCare helps many Mainers of all ages …

2022 MaineCare Eligibility Guidelines v4
2-step income test: Unearned income must be under 100% of FPL. Total earned and unearned income must be under 250% of FPL. Asset Limit: $8,000 per individual or $12,000 per couple. Must …

Medicaid Management Information Systems - Maine
Nov 12, 2018 · Introduction. Trading Partners who are Providers, Billing Agents or Health Plans can check member eligibility on the MIHMS Health PAS Online Portal. The MyHealth PAS Eligibility …

MaineCare Eligibility Guidelines - Maine Family Planning
MaineCare Eligibility Guidelines. Income: Includes household money from sources such as Social Security, pensions, wages, alimony, self-employment, etc. Some income is partially or …

Appendix A Medicare and the Buy-In Process
10-144 Chapter 332, MaineCare Eligibility Manual: Appendices and Charts Appendix A . Medicare and the Buy-In Process . Medicare (Title 18 of the Social Security Act) is a health …

10-144 Chapter 101 MAINECARE BENEFITS MANUAL …
May 21, 2020 · 10-144 Chapter 101 MAINECARE BENEFITS MANUAL CHAPTER II SECTION 65 BEHAVIORAL HEALTH SERVICES ESTABLISHED 8/1/08 EMERGENCY RULE LAST UPDATED 5/21/20 3 65.02 DEFINITIONS (cont.) 65.02-14 Continuing Education Unit (CEU) is a measure used in continuing education programs, particularly those required in a licensed …

Estate Recovery Overview Updated December 2021 - Maine
Maine offers two options for MaineCare members to seek a waiver from full estate recovery of MaineCare payments. MaineCare deducts the amount of the waiver granted from the value of the estate assets. These two waivers options are: 1. “Care Given” Waiver Heirs who provided care for the MaineCare member while living in the member’s home

10-144 Chapter 101 MAINECARE BENEFITS MANUAL …
Mar 16, 2020 · of home health services, pursuant to Ch. II Section 40 of the MaineCare Benefits Manual (“Home Health Services”). 4.01-4 MaineCare Covered Services Services covered and reimbursed through MaineCare as provided in the MaineCare Benefits Manual. 4.01-5 Member Any person certified as eligible for services under the MaineCare program.

State of Maine Developmental Services Application for …
4. MaineCare covered services (subject to age, eligibility, and coverage restrictions as specified in other Sections of the manual as well as Early and Periodic Screening, Diagnosis and Treatment Services requirements as detailed in Chapter II, Section 94 of the Maine care Benefits Manual.) 5.

MaineCare for Working People with Disabilities
This is a MaineCare program for working people with disabilities who do not qualify for free MaineCare because of their income and/or assets. The purpose of the program is to provide people with disabilities the opportunity to work and access health care services and supports they need. You may qualify for this MaineCare option if: 1.

MaineCare in Education: An Overview for School Administrators
School districts may also contract with MaineCare providers to provide medical services to students by allowing them to utilize space in their buildings or on school grounds. MaineCare does NOT consider this to be a school-based service. MaineCare providers must deliver all services in accordance with the MaineCare Benefits Manual. Provider ...

MAINECARE/MEDICAID PROVIDER AGREEMENT
Office of MaineCare Services 11 State House Station Augusta, Maine 04333-0011 Tel; (207) 287-2674; Fax (207) 287-2675 TTY: Dial 711 (Maine Relay) Janet T. Mills Governor Jeanne M. Lambrew, Ph.D. Commissioner MAINECARE/MEDICAID PROVIDER AGREEMENT This is a Provider Agreement for participation in the MaineCare/Medicaid program. This

DATE: TO: FROM: Location: 179 Western Ave.
MaineCare Services 11 State House Station Augusta, Maine 04333-0011 Tel.: (207) 287-2674; Fax: (207) 287-2675 TTY Users: Dial 711 (Maine Relay) DATE: July 11, 2017 TO: Interested Parties FROM: Stefanie Nadeau, Director, MaineCare Services SUBJECT: Proposed Rule: MaineCare Benefits Manual, Chapter 101, Section 21, Home and Community Benefits

MaineCare in Education
MaineCare members have a responsibility to report changes within ten days. This includes, but is not limited to: changes in income, assets, pre-tax deductions, other household insurance coverages, household composition, and address changes. MaineCare members are required to provide all requested verifications and complete annual eligibility ...

BRAP Program Manual - Maine
Co-Occurring Substance Use Disorders (SUD) who meet Eligibility for Care Criteria for Community Support Services, as defined in the most recent version of Section 17 of the MaineCare Benefits Manual. Correctional Facility: A jail, prison, or other place of incarceration by government officials.

Office of MaineCare Services COVID-19 Vaccination …
presumptive eligibility categories (also known as “pregnancy-related coverage”) ... MaineCare Benefits Manual (MBM) Policy Sections Providers who administer a COVID-19 vaccine to a MaineCare member shall bill in accordance with the requirements of the section of the MBM under which the provider is enrolled and shall

MaineCare in Education 2023 - measbo.org
What Factors Impact Eligibility for Different MaineCare Programs OFI determines eligibility for several different MaineCare programs. At a basic level, the following are used to determine eligibility (not necessarily in this order): Family Household size, income, assets, citizenship, and disability. MaineCare Member Responsibilities

MaineCare in Education: School-Health Related Services
CHILDREN’S ELIGIBILITY MAINECARE IN EDUCATION 15. ELIGIBILITY EXPANSION As directed by the Legislature through PL 2021, Ch. 635, Part CCC, the ... The new rule will be a stand-alone Section of the MaineCare Benefit Manual. Public law 2021, ch. 227, passed under the 130th legislature, ...

10-144 Chapter 101 MAINECARE BENEFITS MANUAL …
10-144 Chapter 101 MAINECARE BENEFITS MANUAL CHAPTER II SECTION 40 HOME HEALTH SERVICES ESTABLISHED 10/1/79 Major Substantive Rule FINAL ADOPTION 8/11/19 3 40.01 DEFINITIONS (cont.) 40.01-15 Medical Social Services are assessment, counseling, and assistance services that are needed by a member to resolve social or emotional problems that …

MAGI-Based Household Income Eligibility Training Manual
Dec 1, 2020 · This manual explains how to determine Medicaid and CHIP eligibility using the MAGI-based methodology. Children. Adults ages 19-64. Parents and caretaker relatives. Pregnant women. 5. Use MAGI to determine eligibility for the following eligibility groups: Comparing Results to Eligibility Levels Determining Household Income Constructing a ...

Mainecare Benefits Manual Chapter 1 - konsnelmovens
Mainecare Benefits Manual Chapter 1 MaineCare Benefits Manual, Section 29, Chapter III, Allowances for Support In order to be able to reimburse for the new services effective September 1, 2014. Contact MaineCare Provider Enrollment at 1-866-690-5585, Option 2, to verify that the ITRT are also subject to rules in

Member’s must have active MaineCare in order to submit a …
97 eligibility criteria. To review the Section 97 criteria, please visit www.maine.gov to access the MaineCare Benefits Manual. The guidance presented in this presentation is meant to give providers a basic understanding of the Adult PNMI Referral …

BRAP Eligibility - Maine
2. Adults with Severe and Disabling Mental Illness who meet Eligibility For Care Criteria for Community Support Services as defined in most recent version at any given time of the Section 17.02 of the MaineCare Benefits Manual (see Appendix . 1). II. DHHS requires that all recipients of BRAP also meet the following conditions: 1.

Maine Behavioral Health Organization
MaineCare Benefits Manual, or who have been granted retroactive MaineCare eligibility after services have been provided. Recipients of services will not be charged for covered services provided during any period of MaineCare eligibility unless a member has knowingly misrepresented, in writing, his or her MaineCare or other insurance coverage ...

MDS-ALS: The Mini-Series Session #1 - Maine
MaineCare Benefits Manual, Chapter II, Section 2, §207-1.A.8: “The Department will sanction providers who fail to accurately complete assessments in a timely manner.” MaineCare Benefits Manual, Chapter II, Section 2, §207-1.A.8.e: e. 10% (sanctions) of MaineCare payments if …

MaineCare Comprehensive Adult Dental Benefit - Maine …
Apr 25, 2022 · PO Box 5137, Augusta, ME 04332 | (207) 621-0677 Comprehensive Adult Dental Benefit mepca.org LD 996, An Act To Improve Dental Health Access for Maine Children and Adults with Low Incomeswas approved by the 130thLegislation and funded by Governor Mills second supplemental budget in May 2021 • Other comprehensive preventive, diagnostic and …

Katie Beckett Benefit:
To qualify for the MaineCare Katie Beckett benefit, your child must: 1. Be under age 19 2. Not be eligible for MaineCare under any other category 3. Meet criteria for physical or mental disability, according to Social Security Disability guidelines 4. Be living at home, not in a medical institution, as defined in the MaineCare Eligibility Manual 5.

ANDROSCOGGIN, FRANKLIN, AND OXFORD COUNTIES …
MaineCare eligibility requirements and specific eligibility requirements for Community Support Services under Section 17 of the MaineCare Benefits Manual. General Requirements. Individuals must meet the eligibility criteria as set forth in the MaineCare Eligibility Manual. Some members may have restrictions on the type and amount of services ...

Maine Department of Health and Human Services Office of …
MaineCare provides free and low-cost health insurance to Mainers who meet certain requirements, based on household composition, income, and/or disability status. MaineCare eligibility will be determined by the criteria set forth in the MaineCare Eligibility Manual. Where do I send my application?

10-144 Ch. 101 MAINECARE BENEFITS MANUAL CHAPTER II …
75.02 MEMBER ELIGIBILITY FOR COVERED SERVICES MaineCare members are eligible for medically necessary vision services as long as they are enrolled in MaineCare. If a member loses his/her MaineCare eligibility, MaineCare will pay for eyeglasses if the provider requested and received approval for eyeglasses and laboratory services while the

KEPRO and Maine Department of Health and Human Services
eligibility. (Please note: Providers must obtain a valid Authorization Number from KEPRO in order to bill for MaineCare-funded services which require such a number. Claims for these services will not be accepted by MaineCare without the Authorization Number.) The KEPRO/Maine Provider Relations team is available to answer any questions about the

MAINE COUNTY COMMISSIONERS ASSOCIATION - MCCA
Jul 22, 2022 · Ch. 332, MaineCare Eligibility Manual: MaineCare Rule #298P (COVID-19 testing for Uninsured Individuals), Part 9, Limited Benefit Groups This rule proposes that the MaineCare Eligibility Manual adopt the eligibility criteria established by The Families First Coronavirus Response Act to reduce barriers to COVID-19 testing, diagnosis, and treatment.

Initial Health Assessment of Select Foreign-Born Populations …
MaineCare. See MaineCare Eligibility Manual for current regulations. Unlikely to have private health insurance as is not eligible to work legally in U.S. Usually none. Asylum seekers must undergo an H&P, PPD, CXR if PPD+, HIV, and RPR with a Civil Surgeon appointed by the USCIS. This is done for administrative purposes and does not really

Maine Immunization Program Provider Policy and Procedure …
This manual will undergo a comprehensive review annually. Consultation on the policies in this manual are conducted routinely with the Centers for Disease Control and Prevention (CDC), the Center for Medicare and Medicaid Services (CMS), and other organizations. Both the provider manual and latest updates can be found on the MIP website at

Making Certain Appropriations and Allocations and Changing …
SUBJECT: Proposed Rules: 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Section 93, Opioid Health Home Services, Chapters II & III DATE AND PLACE OF PUBLIC HEARING: Date and Time: January 2, 2019, 9:00am ... who meet eligibility for MaineCare Benefits Manual, Section 92, Behavioral Health Home Services, Section 91, Health Home Services ...

MaineCare in Education: Medically Necessary Health-Related …
MaineCare Services Policy Division 11 State House Station Augusta, Maine 04333-0011 ... It is the provider’s responsibility to verify a member’s eligibility for MaineCare prior to providing services, as described in Chapter I, Section 1 of the MaineCare Benefits Manual. Medically Necessary Services are: • MaineCare covered services ...

ANDROSCOGGIN, FRANKLIN, AND OXFORD COUNTIES …
MaineCare eligibility requirements and specific eligibility requirements for Community Support Services under Section 17 of the MaineCare Benefits Manual. General Requirements. Individuals must meet the eligibility criteria as set forth in the MaineCare Eligibility Manual. Some members may have restrictions on the type and amount of services ...

MaineCare Snapshot - EDMS
This Snapshot does not represent a comprehensive or exhaustive summary of respective sections from the MaineCare Benefits manual. The MaineCare Snapshot is designed as an introductory overview of the policy requirements. ... Revision Date 1/16/18 Service Order/Referral Eligibility for Care Practitioner Qualifications Service Summary ...

Determining Student Eligibility For Meal Benefits - Maine
•USDA’s Eligibility Manual for School Meals July 18, 2017* •Current year Income Guidelines •Quick Reference Guide •Maine CN YouTube Video Resources. ... • MaineCare • EBT numbers • Any number that does not fit the space provided! • Statement from parent Free and Reduced Price Applications:

Children’s Residential - Maine
Children’s Residential Care Facility eligibility requirements, found in MaineCare Section 97. Kepro will document whether the youth meets criteria for CRCF services in Atrezzo. Section 3: Written Summary Upon completion of the records review, interviews and SIA Meeting, Kepro will prepare a written summary of

Public Law 2021, Ch. 635: An Act to Improve the Child Welfare …
This program increased eligibility by raising the income limits to 133% of the federal poverty level (currently $1507 for a single adult). As of July 2022, over 95,000 people are enrolled through MaineCare expansion, including over 82,000 adults without children. Resources: • MaineCare eligibility guidelines can be located at this link:

DATE: TO: FROM - CCHP
Notice of Agency Rule-making Adoption AGENCY: Department of Health and Human Services, Office of MaineCare Services CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual Ch. I, Section 4, Telehealth Services ADOPTED RULE NUMBER: CONCISE SUMMARY: This adopted rule implements increased access to all pharmacy …

PNMI AFA-HHS Presentation - Maine State Legislature
• Residents assessed with the Medical Eligibility Determination (MED) tool and meet specific medical eligibility • Services provided include personal care, supervision (24/7), medication administration, Nursing, Rehabilitation, coordination of other medical services and transportation and room and board (non MaineCare funds).

Criminal Justice & Public Safety Committee: County Jail Funding
See MaineCare Benefits Manual: 10-144 C.M.R. ch. IOI, Chapter I, Section l .04(B) ("For inmates involuntarily confined in a public institution, state or federal prison, jail, detention facility or other penal facility, who are MaineCare members, MaineCare will pay only for covered inpatient medical institution services provided to the

Maine Immunization Program Provider Policy and Procedure …
Maine Immunization Program Provider Policy and Procedure Manual . Tel: (800) 867 -4775 11 State House Station www.ImmunizeME.org Fax: (207) 287 -8127 Augusta, ME 04330 ImmunizeME.DHHS@maine.gov

DATE: TO: FROM: PUBLIC HEARING - MAINE COALITION FOR …
AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Chapter 101, MaineCare Benefits Manual, Proposed Rule - 10-144, Chapter 101, MaineCare Benefits Manual (MBM), Chapters II and III, Section 106, School-Based Services PROPOSED RULE NUMBER: CONCISE SUMMARY:

131st MAINE LEGISLATURE
4 Human Services shall amend its rule Chapter 332: MaineCare Eligibility Manual, Part 16 5 to increase the amount of a prepaid burial contract from $12,000 to $18,000 that is 6 considered unavailable for use as an asset in determining eligibility for MaineCare and 7 further provide that the amount of a prepaid burial contract considered ...

Primary Care Provider (PCP) Service Location Policy …
MBCHP Primary Care Provider Service location Manual Page 4 of 20 Revised October 2016 MBCHP MEMBER ENROLLMENT MBCHP Member Enrollment Eligibility Criteria The following is a summary of the eligibility criteria used by the MBCHP staff when processing an enrollment application: Age:

Diagnostic Provider Policy Manual 2017 - Maine
The remainder of this manual describes MBCHP services and eligibility requirements, and outlines procedures to be followed by diagnostic providers. MBCHP CLIENT ENROLLMENT MBCHP Client Enrollment Eligibility Criteria The following is a summary of the eligibility criteria used by the MBCHP staff when processing an enrollment application:

New MaineCare Eligibility Workshop Guide - Aroostook …
MaineCare Eligibility Workshop Guide: Navigating Maine’s Medicaid Program Page 6 of 72 Section 1: Foundations Got Questions? Call the Consumers for Affordable Health Care HelpLine: 1-800-965-7476 or Maine Equal Justice Partners: 1-866-626-7059 2. Non-MAGI, traditional or SSI-related are three names for screening predating the ACA.

INFORMATION SHEET: AWAITING PLACEMENT FOR …
need to appeal the denial of medical eligibility for nursing facility level of carein order to apply for APRC. If a member chooses to appeal the denial, the application for ... (Section 67.029, Chapter II, MaineCare Benefits - Manual): • The individual must be a resident of the nursing home at the time the application is

Office of MaineCare Services COVID-19 Vaccination Coverage …
This document summarizes MaineCare’s coverage of COVID-19 vaccine administration and product, reimbursement rates, and covered populations. Please note that a provider administering a COVID-19 vaccine to a MaineCare member must be enrolled with both MaineCare and the Maine Centers for Disease Control (CDC). Providers must

Permanent Supportive Housing Program Frequently Asked …
PSHP program, maintaining MaineCare eligibility ensures a participant has access to supportive services throughout their duration in the program. ... requirements within the MaineCare Benefits Manual. To apply to become a Community Care Team, HOME, BHH or Opioid Health Home provider and see a list of current providers, please visit: Health ...

OFFICE OF POLICY AND LEGAL ANALYSIS - Maine State …
SUMMARY: This resolve directs DHHS to amend its MaineCare rules to provide for increases in the personal needs allowances of residents in nursing facilities from $40 to $70 per month and residential care facilities from $70 to $100 per month. (The personal needs allowance is in chapter 332 of the MaineCare Eligibility Manual.)