Key Facts
MaineCare (Medicaid) in Maine
Maine expanded Medicaid in 2019 following a voter referendum that passed in 2017. MaineCare, the state's Medicaid program, now provides comprehensive health coverage to low-income adults who previously had no affordable options. This expansion has been particularly important for Maine's large rural population.
Who Qualifies for MaineCare?
- Adults ages 19-64 with income up to 138% FPL ($20,783/year for individuals)
- Pregnant women with income up to 214% FPL
- Children under 19 with income up to 213% FPL
- Seniors and people with disabilities meeting income and asset requirements
- Parents/caretakers meeting income requirements
MaineCare Benefits
- Preventive care and wellness visits
- Doctor visits and specialist care
- Hospital inpatient and outpatient services
- Prescription drug coverage
- Mental health and substance abuse treatment
- Dental services (limited for adults)
- Vision care
- Laboratory and X-ray services
- Transportation to medical appointments
How to Apply
You can apply for MaineCare through:
- Online at maine.gov/dhhs/ofi/applications-forms
- By phone: 1-855-797-4357
- In person at your local Department of Health and Human Services office
- Through a certified application counselor or navigator
Health Insurance Marketplace
Maine uses the federal Health Insurance Marketplace at HealthCare.gov. If you earn more than 138% FPL or prefer private coverage, the marketplace offers plans from several insurance carriers.
Available Plan Types
- Bronze: Lower premiums, higher out-of-pocket costs (60% coverage)
- Silver: Moderate premiums and costs (70% coverage) - best for subsidies
- Gold: Higher premiums, lower out-of-pocket costs (80% coverage)
- Platinum: Highest premiums, lowest out-of-pocket costs (90% coverage)
Enrollment Periods
Open Enrollment: November 1, 2024 - January 15, 2025
MaineCare accepts applications year-round. You can also qualify for a Special Enrollment Period on the marketplace if you have a qualifying life event.
Average Costs in Maine
Health insurance costs in Maine vary based on your age, location, plan type, and tobacco use. Maine's rural nature and older population can contribute to higher premiums. Here are typical monthly premiums before subsidies:
| Plan Type | Individual (Age 40) | Family of 4 |
|---|---|---|
| Bronze | $360 - $430 | $1,150 - $1,400 |
| Silver | $450 - $550 | $1,400 - $1,800 |
| Gold | $520 - $620 | $1,600 - $2,000 |
| MaineCare | $0 | $0 |
Frequently Asked Questions
Has Maine expanded Medicaid?
Yes, Maine expanded Medicaid in 2019 following a voter referendum. Adults with household incomes up to 138% of the Federal Poverty Level now qualify for MaineCare, the state's Medicaid program.
Where do I buy health insurance in Maine?
Maine uses the federal health insurance marketplace at HealthCare.gov. Residents can shop for and enroll in qualified health plans during open enrollment or with a qualifying life event.
When is open enrollment for Maine health insurance?
Open enrollment for 2025 coverage through HealthCare.gov runs from November 1, 2024 through January 15, 2025. Enroll by December 15 for coverage starting January 1.
What is MaineCare?
MaineCare is Maine's Medicaid program providing free or low-cost health coverage to eligible low-income residents. With expansion, adults under 65 with incomes up to 138% FPL qualify for coverage.
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