Coverage Team | MaineCare, Health Insurance Marketplace, & Other Community Resources
Who do we help?
We have a team of caseworkers who specialize in helping uninsured or under-insured patients enroll in programs like Medicaid/MaineCare and the Health Insurance Marketplace. We can also help with other needs such as food insecurity, heating assistance, transportation, etc.
- We make applying for programs easy for you! We assist patients with the entire application process for many programs, and make referrals to several program partners within our communities.
- Patients are able to get assistance over-the-phone or in-person at our many walk-in locations across the MaineHealth system.
Health Insurance Marketplace | Affordable Care Act (ACA)
Our Certified Application Counselors (CACs) offer in-person and phone counseling to help you enroll in the Health Insurance Marketplace/ACA plans. Typically, 85% of Mainers receive financial assistance to make the plans more affordable.
Open Enrollment is November 1 to December 15 each year. You may be eligible for a Special Enrollment Period during the year if you have a qualifying life event such as:
- Losing your health coverage
- Getting married
- Having a baby
- Adopting a child
For more information see the Health Insurance Marketplace, or email us at email@example.com.
How will Medicaid/MaineCare help me?
- Medicaid/MaineCare is health insurance for people with limited income. It pays for the care you get when you go to the doctor for a yearly well visit or when you are sick, including prescriptions.
- If you have kids, it also covers their dental and vision care.
- Medicaid/MaineCare is free, and most services are covered for free or a small copayment.
How do I know if qualify?
- To qualify for Medicaid/MaineCare your family income must be below a certain level, depending on how many people live with you. Call us to find out if you qualify!
- If you think your income is too high, call us anyway. There are other programs that you or your family members may be able to get. We can help you figure that out.
Other Medicaid/MaineCare Programs
Here is a sampling of some of the other programs offered by Medicaid/MaineCare:
- Medicare Savings Programs: This is a program for people with Medicare who have limited income. The Medicare Savings Program pays your Medicare Part B monthly premium, covers Medicare deductibles and co-pays, and reduces your prescription drug out-of-pocket costs.
- MaineCare Limited Benefit: MaineCare’s Limited Benefit covers yearly physicals, all types of birth control, and many reproductive/sexual health care services. This benefit is unique in that it has a higher eligibility income threshold and only counts your individual income (spousal income is not counted) to qualify.
- Private Health Insurance Premium: To qualify for the Private Health Insurance Premium, someone in the household, usually a child, meets the eligibility requirements for Medicaid/MaineCare and a parent has health insurance through an employer. With the Private Health Insurance Premium, Medicaid/MaineCare becomes secondary insurance coverage to the employer coverage and pays the portion of health care costs that the employer coverage does not. It also pays the monthly premiums (via reimbursement) for the employer coverage.