Eligibility for Medicaid in Maine

You may be wondering, “What are the requirements for Medicaid in Maine?” if you are in need of affordable health insurance. Maine Medicaid benefits eligibility is determined by citizenship, residency, income, age and familial status. Benefits and coverage options are also available for qualifying adults who have been deemed disabled by the Social Security Administration. Understanding who is eligible for Medicaid can help you and your family is better prepared when submitting a Medicaid application.

Before asking, “What are the Medicaid application guidelines in Maine?” familiarize yourself with MaineCare. MaineCare is the name of Maine’s state Medicaid program. MaineCare provides Medicaid health insurance benefits and other forms of assistance to qualifying individuals and families who have limited resources. For more information on how to qualify for Medicaid – it is recommended that you review the sections that have been provided below.

Who is Eligible for Medicaid in Maine?

When asking, “What are the requirements for Medicaid in Maine?” It is recommended that you familiarize yourself with the different covered groups that are eligible for Medicaid health insurance benefits. When determining who is eligible for Medicaid, it is important to know that Medicaid benefits are available to qualifying children who are 18 years of age or younger as well as parents and caretakers who live with them. Adults who are either 19 years old or 20 years of age and still live with their parents may also be eligible to receive Medicaid coverage. Senior citizens who are ages 65 years old and older may also meet Medicaid benefits eligibility, so long as they meet all other requirements such as citizenship, residency and income. Lastly, adults who meet the Social Security Administration’s definition of disability may be eligible for Medicaid benefits in Maine.

While these are the general Medicaid eligibility requirements concerning covered groups, there are some exceptions. Qualifying pregnant women may also qualify for Maine Medicaid health insurance. Individuals, who are between the ages of 40 years old and 64 years old, do not have any other health insurance and have a positive screening for breast or cervical cancer may also be eligible for full benefits. Individuals who are HIV positive, but do not meet covered group requirements, may still be eligible for limited Medicaid benefits.

What Are The Requirements for Medicaid Concerning Citizenship and Maine Residency?

If asking, “What are the Medicaid application guidelines in Maine?” it is important to familiarize yourself with citizenship and immigration status requirements. Medicaid benefits eligibility require that an applicant must be either a United States citizen, a permanent resident or have a qualifying immigration status. In some cases, qualifying immigrants may be required to have resided within the United States for a minimum of five years prior to receiving Medicaid benefits. However, some emergency benefits may be available to non-citizens who do not possess documents from Immigration and Naturalization Services (INS). Income limits and asset limits for non-citizens without documentation will depend on their age. Emergency refers to a sudden, severe and short lived physical injury or illness that requires immediate treatment in order to prevent further harm or death. Childbirth is also covered under this type of Medicaid benefit.

In order to determine who is eligible for Medicaid in Maine, you must also understand residency requirements. In order to be eligible to receive Medicaid assistance in Maine, you must reside within the state of Maine. This is the case even if you reside on the border of Maine and another state or work in Maine and live within a neighboring state. Your state residence is determined by the residential address of your primary residence. Download our comprehensive guide to health care to understand more about the requirements for Medicaid.

What are the Income Requirements for Medicaid in Maine?

If you are wondering, “What are the income requirements for Medicaid in Maine?” you should know that is a valid question. However, it is not one that is always the same from one qualifying individual or family to the next. Income requirements are, in part, based upon the covered group that you belong to such as a child who is 18 years of age or younger, a pregnant woman, a parent or a senior citizen. For example, children and pregnant women have higher income limits than other covered groups for Medicaid eligibility. Additionally, if a child who is receiving Medicaid would lose coverage due to an increase in family income, that child may still be eligible for Medicaid benefits for up to 18 months with an imposed monthly premium. There are also different Medicaid eligibility requirements regarding individuals who are residing in a nursing facility, residential care facility or individuals who are receiving nursing care services within their home.

When calculating whether or not your income meets Medicaid benefits eligibility, it is important to know that income refers to money from any sources such as wages, child support, alimony, rental income, Social Security and pensions. It is also worth knowing that some covered groups have different rules in regards to which of these incomes are disregarded when accessing Medicaid eligibility. There are also certain expenses that may count as a deductible against your gross income, such as rent, mortgages and utilities.

Who Does Not Meet Maine Medicaid Eligibility Requirements?

Now that you better understand who is eligible for Medicaid in Maine, it is important to know who does not meet eligibility requirements. Generally, adults who do not live with a dependent child, are not pregnant and are not disabled will not be eligible for Maine Medicaid, even if they otherwise meet citizenship, residency and income requirements. Furthermore, individuals who are not United States citizens and do not have paperwork from the Immigration and Naturalization Services (INS) will not be eligible for Medicaid, other than the emergency services benefits that may be available. If you are an applicant who does not reside within the state of Maine, you will not be eligible for state benefits for any reason. Families and individuals who do not meet income requirements will not be eligible for Medicaid in Maine. The only exception is for children. Children may still be eligible for the Children’s Health Insurance Program (CHIP), a division of Medicaid, which provides insurance to children whose family does not meet Medicaid income limits.

For more information on how to qualify for Medicaid – download our comprehensive guide. This informative guide will go into more detail on eligibility requirements for Medicaid.