If one of these coverage groups describes your situation and you meet eligibility requirements, you may be covered by MaineCare’s full benefit package:
- Parent or Caretaker Relative - You are the guardian, caretaker, or relative of a dependent child or you are related by blood or marriage or have adopted the child. The child must also be living with you and you must have primary responsibility for the child’s care.
- Adults between age 21 and 64 who are not eligible for Medicare
- Pregnant Women - You are pregnant, or you had a pregnancy that ended within the last 60 days.
- Former Foster Care Children - You are under 26 years old, were in foster care in the State of Maine and were enrolled in Medicaid through the State of Maine at age 18, and are not otherwise eligible for, or enrolled in, other Medicaid coverage.
If you are an adult who is age 65 and older or eligible for Medicare, please see the Older Adults and Adults with Disabilities webpage.
MaineCare also offers more limited benefits to help Mainers cover the cost of pharmacy and dental services, as well as programs that help with the cost of drugs, private health insurance premiums, and more. Learn more about limited benefit packages.
How to Apply
Ready to apply? Learn about your options for applying online, by mail, and in person. Applications for MaineCare are processed by DHHS’s Office for Family Independence.
MaineCare covers only services that are medically necessary. There may be limits on how many times you can use a service.
Some examples of services that may be covered:
- Visits to your doctor
- Behavioral health services
- Inpatient and outpatient hospital visits
- X-rays and labs
The services covered depends on your MaineCare eligibility category. MaineCare may not cover all services listed.
What do I need to get a service?
For some services, you may need:
- You provider to get Prior Authorization (PA) from MaineCare
- A prescription for medication
- To pay a copayment
- A medical assessment of your ability to take care of yourself and do household tasks
Services Not Covered
Some examples of services that are not covered:
- Cosmetic surgery
- Experimental procedures or drugs
- Health club memberships, such as the YMCA
- Massage therapy
MaineCare pays for many preventive services. These services keep you well and can find health problems before they become serious.
What are some examples of preventive services that are covered?
- Annual physical exams
- Immunizations, also called vaccines or shots
- Pap smears for women
- Prostate screenings for men
- Eye exams
Adult Dental Coverage
Expanded Adult Dental Coverage
Beginning on July 1, 2022, we expanded adult dental coverage. All individuals over age 21 years old have access to comprehensive dental coverage.
What services may be covered?
- Diagnostic services, such as oral evaluations and x-rays
- Preventive services, such as cleanings, fluoride, and tobacco and substance use counseling
- Restorative services, such as fillings and crowns
- Endodontic services, such as root canals
- Periodontic services, such as various gum surgeries and cleanings that occur below the gums
- Complete, partial, and immediate dentures and denture repairs
- Oral surgeries, such as tooth extractions and removal of tumors and lesions
- Adjunctive services, such as sedation and night guards
How can I find a dentist who accepts MaineCare?
To find a dental provider, please call MaineCare Member Services at 1-800-977-6740.
If you want to quit tobacco, MaineCare can help!
MaineCare may cover these services to help you quit:
- Tobacco treatment counseling services
- Nicotine replacement options like the nicotine patch or gum
- Doctor visits
If you're ready to quit, you can call or visit:
- The Maine QuitLink at 1-800-QUIT-NOW or mainequitlink.com to get free help with your quit plan.
- Your doctor for help finding services and determining which products might be best for you.
MaineCare Member Services Can Help
To see if a service you need is covered, call MaineCare Member Services at 1-800-977-6740. TTY users, dial 711. Make sure MaineCare covers the service you need before you get care. There are limits or special rules for most covered services.