Maine Medicaid

Last verified: June 2026

What is MaineCare, Maine's Medicaid program?

MaineCare is Maine's Medicaid program. The Maine Department of Health and Human Services (DHHS) Office for Family Independence (OFI) administers it. Maine joined Medicaid in 1966, but the program's modern shape was defined by a 2017 ballot initiative: voters passed Question 2 in November 2017, approving Medicaid expansion under the Affordable Care Act. After a protracted legal dispute with then-Governor LePage, expansion finally took effect on January 10, 2019 — making Maine one of the first states to expand Medicaid through a citizen ballot initiative rather than through legislative or executive action.

As of 2025, approximately 400,000 Mainers are enrolled in MaineCare — about 30% of the state's population. Maine uses a mix of managed care and fee-for-service delivery, depending on region and eligibility category. Anthem and Harvard Pilgrim Health Care operate managed care plans in some parts of the state.

MaineCare covers doctor visits, hospital care, prescription drugs, behavioral health services, long-term care, and dental care. Maine has one of the stronger adult dental benefits packages among Medicaid programs nationally — adults receive preventive, restorative, and endodontic services, not just emergency care.

Who qualifies for MaineCare?

MaineCare income limits vary by coverage category. Maine is an ACA expansion state, so adults 19–64 qualify at or below 138% of the Federal Poverty Level. Children and pregnant women qualify at higher income levels.

• Adults ages 19–64 (ACA expansion): at or below 138% FPL — approximately $20,783/year for a single person in 2026
• Children under age 19: up to 209% FPL
• Pregnant women: up to 209% FPL
• Seniors and people with disabilities: income and asset rules vary by program — contact OFI
• Parents and caretaker relatives: income limits vary based on household composition
• Medicare Savings Programs: available for low-income Medicare beneficiaries to help pay premiums

Source: Maine DHHS Office for Family Independence; MyMaineConnection eligibility information. Income figures are approximate annual amounts based on 2026 HHS poverty guidelines. Verify current limits at mymaineconnection.gov or by calling 1-855-797-4357.

How MaineCare is delivered: managed care and fee-for-service

Maine operates a mixed delivery model. In southern and coastal regions, MaineCare members may be enrolled in managed care health plans. In more rural areas, MaineCare operates largely on a fee-for-service basis, where members choose any willing MaineCare-enrolled provider directly.

Maine's managed care plans include Anthem and Harvard Pilgrim Health Care. Members enrolled in a managed care plan get a primary care provider, a member ID card, and a specific network of covered providers. Fee-for-service members can see any MaineCare-enrolled provider statewide without a referral requirement.

Long-term care services — home-based personal care, nursing facility care, and waiver programs — are administered separately through DHHS's Office of Aging and Disability Services (OADS). The Home and Community Benefits (HCB) waiver covers home-based care for MaineCare members who would otherwise need nursing facility placement.

Cub Care: Maine's CHIP program for children

Cub Care is Maine's Children's Health Insurance Program (CHIP), covering children up to 209% FPL whose family income is above the MaineCare limit for children. Cub Care is integrated with MaineCare — a single application through MyMaineConnection covers both programs. The same comprehensive benefit package applies. Apply at mymaineconnection.gov.

Maine Medicaid topics

What does MaineCare (Maine Medicaid) cover?

Medicaid covers a broad range of health services. Federal law mandates certain benefits — inpatient and outpatient hospital care, physician services, lab work, X-rays, and nursing facility services, among others. States add optional services on top of those. Dental, vision, and long-term home care coverage vary by state.

The national benefits overview lists required and commonly optional services. Check the MaineCare (Maine Medicaid) website for the current state-specific benefit package.

How to apply

Most people can apply online through Maine's Medicaid portal, by phone, or in person at a local eligibility office. The how to apply page walks through each method, what documents you'll need, and what to expect during the review period.

Under 42 CFR 435.912, states must process most standard Medicaid applications within 45 days (90 days for disability-based applications). Maine must follow that federal timeline.