Changes to MaineCare: What You Need to Know
Significant changes are underway for MaineCare (Maine's Medicaid program) and the Children’s Health Insurance Program (CHIP). Since March 2020, due to the pandemic, the federal government waived certain Medicaid and CHIP requirements. This measure, known as the continuous coverage requirement, ensured that people retained their health coverage despite changes in their circumstances, in exchange for enhanced federal funding.
The continuous coverage requirement expired on March 31, 2023, and the state must conduct a full redetermination of eligibility for all MaineCare members—a process known as the "unwinding" of the continuous coverage requirement. To help ensure that as few people as possible lose their coverage during this process, the Maine Department of Health and Human Services is collaborating with organizations and stakeholders across the state to help spread the word.
What You Should Do Now
If you receive healthcare coverage through MaineCare, you will be sent a renewal form by mail or e-notice (many Mainers have already received theirs). Over 300,000 Mainers have already renewed their coverage. To stay covered, it's crucial to take the following steps:
Update Your Address: If you've moved, inform MaineCare of your updated address so they can contact you about your renewal. Also, make sure they have your current email and phone number. You can update your information by calling 1-855-797-4357 (option 1) through an automated system, or by visiting MyMaineConnection.gov.
Stay Connected: Keeping your contact information up to date ensures you receive all necessary communications about your coverage and renewal process.
Look for Your Renewal Form: If you have not already received it, be on the lookout for an envelope with a blue block that contains renewal information and instructions. If you signed up for e-notices, you will get a message in your account when it's time for your renewal.
Complete and Return the Form: Fill out the renewal form as soon as you receive it and return it right away to avoid any gaps in your coverage. MaineCare reviews will be completed by October 31st. Remember, "If it’s blue, it’s time to renew!"
Upcoming Eligibility Changes
Starting November 1, 2024, additional changes to MaineCare eligibility and enrollment will be phased in. Here’s what to expect:
Resumption of Premiums: Premium payments will resume for certain coverage groups, including Katie Beckett, Special Benefits Waiver, and MaineCare for Working People with Disabilities, after the household completes their annual renewal. Unpaid premiums could result in a loss of coverage.
Verification of Financial Factors: Verification of financial information will be required at application, renewal, or reported change if the Department cannot verify income through electronic data sources.
Medically Needy Deductibles: Deductibles for the Medically Needy program will start again. Individuals who met a deductible to gain MaineCare coverage on or after March 18, 2020, may have had coverage continue past the deductible period. Eligibility for these members will be redetermined to establish new deductible amounts.
Ensuring Continuity of Coverage
The Department is committed to minimizing disruption in coverage. For those no longer eligible for MaineCare, there will be an application transfer to CoverME.gov, Maine's Health Insurance Marketplace. CoverME.gov is conducting targeted outreach and providing a special enrollment period for those losing MaineCare coverage from April 15, 2023, through December 31, 2024.
For more information or assistance, visit MyMaineConnection.gov or call (855) 797-4357.