Advocating the right to quality, affordable health care for every person in Maine.
Consumer Assistance HelpLine

1-800-965-7476

Pregnant Women

Depending on income level, pregnant women may be able to get free MaineCare coverage. If the pregnant woman is under 21 years old, then her parents’ income may be counted if she lives with them and they and claim her on their tax returns.  Use the chart below to see if you could get MaineCare as a pregnant woman.

2017 Monthly Income Guidelines for Pregnant Women 
Household SizeFree MaineCare
1 (plus 1 for pregnancy)$2,897
2 (plus 1 for pregnancy)$3,642
3 (plus 1 for pregnancy)$4,387
4 (plus 1 for pregnancy)$5,133
5 (plus 1 for pregnancy)$5,878
each additional
household member
add...
$746
Last updated on 03/06/2017

Common Questions:

 

 

What kind of income counts?

For wages, use the full amount, minus any pre-tax withholdings. For self-employed income, use net (after business expenses and taxes).  Child support will not count against you, but alimony received will be included. There are many types of income – too many to list here! If you have questions about what income counts, or are unsure whether you qualify, call our HelpLine at 1-800-965-7476.

 

 

How do I apply?

You do not have to apply in person. There is a simple, two-page application that is easy to fill out and can be mailed to the Department of Health and Human Services (DHHS). Please note – this application is for Parents with children, Pregnant Women, and Young Adults. You also have the option to submit your application online at My Maine Connection. Call the HelpLine at 1-800-965-7476 if you want to talk through the application process.

 

When will I know if I’m eligible?

It usually takes DHHS a couple weeks to make a decision. If it takes them longer than 45 days, you may be able to get temporary coverage until they decide. Call the HelpLine at 1-800-965-7476 if you have questions.

 

 

What’s covered?

MaineCare coverage is full coverage. It includes nearly all health services — doctor’s visits and treatment, hospital care, prescription drugs, physical therapy, mental health services, transportation to doctor’s appointments and much more!

 

 

What if my application is denied?

Mistakes can be made. If you feel your household is eligible but your application is denied, call the HelpLine at 1-800-965-7476. Or, you can call your local DHHS office and ask for a Fair Hearing. It is always a good idea to ask for this in writing as well, and send it in.

 

 

What if I already have private insurance?

Pregnant women can have both private insurance and MaineCare if they choose. Some women may decide to keep both and may qualify for help paying for private insurance through a program called the Premium Health Insurance Payment (PHIP). But keep in mind,  If your private insurance is through the Health Insurance Marketplace, you cannot get Marketplace discounts if you are eligible for MaineCare.  This can get confusing!  Call the HelpLine at 1-800-965-7476 for more information

 

 

Can I get old medical bills paid?

Pregnant women can get medical bills paid back to 3 months before their application, as long as they were eligible at that time. Call the HelpLine at 1-800-965-7476 if you want to talk through getting old medical bills paid back.

 

 

What if my income is too high to qualify for MaineCare?

A pregnant woman who is over income for MaineCare should be offered “Medically Needy” coverage. This is also called the “Spend Down” or “Deductible” program. Basically, if your medical bills go over a certain amount during a (usually) six month period, MaineCare will kick in and cover you for the rest of that time period. This can be an important safety net if you have high medical bills, and you may be able to get more help through other programs.

Check out the Health Insurance Marketplace and  Other Helpful Programs sections of this Guide or call the HelpLine at 1-800-965-7476 for more information.