Young adults age 19 and 20 may be able to get free MaineCare coverage, based on household income. If a young adult is not claimed on their parents’ taxes, they may be able to apply for MaineCare using only their own income. Use the chart below to figure out if you can get MaineCare as a young adult.
|2016 Income Guidelines for Young Adults|
|Household Size||Free MaineCare|
|each additional |
|Last updated on 06/30/2016|
- What kind of income counts?
- How do I apply?
- When will I know if I’m eligible?
- What’s covered?
- What if my application is denied?
- What if I already have private insurance?
- Can I get old medical bills paid?
- What if my income is too high for MaineCare?
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 for more information.
MaineCare 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?
Young adults can have both private insurance and MaineCare if they choose. Some people 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?
Young adults can get medical bills paid back to 3 months before the 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 young adult 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.