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Under Maine
Law,
no one can be denied access to emergency services
because of their insurance status or income level.
And, emergency services must be provided free
of charge for people at certain income levels.
Any hospital you visit should be able to give
you information about the "Free Care"
program it offers.
In
addition to "Free Care," some hospitals
also provide care to those at higher income levels
on a "Sliding-Scale" system, where the
higher your income, the larger part of the bill
you're required to pay.
What you'll
find on this page:
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What's
covered?
By law, hospitals must provide Free Care to eligible
people for “medically necessary” hospital
services. This is often interpreted to mean emergency
services only and may not include other services like
lab work, some surgeries, and other treatments. However,
many hospitals go above and beyond this law and will
provide help for many non-emergency services as well
as emergency services. To find out if a Hospital Free
Care Program covers services that you need, you can
contact the hospital Patient Accounts Office (billing
office) for that hospital.
Can I get Hospital
Free Care?
If
your household income is at or under the level listed
below, you can get Free Care. By Maine law, people at
this income have a right to free “medically necessary”
care at any hospital in Maine. But many hospitals
in Maine give Free Care to people with income ABOVE
this level! And, many hospitals will provide Sliding-Scale
care for people with even higher income.
Income
guidelines
The
hospital may ask you for proof of household income (like
check stubs or tax returns). The hospital can look at
income over the past 12 months OR the past 3 months.
You will qualify if your income is under the limit for
EITHER time period. If you do not qualify one way, you
may qualify the other way! For example, looking at the
last 3 months may help people with higher yearly income
if their income dropped in the 3 months before the application.
Even
if your income is above the levels listed you should
apply anyway! Some hospitals have programs for people
with higher income. If you have questions, or are unsure
whether you qualify, call our HelpLine at 1-800-965-7476.
2011
Monthly Income Guidelines for
Hospital Free Care
at
ALL Maine Hospitals
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Family
Size
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Income
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1
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$1,362
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2
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$1,839
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3
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$2,317
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4
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$2,794
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5
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$3,272
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6
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$3,749
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For
each additional family member add:
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$478
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What if my income is too high?
If your income is above the figures listed above, you
could still qualify for Free or Sliding-Scale Care at
many hospitals. Under Maine law, ALL hospitals must
offer Free Care to people at the income listed above,
but many hospitals go above and beyond the law. Take
a look below, to see if you qualify for either Free
or Sliding-Scale Care at a hospital near you. Call
the HelpLine at 1-800-965-7476 for help or for
more information.
How
do I apply?
Call
the hospital and ask for the Patient Accounts Office
(billing office), or ask for the hospital’s Free
Care Program at the hospital where you intend to apply.
They will speak to you about Free Care and help you
to fill out an application. Sometimes hospitals ask
that you apply for MaineCare as a first step.
What
if my application is denied?
If
you believe you should have been accepted, you can
appeal the hospital’s decision. To appeal, you
must request an administrative fair hearing from the
Department of Health and Human Services within 60
days of the date of the denial letter. Your request
can be made in writing or verbally. The request must
be made to the Administrative Hearings Unit, DHHS,
11 State House Station, Augusta, ME 04333-0011 or
by calling 207-287-8792. If you believe that the denial
is correct, there may be other programs for sliding-scale
help. Call the Consumers for Affordable Health Care
HelpLine at 1-800-965-7476 for ideas for help
with health care costs.
What
if I already have private insurance?
Hospital Free and Sliding-Scale programs can be helpful
even if you already have private insurance. The hospital
programs can "wrap around" private insurance
to help with things like the cost of deductibles and
other co-insurance. Call the HelpLine at 1-800-965-7476
for more details.
Can
I get old medical bills paid?
To get back bills paid, you must be able to prove
that you met the Hospital program guidelines at the
time you incurred the bills. Please call the HelpLine
at 1-800-965-7476 if you have questions about
this process.
Local Health Programs
These
programs are specific to your town or area of residence,
and have their own eligibility guidelines.
CarePartners - 1-877-626-1684
CarePartners
can provide very low-cost health care including primary
care, drugs, and hospital care. This program is for
people living in Cumberland, Lincoln, Kennebec, and
Waldo counties. To qualify you must be uninsured and
meet certain income and asset guidelines. Call for
more information or click here: http://www.mmc.org/mh_body.cfm?id=3441
Community
Clinical Services - 777-8899
Community Clinical Services is a group of doctor offices
associated with St. Mary's Regional Medical Center
in Lewiston. Uninsured individuals that meet certain
income guidelines can receive medical services from
participating offices in the Lewiston-Auburn area
on a free or sliding scale basis. Call for more information.
Online
Health Care Guide