Consumers for Affordable Health Care

Health Care for Adult and Kids
with Disabilities
People with disabilities have special needs when it comes to health care. While there may be gaps and frustrations in obtaining coverage, there is assistance for many serious health problems.
Last updated in April 2008.

MaineCare for Adults with Disabilities
Individuals who receive Social Security disability benefits, or who think they would qualify for disability, may be eligible for health insurance through MaineCare.

If you do not recieve Social Security benefits, but believe that you may be considered disabled, you can still apply for MaineCare in the "disabled" category. MaineCare's Medical Review Team will contact you and your health care provider to make their own decision about your disability.

If you are disabled and receive SSI, only your own income will be considered - not income from other family members. If there is more than one person in your home receiving SSI, or if you have other questions, please call the Consumer Assistance HelpLine at 1-800-965-7476 and they will help you determine if you qualify. You may qualify even if you have significant assets.

MaineCare for Working Disabled
If you receive Social Security benefits based on a disability and you don't qualify for MaineCare because income from a job puts you over the guidelines, you may still be able to obtain coverage by paying a monthly premium. Individuals may qualify if BOTH their "Unearned" income and their "Total" income are below the guidelines listed in the chart below, and certain assets do not exceed the limit. If you disabled and receive SSI, only your own income will be considered - not income from other family members. If there is more than one person in your home who receives SSI, or if you have other questions, please call the Consumer Assistance HelpLine at 1-800-965-7476 and they will help you determine if you qualify. You may qualify even if you have significant assets.

2007 Monthly Income Guidelines

"Unearned" Income must not be over:	"Total" income must not be over:

$942 per month for one person	$2,167 per month for one person
Example: Social Security check	Example: Social Security check plus* work-related income*

Medicare Savings Programs (MSP)
for People on MEDICARE
Even if you don't qualify for full-coverage MaineCare, if you receive MEDICARE you may be eligible to participate in one of the MSPs. Like full-coverage MaineCare, these buy-in programs will pay for your Medicare premiums, co-insurances and deductibles. Click here for more information about the MaineCare Buy-in Programs.

MaineCare for Children with Severe Disabilities
The Katie Beckett Program for Disabled Children provides MaineCare coverage for children with severe disabilities who do not qualify for regular MaineCare. The parents income and assets are NOT looked at when determining eligibility for Katie Beckett - only the child's income and assets are considered. A child can get coverage through Katie Beckett even if he or she has other health care benefits, such as insurance from the parents employer coverage. A call to the HelpLine at 1-800-965-7476 can help you determine if your child qualifies.

Criteria for Katie Beckett Coverage

Child must be 18 years old or younger and must qualify as disabled under SSI program (Supplemental Security Income);
If the Child were in a mental institute, they would qualify for medical assistance (Medicaid/SSI) and;
The State determines that:

The child requires hospital, nursing facility or intermediate care facility for the mentally retarded level of care;
It is appropriate to provide such care outside such an institution, and;
The estimated cost of care outside the institution is not greater than estimated cost within an institution

Other Resources
Individuals with disabilities may also find it helpful to visit the prescription drugs and resources sections of this guide.

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