Health Care for Kids
OTHER THINGS YOU SHOULD KNOW

What if I already have private insurance but can't afford it?
The answer depends on whether you are eligible for MaineCare Free or Low-Cost Care. However, since you will not know whether you qualify for Free or Low-cost Care until after you apply, the best course is usually to simply apply and see what happens. If you are denied because of your other insurance, you should call the Consumer Assistance HelpLine at 1-800-965-7476 to discuss your options. Do not drop your child's private insurance without first checking with the HelpLine or your local DHHS office. Some children that have recently been covered by a private plan will not be eligible for coverage right away, even if the family is below the income guidelines.

How long will my coverage last?
If your child is found to be eligible for Free Care or Low-cost Care, coverage will continue for at least 12 months even if your income increases the very next month. After 12 months, DHHS will send forms that you will need to fill out and return in order to continue getting benefits.

What can I do if I lose MaineCare and Cub Care for my kids because my income increases?
The Full Cost Purchase Option (FCPO) is available for 18 months for children who lose MaineCare Free Care and Low-cost coverage because their parents' income increases. It currently costs $100 per month per child, and continues the same benefits. Contact the Bureau of Medical Services at 1-800-572-3839. When you hear the recording, select the option for "Third Party Liability."

Can I get old medical bills paid?
MaineCare Free Care & Low-cost Care will pay for medical services you received during the same month you apply for coverage. If DHHS receives your application on Nov. 26, for example, MaineCare Free Care and Low-cost Care will cover services going back to Nov. 1 if you are found eligible. If you are approved for coverage, you should request that your provider refund any payments you made earlier. All providers that accept MaineCare are required to give you a refund. Some families can get payment for services received up to three months before applying for MaineCare. The application will ask you if you need help with old bills.

What if my child has a disability? Is special help available?
Children with disabilities may qualify for full MaineCare coverage through the Katie Beckett option even if their parents do not meet the regular income guidelines. This option offers all standard MaineCare services including hospital, nursing or intermediate care for many children who are considered disabled under the SSI program. Call your local DHHS office for more information about Katie Beckett.

What if my income is too high to qualify for MaineCare or Cub Care?
Any parent or child who applies for MaineCare coverage and is denied will be offered "Medically Needy" coverage - also called "Spend Down". There is usually a very high deductible over a six-month period, but this can help with large hospital or other medical bills.

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