Copay Exemptions, CR10241

February 12, 2013

Copay Exemptions, CR10241 Most MaineCare members are responsible for a copayment when they receive MaineCare-covered services but, there are some exceptions.

Copay exemptions include:

• Services provided in Indian Health Centers • Members of a Federally Recognized Tribe who are Native American/Alaskan Native • Members who have a Cost of Care (COC) category of Nursing Home or Residential Care *see exceptions to the exemption, below • Services furnished to pregnant women • Members in State custody • Members under State guardianship • Services furnished to members under twenty-one (21) years of age

*Members residing in Nursing Home or Residential Care Facilities will not be copay exempt if they have a coverage code of: • Section 19 – HCB Elderly and Adults • Section 21 – Developmental Services Comprehensive Waiver • Section 22 – HCB Physically Disabled