10-144 C.M.R. 332; MaineCare Eligibility Manual, Parts 2, 3, 4, 5 and Chart 7; Rule #301 - Certain MAGI and CHIP Coverage Group Changes

Date posted:


This adopted rule provides continuing MaineCare coverage for parents, of children in the custody of the Office of Child and Family Services (OCFS), who are actively participating in family reunification. It also removes exclusions, lock-out periods, and premiums for Cub Care and increased the Federal Poverty Level (FPL) to 208% for all children. The adopted rule changes increase access to health insurance coverage.

The Department corrected a typo in Part 2, Section 3.2(III)(B)(2)(a) and (b) from February 25, 2027 to February 25, 1927. In addition, the adopted rule removed Part 2, Section 16 language regarding Cub Care ineligibility due to premium non-payment and references to a penalty for premium for non-payment. Further, the adopted rule corrected a typo in Part 3, Section 3(I)(C).

Part 3, Section 2.2., is changed to allow Parent/Caretaker Relatives to maintain coverage while actively working towards reunification with the OCFS. Parents with Substance Use Disorder (SUD) whose children have been removed from the home will maintain necessary health coverage to continue SUD treatment, which will increase the success of reunification efforts, and thus the overall health and wellness of Maine families.

Part 5, Section 1, Definitions replaced "Federally Facilitated Marketplace" with State-Based Marketplace as Maine's State-Based Marketplace is utilized. In addition, website addresses have been added for the State-Based Marketplace and MyMaineConnection. Part 5, Section 2, CubCare added clarifying language. Part 5, Section 3, Basic Eligibility Requirements removed exclusions for children residing in a public institution or an inpatient psychiatric facility. In addition, Part 5 removed Section 3(B), Children with a Three Month Waiting Period, Section 8, Changes in Household, and Section 12, Premiums. Part 5, Section 9, Eligibility Periods added clarification regarding retroactive coverage and renewal notice time frames. Part 5, Section 10, Notices(D) added clarification regarding case closings. Further, Part 5, Section 10, Administrative Hearings directs readers to Part 1, Section 7 for rules regarding hearings. 

In addition, Chart 7, CubCare, is removed to align with the adopted rule changes to CubCare.

The following adopted changes shall be retroactive. Part 3, Section 3(III) aligns with federal requirements for coverage of Former Foster Children effective retroactive to January 1, 2023. Part 4, Section 4(D and E) updates the FPL limit for children under age 19 effective retroactive to March 1, 2023. Part 5, Section 3 removed exclusions and wait periods for Cub Care eligibility, and Part 5 is further amended to remove premium payments for Cub Care effective retroactive to March 1, 2023. Removing exclusions, wait periods, and premiums for Cub Care eases financial burdens for programs and beneficiaries. Retroactive rulemaking is permissible under 22 M.R.S. Section 42(8) as these changes afford this benefit to more residents of the State of Maine and does not adversely impact applicants, participants, beneficiaries, or providers. 

This rule will not have an impact on municipalities or small businesses.

Statutory Authority: 22 M.R.S. Sections 42(1); and (8), 3174-G, and 3174-FFF

Effective Date: August 15, 2023


Office: Office for Family Independence

Routine technical

Email: Lea.Studholme@maine.gov

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