MaineCare Rule #312A - Part 9 and Chart 3.8 Premium Updates

Date posted:

Attachment(s):

10-144 C.M.R. Ch. 332; MaineCare Eligibility Manual – Part 9: LIMITED BENEFITS GROUP and Chart 3.8: Premiums for Special Benefits Waiver [Maine Section 1115 Health Care Reform Demonstration for Individuals with HIV/AIDS]

Rule #312A – Part 9 and Chart 3.8 Premium Updates

The adopted rule effectuates updates to Part 9: LIMITED BENEFITS GROUPS and Chart 3.8: Premiums for Special Benefits Waiver [Maine Section 1115 Health Care Reform Demonstration for Individuals with HIV/AIDS]. The adopted rule change provides clarity and increases accessibility for readers.

The adopted rule updated Part 9, Section 1(2) Premiums as follows:

  • “Premiums are set by the Office of MaineCare Services and increase 5% annually on January 1st”.
  • “Starting January 1, 2025, premium amounts due are posted online at https://www.maine.gov/dhhs/ofi/programs-services/health-care-assistance.” replaced “See Chart 3.8 for premium amounts due.”
  •   2(A) “$37.73” replaced “$35.93” and “$415.03 replaced “$395.23.”

For consistency and clarification, Part 9 was updated as follows:

  • “250%” replaced “250 percent”
  • “Medicare” replaced “other benefits”
  • “1st” replaced “first” for the first day of a calendar month.

The adopted rule removed Chart 3.8 – Premiums for Special Benefits Waiver [Maine Section 1115 Health Care Reform Demonstration for Individuals with HIV/AIDS] from the charts and appendices. In addition, the adopted rule added “Effective January 1, 2025, amounts due are posted online at https://www.maine.gov/dhhs/ofi/programs-services/health-care-assistance.” Further, “For additional information, see 10-144 Chapter 332; Part 9, Limited Benefit Group, Section 1(2) Premiums for Special Benefit Waiver” was added.

Retroactive rulemaking is permissible under 22 M.R.S. § 42(8) as the adopted rule update does not negatively affect reimbursement or other payments, benefits or services for Special Benefits Waiver recipients under the rules previously in effect.

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

Statutory Authority: 22 M.R.S. §§ 42(1), (8) and 3173

Effective Date: April 29, 2025

Office: Office for Family Independence

Comment deadline:

Effective date:

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