Maine Medicaid State Plan Methodology

The Maine Medicaid State Plan outlines how the Medicaid program is implemented in Maine. The State Plan covers many topics, from program administration to reimbursement, and is updated regularly through State Plan Amendments.  The Centers for Medicare and Medicaid Services (CMS) is the federal agency responsible for overseeing the Medicaid program in each state, including approval of changes to the State Plan.

Limited Benefits

MaineCare offers additional benefits to help Mainers cover the cost of pharmacy and dental services, as well as programs that help with the cost of drugs, private health insurance premiums, and more.

Adults

There are free and low-cost health coverage options that ensure adults can get the important care they need to stay healthy.

Children

There are free and low-cost health coverage options that ensure children and young adults under age 21 can get the important care they need to stay healthy.

Types of Health Coverage for Children

MaineCare

MaineCare provides free health insurance, other health benefits, and assistance to childen and young adults under age 21 who meet income guidelines or disability criteria.

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MaineCare Options

MaineCare helps to ensure that all Maine people are able to access the critical health services, both preventative and emergency, that help them stay healthy and safe.

With the expansion of MaineCare in 2019, more individuals are now eligible. To see what health coverage options are available to you and to find out if you qualify for a free or low-cost health plan, go to CoverME.gov.

Advisory Groups

MaineCare Advisory Committee (MAC)

The MaineCare Advisory Committee (MAC) is a federally mandated committee to ensure that MaineCare is an effective and efficient program informed by the diverse experiences of beneficiaries, their caretakers, and other interested parties. 

Payment Error Rate Measurement (PERM)

Current Audit

Maine is currently participating in a PERM audit for Reporting Year (RY) 2024 which covers randomly selected paid claims with a payment date from July 1, 2022 through June 30, 2023.

Error Rates

PERM is a federally contracted audit process that measures improper payments in Medicaid and Children's Health Insurance Program (CHIP) and produces error rates for each program. Error rates only indicate that a payment made did not meet statutory, regulatory, or administrative requirements; these are not fraud rates.

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