Older Adults and Adults with Disabilities

There are free and low-cost health coverage options that ensure older adults and adults with disabilities can get the important care they need to stay healthy, including:

• Aged, Blind, or Disabled Coverage
• Home and Community-Based Waiver Recipients
• Medicare Savings Programs
• Long-Term Care Coverage, including estate recovery
• Deductibles for the Medically Needy
• Working Disabled Coverage
• Health Homes for Chronic Conditions

Aged, Blind, or Disabled Coverage

If you are over the age of 65, are blind, or have another disability, MaineCare may be able to help you afford health coverage and services.

Home and Community-Based Waiver Recipients

If you are in an eligibility category and meet the medical and financial requirements of a Home and Community-Based Waiver program then you may qualify to receive services through one of our Home and Community Based Services waiver programs. Visit the Office of Aging and Disability Services webpage or the MaineCare Member Handbook (PDF) for more details about waivers.

Medicare Savings Programs (also called Buy-In)

If you have Medicare, you may qualify for a Medicare Savings Plan (MSP). Depending on your income, MaineCare may pay for Part A premiums, Part B premiums, Medicare deductibles, coinsurance, and copayments.

Medicare Savings Programs:

• Qualified Medicare Beneficiary (QMB)
• Qualifying Individual (QI)

Your eligibility is based on several factors, including your income. You do not need to figure out whether you qualify before applying.

Note that both estate recovery and asset tests do not apply to MSP benefits.

Effective July 1, 2024, people with higher income levels now qualify for MSP! For more information on eligibility guidelines, please visit the Office for Family Independence’s Health Care Assistance webpage. 

Long-Term Care Coverage

Estate Recovery

MaineCare estate recovery is a federally mandated process which requires MaineCare to seek reimbursement from a deceased recipient’s estate for long-term care and related medical expenses that were paid by MaineCare.

MaineCare may seek repayment from a member's estate if the member:

• Was age 55 or older when they received certain services
• Received qualifying long-term care services
• Did not have a surviving spouse
• Did not have a surviving child under age 21
• Did not have a surviving child of any age who was blind or permanently disabled

Most MaineCare members will never be affected by estate recovery.

For more information about estate recovery, see the Estate Recovery webpage. You can also email MaineCare’s Estate Recovery Unit at EstateRecoveryUnitQuestion.OMS@maine.gov.  

Deductibles for the Medically Needy

If you qualify for MaineCare based on medical needs but are over the income or asset limits, you could be eligible for a deductible. Your deductible is based on your household size and income.

The deductible is the amount of money that you must pay for covered health services before MaineCare starts paying. If you meet your deductible, full MaineCare coverage for the rest of the deductible period will begin. You are responsible for the medical bills you received before you met your deductible— MaineCare will not pay for them.

When the deductible period ends, your MaineCare coverage will end, and you must reapply for a new deductible.

Working Disabled Coverage

This is a MaineCare program for working people under age 65 with disabilities who do not qualify for free MaineCare because of their income and/or assets. The purpose of the program is to provide people with disabilities the opportunity to work and access health care services and supports they need. People who have this coverage may have to pay premiums of up to $20 per month. You can go to the Office for Family Independence’s Health Care Assistance webpage or their brochure for more information.

Health Homes for Chronic Conditions

If you have chronic health conditions, you may be eligible to participate in a Health Home, Behavioral Health Home, or Opioid Health Home. A Health Home partners with your Primary Care Provider to manage your chronic health conditions. See the Primary Care and Your Health webpage for more Health Home information.

Covered Services & Benefits

Please visit our Covered Services & Benefits webpage for more information.

MaineCare Can Help

For questions or to see if a service you need is covered, call MaineCare Member Services at 1-800-977-6740. TTY users, dial 711. You can also email.

For prescription drug benefits, medication prior authorizations, and Medicare Part D questions, call the Pharmacy Helpdesk at 1-866-796-2463. TTY users dial 711.