Federal Changes to MaineCare Eligibility

Federal Changes are coming to MaineCare Eligibility Rules

The federal government is making changes to Medicaid programs across the country. In Maine,  Medicaid is called “MaineCare”. Eligibility won't change for most MaineCare members. The group with the most eligibility rule changes are MaineCare Expansion Adults. A MaineCare Expansion Adult is a member who is 19 to 64 years old who gets MaineCare based on their income, does not meet the Social Security disability guidelines, and does not have Medicare. This page contains overall changes and when they are expected to happen.

The information we have about these changes is incomplete. We expect the federal government to provide more details in late Summer 2026. Our goal is to provide Mainers with clear, accurate, and actionable information so you can confidently understand how these changes may affect yourself and others. As we learn more, we’ll update and add to this webpage. Note: The OFI Eligibility Call Center does not have more information about the federal changes than you’ll find on this page.

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Table of Contents: August 2026: Information to Know Right Now

When are changes happening and who will be affected?

Most changes to MaineCare are not happening right away, and they will not impact most MaineCare members. Here is a list of important dates:

October 2026:
  • Some immigrants legally in the U.S. will stop being eligible for full MaineCare coverage and will only qualify for Emergency Services MaineCare coverage.

January 2027:
  • Eligibility rule changes will start for MaineCare Expansion Adults. MaineCare Expansion members are adults between 19 and 64 years old who get MaineCare based on their income. They do not meet the Social Security disability guidelines or have Medicare. MaineCare Expansion Adults will have:
    • New Work Requirements; and
    • MaineCare eligibility renewals every 6 months instead of every 12 months
  • Retroactive coverage changes for all MaineCare applicants.

To view a comprehensive timeline of changes from 2025 through 2028, visit Timeline of Federal Budget Reconciliation Changes to MaineCare.

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Who is a MaineCare Expansion Adult?

MaineCare Expansion members are Adults between 19 and 64 years old who get MaineCare based on their income. They do not meet the Social Security disability guidelines or have Medicare.

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How do I know if I am a MaineCare member?

If you have a valid member ID card and have received a letter stating you are open MaineCare, you are a MaineCare member.

Mainecare Member Card Example

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What can I do right now to keep MaineCare coverage?

The most important things you can do now are:

  • Keep us updated on your current mailing address, email, and phone number so that you receive important messages from us.
  • Read all letters the Office for Family Independence (OFI) sends you.
  • Report any changes that could affect your coverage, like a new pregnancy or disability, a change in your income, or a change to the size of your household.
  • Create a My Maine Connection account to see important information about your coverage 24 hours a day. You can also opt in to e-noticing to avoid mail delays and receive your letters faster.
  • Add the OFI phone number to your contacts in your phone to make sure you don't miss a call: 1-855-797-4357.

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What are the changes for MaineCare Expansion Adults? (January 2027)

What is changing and who is affected:

Starting in January 2027, MaineCare Expansion Adults will need to meet new Work Requirements to maintain eligibility for MaineCare. Current MaineCare Expansion Adults will see the rule change at their 2027 MaineCare Renewal date. Everyone this rule applies to will receive communication from OFI ahead of the change. To learn more about these requirements, visit the MaineCare Work Requirements page.

MaineCare Expansion adults will also need to renew their coverage more frequently. It will now be every 6 months instead of every 12 months. Renewing coverage means OFI reviews your eligibility for MaineCare. Sometimes, OFI can do this through an automatic check without needing more information from the member. At other times, OFI needs the member to complete the renewal form and provide documentation. MaineCare members can renew their coverage online at www.MyMaineConnection.gov or by calling OFI at 1-855-797-4357.

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What are the changes to retroactive coverage? (January 2027)

What is changing and who is affected:

Right now, when someone applies for MaineCare, they can ask for coverage up to 3 months before the application date. This retroactive coverage can help pay medical bills from before they applied. Starting January 1, 2027, this retroactive coverage will be limited to:

  • 1 month for MaineCare Expansion Adults
  • 2 months for all other MaineCare applicants

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What are the changes for members with certain immigration statuses? (October 2026)

What is changing and who is affected:

Under the new federal law, as of October 1, 2026, some lawfully present immigrants will no longer be eligible for comprehensive Medicaid (called full MaineCare in Maine). MaineCare estimates that approximately 1,000 members will be impacted by these changes.

This may affect members who:

  • Came to the U.S. as refugees
  • Were granted asylum
  • Were given humanitarian parole
  • Have immigration status because they or their family survived abuse or trafficking
  • Have immigration status because they or their family are a noncitizen veteran
  • Have had deportation withheld by the Attorney General
  • Are pre-1980 conditional entrants
  • Fall into certain categories of Iraqi, Afghan, Ukrainian, or Amerasian immigrants
  • Are certain non-U.S. born Native Americans

Even if you fall into one of the above categories, you should not be affected by these changes if you:

  • Also have one of the following statuses:
    • Legal permanent resident (Green Card holders)
    • Cuban and Haitian Entrant
    • People from Micronesia, the Marshall Islands, and Palau living in the U.S. under a special agreement called the Compact of Free Association (COFA)
  • Are a child under 21 years of age
  • Are pregnant or postpartum (that is, you've been pregnant in the last 12 months, no matter the outcome of the pregnancy)

Members who are affected by these changes will switch to a different type of MaineCare coverage called Emergency Services MaineCare. Emergency Services MaineCare coverage will only cover emergency medical services. This includes care for serious emergencies like life-threatening medical emergency care and emergency ambulance transportation. 

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Stay informed about the upcoming federal eligibility changes

  • Are you a MaineCare member, provider, or other partner who wants to stay up to date on federal eligibility changes that impact MaineCare? We will always communicate eligibility changes with members through official letters or notices but for even more information – sign up for our email newsletter to stay connected.
  • Subscribe to e-messages from the Office of MaineCare Services. 

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