Upcoming Federal Changes to MaineCare Eligibility for Some Non-citizens

Aug 20, 2026

We are writing to inform you about an upcoming change to MaineCare eligibility that may affect some of your MaineCare patients. This change is required by federal legislation signed into law in July 2025 (also called H.R.1, One Big Beautiful Bill, P.L.119-21, or Working Families Tax Cuts Act) that made changes to the Medicaid program nationally. These changes apply in all states, including Maine.

Beginning October 1, 2026, MaineCare eligibility is changing for some noncitizen groups. As a result, some individuals who currently receive full MaineCare benefits will no longer qualify for full coverage and will instead be eligible only for Emergency Services MaineCare. An explanation of covered benefits under Emergency Services MaineCare is available in the MaineCare Benefits Manual, Chapter 1, Section 1.02-4(D).

These changes will not affect children under age 21, or pregnant individuals through 12 months after the end of their pregnancy. Please note that the Office for Family Independence (OFI) is still completing the state rulemaking process to implement these federal requirements.

What You Should Know:

• The eligibility changes are expected to take effect on October 1, 2026.
• Members who are affected will receive a formal Notice of Decision from OFI before any eligibility changes take place. These notices are expected to be mailed in September 2026.
• Some members received an early awareness letter in June or July 2026 to let them know they may be affected. This letter was informational only and is not an eligibility determination.

How You Can Help:

As a trusted healthcare provider, you can play an important role in helping your patients prepare for these changes by:

• Encouraging patients to read any letters they receive from MaineCare or OFI.
• Reminding patients to report any changes to their immigration status to OFI if it has changed since May 2026, as this could affect their eligibility.
• Encouraging patients to continue using their MaineCare benefits to access covered healthcare services, including getting checkups and preventive care and refilling prescriptions, while they remain eligible.
• Helping reassure patients that an early awareness letter does not mean their coverage has already changed.

Resources:

We developed resources to help providers understand these federal changes and answer patient questions. You can find these resources in this linked toolkit.

MaineCare and OFI will continue to share updates through provider e-messages and our webpage and other typical communication channels as additional information becomes available.

See the Non-citizen Resource Guide for resources that you can share with your patients to help support them in preparing for this change, and after their full MaineCare coverage ends. This list will be continually updated as we become aware of new resources.

If you have additional resources for us to add, please email MaineCare at Communications.MaineCare@maine.gov

If members have questions about covered services, please have them call Member Services at 1-800-977-6740.

Thank you for your continued partnership and for helping to ensure MaineCare members receive accurate information and access to the care they need.