MaineCare is the Medicaid program in the state of Maine. It was created to give certain low-income populations access to affordable, high-quality health insurance. MaineCare is comprehensive coverage just like any other health insurance, but some benefits may vary depending on an enrollee's qualifications (such as age).
Hospital Services
MaineCare covers several types of hospital services, including any care received to treat an illness or injury, preventive care or therapy as long as it's supervised by a licensed physician. MaineCare enrollees can expect to pay up to $300 in copayments for hospital services, but no more than $30 a month.
Doctor Services
MaineCare covers doctor office visits that are considered medically necessary in order to conserve the health of the enrollee, plus any supplies necessary. It will also cover laboratory and x-ray tests that are ordered by the doctor. Copayments for doctors' services vary, but copayments for lab services will be no more than $1 per day.
Preventive Services
The Early Periodic Screening Diagnosis and Screening Program offers preventive care. This includes screening exams to catch diseases early and immunizations as they become necessary with age. MaineCare also covers a full range of family-planning services.
Dental Services
Children enrolled in MaineCare are qualified for exams and a full range of dental services. They may also be qualified for braces, but only with prior authorization. Adults have access to dental care only to relieve tooth pain. This means it will cover things like extractions or the draining of an abscess.
Prescription Drugs
MaineCare will cover any drug found on its formulary, or the list of drugs that it agrees to cover. Some drugs require authorization. Additionally, it will also cover over-the-counter medications and vitamins. Medications have a $2.50 copayment, though no member will pay more than $25 a month.
Case Management
Several populations are qualified for case-management services under MaineCare. These include developmentally disabled adults; HIV-positive individuals; children who are at risk for development disabilities; at-risk, abused or neglected children; those who require mental health services; and many more.
Transportation
If an enrollee requires transportation to or from a MaineCare-covered service, MaineCare will pay for public transportation, taxi, wheelchair van or a private carrier.
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