Attention Providers: Supporting MaineCare Members During Temporary Provider Payment Holds

MaineCare is receiving reports regarding increased member concern about the status of their MaineCare coverage as a result of the temporary hold on certain provider payments. The temporary holds on provider payments do not affect MaineCare coverage for members.

MaineCare sent this electronic message to our member list serv on March 10, 2025, regarding impact on members.

Members may call MaineCare-enrolled providers as a trusted source of information during this time of uncertainty. If you receive calls from members concerned about their coverage due to the temporary hold on provider payments, here are some talking points to help reassure them:

  • The temporary holds on provider payments do not affect MaineCare coverage for members.
  • MaineCare has not changed member eligibility rules or covered services due to the budget shortfall.
  • MaineCare members are not responsible for paying for MaineCare-covered services, with the exception of copayments. Members can learn more about required copayments here. 
  • MaineCare will still pay enrolled providers for delivering covered services to MaineCare members; some of those payments are being delayed because MaineCare needs lawmakers to approve access to the funds.

Where to direct members with questions:

  • If members have a question about their prescription drugs, they may contact the MaineCare Pharmacy Help Desk at: 1-866-796-2463.
  • If members have a question about covered services, finding a MaineCare-enrolled provider, or other MaineCare coverage questions, they may call MaineCare Member Services at: 1-800-977-6740.

Reminder:

Consistent with state and federal requirements, providers may not bill, demand, or otherwise seek payment from MaineCare members (or a representative of the member) in order to provide for any MaineCare covered service, with the exception that they may ask for copayments. However, pursuant to MaineCare Benefits Manual Ch 1 Section 1.09-1(B), no provider may deny services to a member for failure to pay a copayment.