Important Copayment Information: End of the American Rescue Plan Act (ARPA) Exemption on Copays

Sep 27, 2024

At the beginning of the COVID-19 pandemic, the federal government relaxed certain requirements to promote continued access to healthcare services for members enrolled in Medicaid. ARPA allows states to cover COVID-19 vaccination, testing, and treatment without member cost sharing through September 30, 2024.

Beginning on October 1, 2024, MaineCare will reinstate copayments (copays) which had been waived for certain services.  

Reinstated Copayments

MaineCare will reinstate copays for services covered under the following sections of the MaineCare Benefits Manual (MBM):

• 40: Home Health Services
• 45: Hospital Services
• 55: Laboratory Services
• 60: Medical Supplies and Durable Medical Equipment
• 80: Pharmacy Services
• 101: Medical Imaging Services

Please reference the MBM for complete descriptions of MaineCare policies, services with copays, copay amounts, and copay limits. In the future, MaineCare intends to simplify its copay structure.

Discontinued Copays

MaineCare had reinstated copays for MBM Ch. II, Section 65: Behavioral Health Services in May 2023 when the Public Health Emergency (PHE) ended. However, in accordance with  P.L. 2023, ch 546, MaineCare will discontinue copays for these services effective October 1, 2024.

For questions about this document, please contact your Provider Relations Specialist.

Additional resources are available on MaineCare’s COVID-19 and End of the PHE webpage.