Important Coverage Information: End of the American Rescue Plan Act (ARPA) Period

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 enabled MaineCare to cover through September 30, 2024, certain COVID-19 related services which were otherwise not covered under the MaineCare Benefits Manual (MBM).

Effective October 1, 2024, MaineCare will only cover COVID-19 specific drugs, supplies, and services that have FDA approval—it will no longer cover services that rely on Emergency Use Authorization (EUA). MaineCare will resume coverage for COVID-19 related vaccine, testing, and treatment services in accordance with the corresponding sections of the MaineCare Benefits Manual (MBM). Specifically:

Vaccines – MaineCare will cover COVID-19 vaccines with FDA approval, like all other vaccines.

Vaccine Administration – MaineCare will reimburse five dollars ($5) for the administration of FDA approved COVID-19 vaccines to eligible members.

Testing – MaineCare will continue to cover FDA-approved COVID-19 tests administered by MaineCare enrolled providers. MaineCare will no longer cover over-the-counter (a.k.a. at-home) COVID-19 tests. The federal government may provide free at-home COVID-19 tests upon request; more information is available on the HHS webpage.

Treatment – MaineCare will cover the treatment of COVID-19 and related conditions for eligible members, provided the treatment is FDA-approved and is a covered service as defined in the MBM.

Copayments – Certain members will now be responsible for copayments (copays) for certain services related to their MaineCare coverage. Member copay guidance is available on the Department’s Member Resources website.

Individuals without vaccination coverage may be eligible to receive free COVID-19 vaccination through local vaccine programs. Additional information is available online at maine.gov/covid19/vaccines and vaccines.gov.

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

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