​​MaineCare Eligibility Reinstatement for MaineCare Members​

Nov 28, 2023

In an e-message on July 10, 2023, the Department alerted providers about coverage reinstatement for certain MaineCare members. MaineCare transitioned some individuals who were no longer eligible for full coverage to a Medicare Savings Plan (MSP) under federal guidance. As a result of a federal court decision to revise this prior guidance, some MaineCare members are entitled to have their prior MaineCare coverage reinstated.  

Affected members will have received a letter from the Department letting them know of this change. This is a reminder that providers should bill MaineCare for services that occurred during the members reinstatement period. Members that receive retro eligibility are not responsible for payment to providers. Per MaineCare Benefit Manual (Ch I Sec 1.22-1.B.7), providers must reimburse payments collected from the member in this situation back to the member. 

If providers have questions, please call Provider Services at 1-855-797-4357. Members who have questions can call the Office for Family Independence at 1-855-797-4357. TTY users dial 711, Maine Relay.