10-144-332 Me. Code R. § 2-2

Current through 2024-51, December 18, 2024
Section 144-332-2-2 - COVERAGE GROUPS AND ASSISTANCE UNITS

To be eligible for MaineCare an individual must fall within a category. With the exception of individuals who qualify for Medicaid under a waiver or for the Medicare Savings Program, individuals must fall into one of the Categorically Needy/Medically Needy coverage groups. Each coverage group has specific eligibility criteria and individuals can meet the eligibility criteria of more than one coverage group at the same time.

Once the Department has determined that an individual meets the criteria of one or more coverage groups possible assistance units for each coverage group are identified.

Choosing a coverage group:

An assistance unit is an individual or group enrolled in or applying for MaineCare. The assistance unit also includes individuals who are not covered, or not applying for coverage, but whose income, assets, and/or needs are considered in determining eligibility.

Individuals are placed in the coverage group and assistance unit that is most beneficial to them. An individual can be included in more than one assistance unit at the same time to ensure that everyone who wants coverage gets coverage. When not everyone who wants coverage can be covered and a decision needs to be made as to which family members will be covered, the Department shall inform the individual of the coverage options and give them the opportunity to choose which coverage is preferred.

10-144 C.M.R. ch. 332, § 2-2