Medicaid Eligibility in Maine: Income Limits & How to Apply
Medicaid Eligibility in Maine
Maine has expanded Medicaid under the Affordable Care Act. This means adults aged 19-64 with household income at or below 138% of the federal poverty level (FPL) qualify for MaineCare. This is approximately $21,597 per year for an individual or $44,367 per year for a family of four in 2026.
Key threshold: If your income is below $21,597 (individual) or $44,367 (family of 4), you likely qualify for MaineCare with free or very low-cost coverage. No premiums, no deductibles.
Medicaid expansion in Maine covers:
- Adults aged 19-64 with income up to 138% FPL
- Children in families with income up to 200-300% FPL (varies by age)
- Pregnant women with income up to 185-200% FPL
- Seniors and people with disabilities who meet income and asset requirements
About MaineCare
If you're a Maine resident trying to understand your health coverage options, MaineCare (Maine's Medicaid program) is a crucial resource. Maine has expanded its Medicaid program, meaning adults with household incomes up to 138% of the Federal Poverty Level (FPL) can qualify. For a single person, this means a monthly income of approximately $1,732, or about $2,350 for a two-person household in 2024. Children and pregnant individuals have higher income thresholds for eligibility. For example, children under age 21 can qualify with household incomes up to 305% FPL, which is around $4,057 per month for a single child household or $5,501 for a two-person household. Pregnant individuals can qualify with incomes up to 214% FPL, which is about $3,830 per month for a two-person household. MaineCare is a significant program, with over 409,000 people enrolled as of October 2023, including 140,666 children in fiscal year 2024, demonstrating its widespread impact across the state.
If your income is slightly above the MaineCare threshold, you might qualify for subsidies through HealthCare.gov, the federal marketplace. These subsidies can significantly reduce your monthly premium costs and out-of-pocket expenses. For instance, with a benchmark Silver plan in Maine costing around $520 per month, subsidies can make this coverage much more affordable. It's important to remember that even small changes in your income or household size can shift your eligibility between MaineCare and marketplace subsidies. If you recently lost MaineCare coverage due to the "unwinding" process (the return to regular eligibility reviews after the COVID-19 public health emergency), you have a Special Enrollment Period to sign up for a marketplace plan. You typically have 90 days after losing MaineCare to enroll in new coverage through CoverME.gov.
MaineCare provides comprehensive health benefits, including doctor visits, emergency care, prescription drugs, and substance use disorder treatment, often with no cost-sharing. Maine also has specific programs like the Elderly and Adults with Disabilities Waiver, which helps eligible individuals receive home and community-based services to avoid nursing home care. Additionally, the state is launching a new "Lifespan Waiver" program in July 2026 for individuals with intellectual and developmental disabilities, aiming to provide continuous support from age 14 through adulthood and reduce the need to navigate multiple programs. For those aged 62 and older or with a disability who aren't eligible for full MaineCare, there's also the Drugs for the Elderly and Disabled (DEL) program, which offers prescription drug discounts. As of January 1, 2024, the asset test for the DEL program has been removed.
When applying for or renewing MaineCare, be aware that processing times can vary. Keeping your contact information updated with the Department of Health and Human Services (DHHS) is crucial, as they will send renewal forms and other important notices by mail or through your My Maine Connection online portal. During the recent "unwinding" period, Maine successfully renewed coverage for nearly 80% of its MaineCare members, with many renewed automatically using existing electronic data. If you receive a renewal form, complete and return it as soon as possible to avoid any gaps in your coverage. If you miss the deadline, you generally have a 90-day reconsideration period to submit your overdue renewal. For personalized assistance, you can contact Consumers for Affordable Health Care (CAHC) for free help navigating your options.
Maine Medicaid Income Limits 2026
The following table shows the key income thresholds for Maine in 2026:
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,650 | $21,597 | $62,600 |
| 2 | $21,150 | $29,187 | $84,600 |
| 3 | $26,650 | $36,777 | $106,600 |
| 4 | $32,150 | $44,367 | $128,600 |
| 5 | $37,650 | $51,957 | $150,600 |
| 6 | $43,150 | $59,547 | $172,600 |
If your household income falls below the 138% FPL column, you qualify for MaineCare. If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.
Maine's average benchmark premium of $520/month is near the national midpoint. For residents earning between 100-400% FPL, premium tax credits offset most of this cost.
Marketplace Insurance in Maine
Maine residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Maine costs approximately $520/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Maine might pay after subsidies:
| Income Level | Annual Income | Expected Contribution | Estimated Monthly Premium |
|---|---|---|---|
| 150% FPL | $23,475 | 4.01% of income | ~$78/mo |
| 200% FPL | $31,300 | 6.52% of income | ~$170/mo |
| 250% FPL | $39,125 | 8.33% of income | ~$272/mo |
| 300% FPL | $46,950 | 9.83% of income | ~$385/mo |
| 400% FPL | $62,600 | 9.83% of income | ~$513/mo |
These are estimates for an individual. Actual premiums depend on your age, household size, tobacco use, and the specific plan you choose. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays.
Residents of Maine shop for marketplace insurance through HealthCare.gov, the federal exchange. The application process screens for Medicaid eligibility first, so you'll be directed to Maine's program if you qualify.
Maine adopted Medicaid expansion, bringing MaineCare coverage to low-income adults who previously had no affordable option. The transition between Medicaid and marketplace coverage is handled through HealthCare.gov.
How to Apply for MaineCare
- Apply online through HealthCare.gov. The system will automatically check your Medicaid eligibility based on your income and household size.
- Apply directly through your state's Medicaid agency. You can apply year-round — there is no enrollment period for Medicaid.
- Call the Medicaid hotline for Maine to get help with your application or check your eligibility over the phone.
- Visit in person at your local Department of Social Services or county human services office.
Have the following ready: recent pay stubs or tax returns, proof that you live in Maine, Social Security numbers for everyone in your household, and details on any existing health insurance.
Calculate Your Subsidy in Maine
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Maine.
Check Your Eligibility →Frequently Asked Questions
What is the Maine Medicaid income cutoff for 2026?
In 2026, the Medicaid income limit in Maine is 138% of the federal poverty level: $21,597 per year for an individual, $29,187 for a household of 2, $36,777 for 3, and $44,367 for a family of 4.
Is Medicaid expanded in Maine?
Yes, Maine has expanded Medicaid under the ACA. Adults aged 19-64 earning up to 138% of the federal poverty level qualify for MaineCare.
Can I get ACA subsidies in Maine?
Yes. Maine residents with household income between 100% and 400% FPL ($15,650 to $62,600 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through HealthCare.gov.
What is the Maine Medicaid program called?
Maine's Medicaid program is known as MaineCare. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and adults up to 138% FPL.
What happens if I lose Medicaid coverage in Maine?
If your MaineCare coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through HealthCare.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
Am I eligible for MaineCare if I'm employed?
Yes. Medicaid eligibility in Maine is based on your Modified Adjusted Gross Income (MAGI), not your employment status. If your household income is at or below 138% FPL ($21,597 for an individual), you qualify for MaineCare even if you work full-time. Many MaineCare enrollees are working adults.
Should I choose Medicaid or a marketplace plan in Maine?
Medicaid (MaineCare) is free or near-free with no premiums or deductibles. Marketplace plans in Maine average $520/month before subsidies. If you qualify for Medicaid, it's the more affordable option. If your income puts you just above the cutoff, subsidized Silver plans with cost-sharing reductions are the next best thing.
Medicaid Eligibility in Nearby States
- New Hampshire Medicaid Eligibility — Expansion state