What Is MaineCare Health Insurance?

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In the State of Maine, Medicaid is known as MaineCare. Medicaid is a health insurance program run by federal and state governments that provides insurance to people who have limited income and assets. 

MaineCare is a vital part of the state’s healthcare system, providing coverage to an estimated one out of every five Maine residents. The State of Maine Department of Health and Human Services states, “MaineCare provides free and low-cost health insurance to Mainers who meet certain requirements, based on household composition and income. There are also additional options for people with disabilities and certain health conditions, young adults who have been in foster care, and those who need long-term care.” 

MaineCare provides those with limited income with free or very low-cost health coverage. If you fall within a certain income bracket, you likely qualify for MaineCare coverage. For more information on MaineCare eligibility, view the MaineCare Eligibility Guide

Like other state regulated Medicaid programs, MaineCare has expanded to include behavioral healthcare coverage, including substance use disorder treatment services. At Pine Tree Recovery Center we believe that quality addiction treatment should be readily available to those who seek it, regardless of socioeconomic status. Financial barriers prevent many Mainers from receiving the life-saving treatment they need, and we remain dedicated to eliminating these barriers as efficiently as possible. Working with MaineCare means we will be able to help more individuals and families overcome addiction and go on to lead healthy, happy, and fulfilling lives in recovery. Contact us directly to learn more about using MaineCare for addiction treatment. 

Does MaineCare Insurance Cover Detox & Substance Abuse Treatment?

If you or someone close to you has been struggling with a substance use disorder and currently lives in Maine, you might be wondering whether or not MaineCare can be used to cover costs associated with substance abuse and addiction treatment. There is a small group of privately run treatment centers throughout the state that are in-network with Mainecare — including Pine Tree Recovery Center. Pine Tree Recovery Center offers medical detoxification and substance use disorder treatment options, focusing on a restoration of physical, mental, emotional, and spiritual health while helping to lay a solid foundation for lasting recovery. If you would like to learn more about using MaineCare insurance to cover detox and substance abuse treatment, contact us today. 

MaineCare Substance Use Disorder & Behavioral Health Treatment Benefits

The Affordable Care Act (ACA) is a comprehensive health care reform law that was enacted in March 2010. One of the primary goals of the law was to make affordable health insurance available to more people by expanding Medicaid programs to cover a greater number of essential healthcare services. Under the ACA, MaineCare expanded to include substance use disorder and behavioral healthcare treatment services. 

The National Library of Medicine states, “The ACA provides greater access to SUD treatment through major coverage expansions, regulatory changes requiring coverage of SUD treatments in existing insurance plans, and requirements for SUD treatments to be offered on par with medical and surgical procedures. The ACA enables states to address the opioid epidemic through four primary mechanisms: insurance coverage expansions, regulatory insurance reforms that require inclusion of SUD treatments, enhanced parity, and opportunities to integrate SUD treatment and mainstream health care.”

Pine Tree Recovery Center opened in Portland, Maine in response to the increasing rates of opioid dependence and overdose throughout the community, coupled with a lack of adequate local addiction treatment services. Becoming in-network with MaineCare means that Pine Tree Recovery Center will have the opportunity to help more Maine residents overcome addictive disorders of all types and severities and reintegrate as valuable members of the community. 

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What Detox & Addiction Treatment Services Are Covered By MaineCare Insurance?

At Pine Tree Recovery Center we offer a comprehensive curriculum of clinical care, beginning with medically monitored detoxification and continuing with intensive outpatient treatment (IOP) and extensive aftercare planning services. 

Which treatment services are covered by MaineCare? In most cases, MaineCare will cover our medically monitored detoxification and IOP program. Our goal is to provide individuals in all socioeconomic demographics with the quality care they need to make a full recovery. We believe in the benefits of a multi-staged program of addiction recovery. Once a person has been physically stabilized, they are encouraged to immediately transition into our therapeutically-based IOP program, which will ultimately improve treatment outcomes and reduce the risk of relapse. 

Medical Detox, Addiction Treatment, & Therapy Programs

The detox and addiction treatment services provided by Pine Tree Recovery Center and covered by MaineCare include:

  • Medical Detox — Medical detox is often the first step on the road to recovery. While in medical detox, a person will undergo a safe drug and/or alcohol withdrawal under the close supervision of a team of licensed medical professionals. 
  • Intensive Outpatient Treatment (IOP)IOP is focused on addressing the underlying causes of addiction while helping the client develop the skills necessary to avoid relapse long-term. Clients begin to heal on a mental and emotional basis while engaged in this level of care. In many instances, clients are introduced to the 12 Step model of recovery, and they have the opportunity to develop aftercare plans that lend themselves to relapse prevention. IOP can serve as a standalone treatment option, though it is most commonly utilized as a step-down level of care once a person has completed medical detox and residential inpatient treatment. 
  • Aftercare Planning — Aftercare planning is a fundamental component of relapse prevention. At Pine Tree Recovery Center we stay involved with our clients as they transition from treatment back into independent living. Our aftercare planning services, which are an extension of our case management capabilities, offer ongoing support to our clients as they transition from our facility into the next phase of their recovery.

Inpatient Residential Addiction Rehab Coverage

Inpatient treatment, also known as residential treatment, is the highest level of clinical care available. Most individuals will stay engaged in inpatient treatment for between 7 and 90 days depending on their personal needs. What makes residential treatment unique is the fact that clients live in a designated rehabilitation center and undergo full days of therapeutic intervention, identifying and working through the root causes of their addiction while developing the coping mechanisms and life skills they need to thrive in their lives of sobriety. 

In some instances, inpatient treatment is covered by MaineCare. While Pine Tree Recovery Center does not currently offer inpatient addiction treatment, we work closely with several reputable inpatient treatment centers throughout the country, and offer placement services as part of our commitment to extensive aftercare planning. 

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How to Verify Your Treatment Coverage With MaineCare Medicaid Insurance

If you are interested in learning more about our treatment program or if you would like to verify your treatment coverage with MaineCare insurance, the best way to do so is by contacting our Admissions Office directly. As soon as you do, you will be connected with someone who can conduct a free, no obligation health insurance benefit check, quickly and easily verifying your coverage. We can be reached at the telephone number listed at the top, right side of this page, or directly through our website. We look forward to speaking with you soon and helping you get started on your personal journey of addiction recovery. 

What Is the Treatment Admissions Process When Paying WIth MaineCare Medicaid Insurance?

If you are currently living in Maine and you are interested in seeking treatment for a substance use disorder, it is a good idea to verify your treatment coverage with MaineCare Medicaid insurance before making any definitive decisions. 

Steps to utilizing MaineCare for substance use disorder treatment:

  • Step 1 — Apply for MaineCare online through My Maine Connection or visit a district office and apply in person. 
  • Step 2 — Once you have been approved for MaineCare, contact Pine Tree Recovery Center with your information on hand. 
  • Step 3 — Ask a Treatment Advisor to conduct a free, no obligation health insurance benefit check to confirm which of our provided services are covered. 

Frequently Asked Questions (FAQs)

What Is the Difference Between MaineCare & Medicaid?

MaineCare is the State of Maine’s Medicaid program. MaineCare provides low-cost health insurance options to those who might not be able to afford private insurance plans. If you have low income or you have a lack of other resources available to you, you might be eligible for MaineCare. Contact us today to learn more. 

What Is the Income Limit for MaineCare in Maine?

The MaineCare income limit is as follows:

  • Households of 1 — $29,160 or less. 
  • Households of 2 — $39,440 or less. 
  • Households of 3 — $49,720 or less. 
  • Households of 4 — $60,000 or less. 

The full table of MaineCare income limit and eligibility can be found on the MaineCare website

How Is MaineCare Eligibility Determined?

To be eligible for MaineCare you must be a resident of Maine and meet the following criteria:

  • “You must be either 18 years of age and under or a primary caregiver with a child(ren) 18 years of age and under, and
  • A U.S. Citizen, National, or a Non-Citizen legally admitted into the U.S, and
  • Uninsured (and ineligible for Medicaid).”

Does MaineCare Cover Detox, Rehab, & Addiction Treatment?

MaineCare does cover medical detox, inpatient rehab, and additional addiction treatment services like IOP. However, many privately funded detox and rehabilitation centers in the Portland area do not accept Medicaid, working exclusively with privately funded insurance companies. Because Pine Tree Recovery Center is dedicated to making quality clinical care available to those in need regardless of socioeconomic status, we do accept MaineCare. 

Contact us today to learn more. 

Does MaineCare Pay for Mental Health or Behavioral Health Services?

Yes, MaineCare covers a range of behavioral healthcare services provided by a network of specific facilities throughout the state. MaineCare covers:

  • Doctor visits. 
  • Prescription medications. 
  • Emergency services. 
  • Substance use disorder treatment. 

Because Pine Tree Recovery Center is in-network with MaineCare, those who are currently covered will have access to some or all of the treatment services we provide. 

  • Case management services: As soon as a client is admitted to our unique recovery program he or she is paired up with a case manager. This case manager walks the client through every phase of the recovery program (from detox to aftercare) and serves as the main point of contact for the client’s loved ones.
  • Regular clinical and medical assessments: The first in-depth assessment takes place immediately upon admission to our facility, and helps us develop a personalized recovery plan and determine appropriate treatment goals. Assessments take place occasionally throughout the remainder of the program to ensure that all treatment goals are being adequately met.
  • Therapeutic intervention: We offer individual therapy sessions, group therapy sessions and family therapy sessions as part of our comprehensive treatment program. Therapeutic intervention is essential to the maintenance of long-term sobriety seeing as it allows clients to work through all underlying issues.
  • Relapse prevention and life skills training: Without the development of adequate relapse prevention skills, there is no way that an individual will stay sober after the treatment process has come to a close. We focus on relapse prevention and life skills training throughout medical detox and residential treatment.
  • Long-term aftercare planning: Aftercare is also essential to the maintenance of long-term sobriety. Our case managers work with clients to develop personalized aftercare plans.

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