MaineCare Insurance offers health care and mental health coverage for adults and children, who are elderly, living with a disability, or low income. MaineCare Insurance is available for those who reside in Maine. (1)Â
At Guardian Recovery, we understand that when choosing the right mental health treatment facility for yourself, or your loved ones, covering the cost of treatment is of utmost concern. For those whose health insurance coverage plan is provided through MaineCare Insurance, we work to ensure that as many of our evidence-based treatment programs are covered as possible.Â
Accessing mental health services with your coverage through MaineCare can be as easy as visiting your primary care doctor. MaineCare pays for medically necessary services and offers different levels of coverage depending on an individual’s specific coverage group. (2) Factors that determine an individual’s coverage group include their age, income, household size, and medical needs. The quickest and easiest way to see how your benefits may apply within the Guardian Recovery network is to contact us directly and speak with an experienced Treatment Advisor.
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Income and Household Limits
In addition to residing in Maine, there are some income and household requirements in order to receive coverage from MaineCare Insurance. Each member’s income, before taxes, must not exceed a certain limit in order to qualify.Â
Income and household limits for MaineCare Insurance are outlined below: (3)Â
Household Size | Adults 19-20 Years of Age | Adults 21-64 Years of Age |
1 | $1,957 | $1,677 |
2 | $2,646 | $2,268 |
3 | $3,336 | $2,859 |
4 | $4,025 | $3,450 |
Additional family members | Add $690 | Add $592 |
Income limits may differ for individuals who are expecting a child. Additionally, individuals who exceed the monthly income limit may still be eligible to receive benefits from MaineCare. Prospective and current members can refer to MaineCare’s eligibility guidelines to learn more information about the eligibility requirements. (4)Â
What Types of Mental Health Disorders & Behavioral Health Services Are Covered by MaineCare?
MaineCare Insurance covers medically necessary services. This includes doctor visits, emergency hospital visits, and behavioral health care. Additionally, MaineCare does provide full or partial coverage for mental health and behavioral health services.Â
MaineCare Insurance for Depression Treatment
Due to the Affordable Care Act, MaineCare is legally required to cover mental health conditions such as mood and depressive disorders. Â
Mood disorders include, but are not limited to:
- Major Depressive Disorder
- Persistent Depressive Disorder
- Disruptive Mood Dysregulation Disorder
- Bipolar Disorder
Will MaineCare Cover Treatment for Anxiety?
Due to the Affordable Care Act, MaineCare is legally required to cover mental health conditions such as anxiety disorders.
Anxiety disorders include, but are not limited to:
- Generalized Anxiety Disorder
- Panic Disorder
- Specific PhobiasÂ
- Social Anxiety Disorder
Does MaineCare Insurance Cover ADHD Treatment?
Due to the Affordable Care Act, MaineCare is legally required to cover neurological conditions such as attention-deficit hyperactivity disorder.Â
The exact amount of coverage provided for each mental health service depends on your MaineCare coverage group.
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Does MaineCare Cover Mental Health Medications?
MaineCare Insurance does cover the full or partial cost of mental health medications. MaineCare has coverage options for all prescription medications.Â
MaineCare Insurance for Therapy, Counseling, & Psychiatric Services
Some individuals may be required to pay a premium, copayment, or the partial cost of care for their mental health and psychiatric services, depending on their coverage group. (5)Â
Additional MaineCare Insurance Benefits
MaineCare Insurance offers coverage for various services offered at Guardian Recovery, including counseling, psychiatric services, inpatient treatment, and telehealth.
Telehealth Services
Telehealth or telemedicine allows individuals to receive their mental health and substance use treatment services in the comfort of their own home. (6) Individuals who own a smartphone or computer, and have access to the internet, can see their doctor, attend counseling sessions, and receive medication management through a secure video call.Â
To learn more about which of our services at Guardian Recovery are covered by your MaineCare coverage plan, contact us today.Â
Pre-Authorization Requirement
Certain services may require pre-authorization before any amount is covered by MaineCare.Â
Services that may require pre-authorization and approval by MaineCare Insurance include: (7)Â
- Certain prescription medications.
- Certain mental health services.Â
- Inpatient psychiatric services.Â
At Guardian Recovery, we offer a free, no obligation insurance benefits check that can help determine which of our mental health treatment services are covered by your MainCare coverage group.Â
Verify Your MaineCare Insurance Benefits & Coverage
MaineCare Insurance can cover the full or partial cost of mental and behavioral health disorders. If you are insured through MaineCare, and you are unsure of your coverage options, call MaineCare Member Services, or reach out to Guardian Recovery as we can help you determine which of our services is covered by your plan.(8)Â
Individuals wanting to apply for MaineCare in order to help cover the cost of their Guardian recovery services can do so on the Maine Connection website. (9) For those with questions about their MaineCare benefits, please visit the Office of MaineCare Services. (10)Â
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At Guardian Recovery, we provide a wide-range of comprehensive treatment options for those experiencing mental health and substance use concerns. In addition to providing services in Maine, our facilities can be found in multiple states across the United States. Every one of our facilities offers beautiful, modern, and serene environments conducive to the recovery journey.Â
Our doctors, clinicians, therapists, nurses and staff are selected with extreme care and have been trained extensively in order to provide the highest standard of care. By pursuing mental health treatment at a Guardian Recovery facility, you or your loved one will be able to develop the necessary tools needed to create beautiful lives and long-term healing. Start your recovery journey today at Guardian Recovery.Â
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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.
- https://www.maine.gov/dhhs/oms/member-resources/coverage-benefits
- https://www.maine.gov/dhhs/oms/member-resources/coverage-benefits
- https://www.maine.gov/dhhs/ofi/programs-services/health-care-assistance
- https://www.maine.gov/dhhs/sites/maine.gov.dhhs/files/inline-files/Updated%202023%20MaineCare%20Eligibility%20Guidelines%202_1.pdf
- https://www.maine.gov/dhhs/oms/member-resources/coverage-benefits
- https://www.maine.gov/dhhs/oms/member-resources/telehealth
- https://www.maine.gov/dhhs/oms/member-resources/coverage-benefits
- https://www.maine.gov/dhhs/oms/member-resources#:~:text=Call%20MaineCare%20Member%20Services%20at,dial%20711(Maine%20relay).
- https://www.mymaineconnection.gov/benefits/s/?language=en_US
- https://www.maine.gov/dhhs/oms/member-resources
