Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter II - Specific Policies By Service
Section 144-101-II-101 - Medical Imaging Services
Subsection 144-101-II-101.08 - COPAYMENT

Current through 2024-38, September 18, 2024

101.08-1 Copayment Amount

A. A copayment will be charged to each MaineCare member receiving services. The amount of the copayment shall not exceed $1.00 per day for services provided, according to the following schedule:

MaineCare Payment For Services

Member Copayment

$10.00 or less

$ .50

$10.01 or more

$1.00

B. The member shall be responsible for copayments up to $10.00 per month whether the copayment has been paid or not. After the $10.00 cap has been reached, the member shall not be required to make additional copayments and the provider shall receive full MaineCare reimbursement for covered services.

C. No provider may deny services to a member for failure to pay a copayment. Providers must rely upon the member's representation that he or she does not have the resources available to pay the copayment. A member's inability to pay a copayment does not, however, relieve him/her of liability for a copayment.

D. Providers are responsible for documenting the amount of copayments charged to each member (regardless of whether the member has made payment) and shall disclose that amount to other providers, as necessary, to confirm previous copayments.

101.08-2 Copayment Exemptions and Dispute Resolution

See the MBM, Chapter I for copayment exemptions and dispute resolution. See Section 101.09 for billing instructions for copayment exemptions.

Disclaimer: These regulations may not be the most recent version. Maine may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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