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
Universal Citation: 10 ME Code Rules ยง 144-101-II-101.08
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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