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-31 - Federally Qualified Health Center Services
Subsection 144-101-II-31.08 - COPAYMENT
Current through 2024-38, September 18, 2024
A. Providers will charge a copayment to each MaineCare member receiving services, unless the member is exempt under the provisions of Chapter I of the MaineCare Benefits Manual. Effective 8/1/14, no copayment shall be charged for smoking cessation treatment services. The amount of the copayment shall not exceed $3.00 per day for services provided, according to the following schedule:
|
MaineCare Payment for Service |
Member Copayment |
|
$10.00 or less |
$ .50 |
|
$10.01 - 25.00 |
$1.00 |
|
$25.01 - 50.00 |
$2.00 |
|
$50.01 or more |
$3.00 |
B. The member shall be responsible for copayments up to $30.00 per month whether the copayment has been paid or not. After the $30.00 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. Providers are subject to the Department's copayment requirements. Refer to Chapter I, "General Administrative Policies and Procedures", for rules governing copayment requirements, exemptions and dispute resolution.
