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-40 - Home Health Services
Subsection 144-101-II-40.10 - COPAYMENT
Current through 2024-38, September 18, 2024
A. A copayment will be charged to each MaineCare member for each day Home Health Services are provided. 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
| 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.
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 cash 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.
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.
