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-60 - Medical Supplies and Durable Medical Equipment
Subsection 144-101-II-60.11 - CO-PAYMENT
Universal Citation: 10 ME Code Rules ยง 144-101-II-60.11
Current through 2024-38, September 18, 2024
Co-payment dispute resolution procedures are described in Chapter I of the MaineCare Benefits Manual.
60.11-1 Co-payment amount
A. A co-payment will be charged to each
MaineCare member who receives Medical Supplies or DME. The amount of the
co-payment shall not exceed $3.00 per day for equipment or supplies, according
to the following schedule:
|
MaineCare Payment for Service |
Member Co-payment |
|
$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
co-payments up to $30.00 per month whether the co-payment has been paid or not.
After the $30.00 cap has been reached the member shall not be required to make
additional co-payments and the provider shall receive full MaineCare
reimbursement.
C. Members shall not
be charged more than $3.00 per month for any rental service.
D. No provider may deny services to a member
for failure to pay a co-payment. Providers must rely upon the member's
representation that he or she does not have the cash available to pay the
co-payment. A member's inability to pay a copayment does not, however, relieve
him/her of liability for a co-payment.
E. Providers are responsible for documenting
the amount of co-payments 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 co-payments.
60.11-2 Co-payment exemptions. No co-payment may be imposed with respect to the following services:
A. All exemptions listed in Chapter I;
and
B. All oxygen and oxygen
equipment services.
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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