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-95 - Podiatric Services
Subsection 144-101-II-95.08 - COPAYMENT
Universal Citation: 10 ME Code Rules ยง 144-101-II-95.08
Current through 2024-38, September 18, 2024
95.08-1 Copayment Amount
A. A copayment will be charged to each
MaineCare member receiving services. The amount of the copayment shall not
exceed $2.00 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 or more | $2.00 |
B. The member shall be responsible for
copayments up to $20.00 per month whether the copayment has been paid or not.
After the $20.00 cap has been reached, the member will not be required to make
additional copayments and the provider will 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 money available to pay the
copayment. A member's inability to pay a copayment does not 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.
95.08-2 Copayment Exemptions
Copayment exemptions apply as defined in the MaineCare Benefits Manual, Chapter I, General Administrative Policies and Procedures.
95.08-3 Copayment Disputes
Procedures regarding copayment disputes apply as defined in the MaineCare Benefits Manual, Chapter I, General Administrative Policies and Procedures.
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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