Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 150 - FREE CARE GUIDELINES
Section 144-150-1.02 - INCOME GUIDELINES

Universal Citation: 10 ME Code Rules ยง 144-150-1.02

Current through 2024-38, September 18, 2024

A. Definitions. For purposes of this Chapter, the following definitions shall apply:

(1) Family. A family is a group of two or more persons related by birth, marriage or adoption who reside together and among whom there are legal responsibilities for support; all such related persons are considered as one family. (If a household includes more than one family and/or more than one unrelated individual, the income guidelines are applied separately to each family and/or unrelated individual, and not to the household as a whole.)

(2) Family Unit of Size One. In conjunction with the income guidelines, a family unit of size one is an unrelated individual, that is, a person of 15 years old or over who is not living with any relatives. An unrelated individual may be the sole occupant of a housing unit, or may be residing in a housing unit (or in group quarters such as a rooming house) in which one or more persons also reside who are not related to the individual in question by birth, marriage, or adoption.

(3) Income. Income means total annual cash receipts before taxes from all sources except as provided in subparagraph (b) below.
(a) Income includes:
(i) money wages and salaries before any deductions,

(ii) net receipts from non-farm or farm self-employment (receipts from a person's own business or from an owned or rented farm after deductions for business or farm expenses);

(iii) regular payments from social security, railroad retirement, unemployment compensation, workers' compensation, strike benefits from union funds, veterans' benefits;

(iv) public assistance including Temporary Assistance to Needy Families, Supplemental Security Income, and General Assistance money payments;

(v) training stipends;

(vi) alimony, child support, and military family allotments or other regular support from an absent family member or someone not living in the household;

(vii) private pensions, government employee pensions, and regular insurance or annuity payments;

(viii) dividends, interest, rents, royalties, or periodic receipts from estates or trusts; and

(ix) net gambling or lottery winnings.

(b) Income does not include the following:
(i) capital gains;

(ii) any liquid assets, including withdrawals from a bank or proceeds from the sale of property;

(iii) tax refunds;

(iv) gifts, loans, and lump-sum inheritances;

(v) one-time insurance payment or other one-time compensation for injury;

(vi) non-cash benefits such as the employer-paid or union paid portion of health insurance or other employee fringe benefits;

(vii) the value of food and fuel produced and consumed on farms and the imputed value of rent from owner occupied non-farm or farm housing; and

(viii) Federal non-cash benefit programs, including Medicare, Medicaid, Food Stamps, school lunches, and housing assistance.

Note: Although one-time insurance payments are excluded from income, one-time insurance payments made for coverage of hospital services would limit the availability of free care to bills not covered by such payments. See subparagraph 1.05 (B) (1) (b).

(4) Resident of Maine. The term "Resident of Maine" refers to an individual living in the state voluntarily with the intention of making a home in Maine. An individual who is visiting or is in Maine temporarily is not a resident.

B. Inability to Pay. A person is unable to pay for hospital services when the family income of that person, as calculated by either of the following methods is not more than the applicable income guidelines set forth in subsection C, (if one method does not apply, the other must be applied before determination of ineligibility is made):

(1) Multiplying by four the person's family income for the three months preceding the determination of eligibility; or

(2) Using the person's actual family income for the 12 months preceding the determination of eligibility.

C. Income guidelines. The Department establishes its income eligibility guidelines for free care based on one hundred and fifty percent (150%) of the Federal Poverty Level Guidelines (FPL). The FPL is also employed in establishing financial eligibility criteria for the Hill-Burton Uncompensated Services Program.

The FPL is issued annually by the U.S. Department of Health and Human Services. Each year's FPL is available on the Internet at http://aspe.hhs.gov/poverty. An individual can also obtain a copy of the current FPL by contacting the individual's local Department of Health and Human Services office; by calling 1-800-321-5557, ext. 79368 or 1-207-287-9368; or by writing to:

Office of MaineCare Services

Division of Policy

Augusta, Maine 04333-0011

11 State House Station

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.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.