Low-Cost or No-Cost Health and Dental Insurance for Families with Children.

If you or Your children need health insurance, Medicaid or Cub Care may be the answer. Apply now. Don't wait.

F. A. Q.

• Doctors visits: Well checkups and sick care; specialist care, if necessary
• Hospital care: inpatient outpatient emergency room
• Immunizations
• Prescriptions
• Surgery
• Laboratory & X-ray
• Dental care: Full coverage for children and limited coverage for adults
• Medical equipment and supplies
• School-based health centers
• Chiropractic treatment services
• Therapies: speech/language physical occupational
• Vision screening/eyeglasses
• Hearing test/hearing aids
• Ambulance
• Case management
• Mental health and substance abuse treatment
• Family planning services
• Prenatal care
• Transportation for medical appointments

Who is eligible for this insurance?

• Children and teens age 18 and under, and pregnant women with gross monthly family income at or below the amount listed in column A on the chart below.
• Parents living with their children and teens age 18 and under with monthly family income at or below the amount in column B on the chart, and with certain assets of $2000 or less.

Note: Even if your family income is above the amount on the chart, you are encouraged to apply. Certain expenses may be taken out of your income.

How much does it cost?

• There is no cost for most families. Some families must pay a small monthly premium for their children's coverage. Premiums are between $5 and $40.00 a month. Some parents must pay a small co-payment for services.

• For children, teens or pregnant women, fill in boxes 1-10 only on the application. Sign and date (box 12).
• For parents applying for themselves along with their children and teens, fill in box 11, plus boxes 1-10 on the attached application. Sign and date (box 12).
• Mail or drop off the application to the Department of Human Services Office nearest you.
  Click here to see a list of the local DHS office addresses and telephone numbers.

Click here to go to our Get an Application page.
No interview is necessary.

How can I get more information or help filling out an application?

• Check information below
• Call the Department of Human Services toll-free at: 1-877-KIDS NOW (1-877-543-7669)
• Call Covering Kids and Teens HelpLine toll-free and TDD/TTY at: 1-800-965-7476.
• Contact the Maine Department of Human Services office nearest to your home.

Information to help you fill out the application for Medicaid and Cub Care.

1. Person Filling Out the Application
   Provide information about the person filling out the application. This is usually the parent or guardian of the children listed under "Household Members" (#3 below). If you are applying for yourself because you are pregnant or you are under age 19 and living on your own, your name is listed here. Listing Social Security numbers will help avoid delays in processing. They are not required unless you are applying for yourself.

2. Mailing Address
   This is the address where you get your mail. Write the address where you live if it is different than your mailing address.

3. Household Members
   List everyone who lives in the household including the children for whom you are applying. This tells us what income to count and who may be covered. If a household member is applying due to pregnancy, special rules apply which may help get coverage.

4. Household Earnings
   Attach paystubs or photocopies of paystubs for the last 4 weeks. We need proof of income before we can process the application. Gross weekly wages are multiplied by 4.3 to arrive at gross monthly wages. Gross monthly wages are what determine eligibility.

5. Self-Employment
   Attach a copy of your most recent tax return including all schedules. If your business is incorporated, include the corporate income tax return as well. If you have not filed a tax return, we will send you forms to complete.

6. Unearned Income
   Examples are: Unemployment Compensation, Workers Compensation, Social Security, Supplemental Security Income (SSI), VA, interest income and child support received. Attach a copy of the check, check stub or award letter from the income source. You do not need to do this for Social Security or SSI.

7. Child Care Expenses
   These expenses are deductions from earnings when figuring Medicaid eligibility. The maximum monthly deduction is $200 per child under age 2 and $175 per child age 2 and over. This deduction is not used when figuring Cub Care eligibility.

8. Child Support (Paid Out)
   This is the monthly amount paid to comply with a court or child support order. It is used as a deduction when figuring Medicaid eligibility. This deduction is not used when figuring Cub Care eligibility. Any child support received as income is not listed here. It should be listed as "Unearned Income" (#6 above).

9. Health Insurance
   If your children have other health insurance, they may not be eligible for Cub Care, but they may be eligible for Medicaid. If this applies to you, the Department of Human Services will give you more information.

10. Special Conditions
    Special rules may apply for children with a disabling condition. This can help them to get coverage.
    There is no Cub Care premium for American Indian children who are members of a Federally recognized tribe or for children who are Alaskan Natives.
    If your children are eligible for Medicaid, their medical expenses for a 3 month period prior to the month of application may be covered.
    Children or pregnant woman do not need to be citizens to be covered by Medicaid or Cub Care. Some non-citizens who are here temporarily, for example, students or visitors, can get coverage for payment of emergency services only.

If you are a parent living with your children age 18 and under, and you want to apply for yourself along with your children, fill in box 11 also:

Assets
List any assets owned by you, your children or your spouse who lives with you. Include assets owned jointly or together with anyone else. Medicaid has a $2000 asset limit for those over age 18.

1. Cashable Assets--This includes savings and checking accounts, certificates of deposit (CDs), credit union shares, stocks, bonds, annuities, individuals retirement accounts (IRAs), Keogh, or profit sharing.
2. Real Estate--This includes any property you own. Medicaid does not count the home where you live toward the asset limit of $2000, or the value of property used to produce income such as rental property. However, income from the rental property is counted toward the income limit.
3. Vehicles--This includes any motorized vehicle such as a car, truck, boat, camper, motorcycle, snowmobile, or ATV. Medicaid does not count one of the vehicles you list. The equity value of others is counted toward the $2000 limit, except for the vehicles used to produce income, such as work trucks and commercial boats.

Get your children insured. You will have one less thing to worry about. Their health is important!

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