Updated for 2025 coverage rules
Maine’s Medicaid program, known as MaineCare, helps residents access essential health services when private insurance is out of reach.
To qualify for 2025-2026 coverage, your household income must fall below certain limits that depend on your family size and category such as adults, children, or pregnant individuals.
This guide breaks down the MaineCare income limits, eligibility rules, and step-by-step application process to help you understand if you or your family qualify.
What MaineCare Covers and Who Qualifies
MaineCare offers comprehensive benefits, including doctor visits, hospital care, prescription drugs, behavioral health support, and long-term care. It serves a broad range of Mainers who meet income and residency requirements, including:
- Adults aged 21 to 64 under Medicaid expansion
- Pregnant individuals
- Children and youth up to age 20
- People with disabilities
- Seniors who need long-term or nursing home care
Because Maine expanded Medicaid under the Affordable Care Act, eligibility now extends to more adults and working families than before.
MaineCare Income Limits by Category (2025-2026)
The Maine Department of Health and Human Services (DHHS) publishes yearly income thresholds based on federal poverty levels (FPL). These limits reflect gross monthly income before taxes or deductions.
| Household Size | Adults (21–64) | Pregnant Individuals | Children / Youth |
| 1 | $1,801 | $2,792 | $3,979 |
| 2 | $2,434 | $3,773 | $5,377 |
| 3 | $3,066 | $4,754 | $6,775 |
| 4 | $3,698 | $5,734 | $8,172 |
| Each additional | +$633 | +$981 | +$1,398 |
These numbers are officially listed by Maine DHHS for 2025. If your household income is only slightly above the limit, you may still qualify under spend-down or medically needy provisions that adjust income based on medical expenses.
Income Limits by Coverage Type in MaineCare
| Coverage Type | % of Federal Poverty Level (FPL) | Household of 4 — Monthly Limit |
| Adults (21–64) — expansion group | 138% FPL | $3,698 |
| Pregnant individuals | 214% FPL | $5,734 |
| Children and youth | Up to ~305% FPL | $8,172 |
| Parents / Caregivers | 105% FPL | $2,254 |
These figures show how income thresholds rise for children and pregnant individuals, reflecting Maine’s goal to protect families and ensure continuity of care during pregnancy and early childhood.
Eligibility Requirements Beyond Income
Income isn’t the only factor that determines MaineCare eligibility. Applicants must also meet other conditions, such as:
- Being a resident of Maine
- Being a U.S. citizen or a qualified immigrant under MaineCare rules
- Meeting asset limits if applying as aged, blind, or disabled (for example, $10,000 for a single applicant)
- Having income below about $2,901 per month for long-term care or nursing home coverage (2025 threshold)
- Providing proof of identity, income, and residence during the application
Those who exceed income limits may still qualify through spend-down programs, where high medical bills reduce countable income until it falls within eligibility limits.
How to Apply for MaineCare in 2025-2026
Applying for MaineCare is simple and can be done in several ways:
- Online: Apply through the official MyMaineConnection portal
- By Mail: Send your completed form to the Office for Family Independence
- In Person: Visit your local DHHS district office
- Fax or Email: Submit your application where accepted by state offices
After submitting your application, you’ll likely need to provide documentation such as proof of income, Social Security numbers, and state ID.
If approved, you’ll receive a notification and a MaineCare card. Coverage typically starts the first day of the month in which you applied.
Frequently Asked Questions for MaineCare Income Limits 2025-2026
1. What is the Maine Medicaid income limit for adults in 2025?
Adults ages 21 to 64 may qualify with a gross monthly income up to $3,698 for a household of four.
2. Do children qualify at higher income levels under MaineCare?
Yes. Children and youth can qualify up to about 305% of the Federal Poverty Level (FPL), around $8,172 monthly for a family of four.
3. Are pregnant individuals eligible with higher income limits?
Yes. Pregnant individuals qualify up to 214% of the FPL, or $5,734 per month for a family of four.
4. Can I still qualify if my income is slightly above the limit?
Possibly. Maine’s medically needy or spend-down programs allow certain applicants to qualify by deducting medical expenses from their income.
5. What are the limits for long-term or nursing home care?
Eligibility for long-term care typically requires income below $2,901 per month for an individual in 2025, with additional asset limits.
6. How often are MaineCare income limits updated?
MaineCare thresholds are reviewed and adjusted each year when new Federal Poverty Guidelines are released.
7. How long does it take to get approved for MaineCare?
Processing usually takes a few weeks if your documents are complete. You’ll receive a mailed decision notice.
Final Thoughts
MaineCare remains a crucial safety net for residents who need affordable health care. Whether you’re a working adult, an expecting parent, or a family with children, understanding these Maine Medicaid income limits for 2025-2026 helps you plan ahead and stay covered.
Because income thresholds and rules can change each year, always confirm your eligibility with the Maine Department of Health and Human Services before applying.
To start your application or check current requirements, visit maine.gov/dhhs/health-care-assistance or log in to MyMaineConnection.gov Staying informed can make the difference between delayed coverage and peace of mind.
