Maine CHIP: Children's Health Insurance Program

Children covered through CHIP-funded MaineCare receive comprehensive coverage equivalent to standard MaineCare. Maine brands its EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) benefit for children and young adults under 21 as "VitalCare for Kids" — it covers medically necessary preventive, dental, developmental, behavioral health, and specialty services, including services not normally covered under standard MaineCare benefits when medically necessary.

MaineCare has minimal cost-sharing for children's coverage, though some coverage categories carry premiums — MaineCare offers an online payment portal for members who owe premiums. Federal CHIP rules cap annual family out-of-pocket costs at 5% of family income. Contact OFI to confirm whether a premium applies to your household's income tier.

Apply through MyMaineConnection at mymaineconnection.gov. A single application screens for both standard MaineCare and CHIP-funded children's coverage — the Office for Family Independence (OFI) determines which funding category applies based on household income. You don't need to file separate applications.

You can also apply by calling OFI at 1-855-797-4357, mailing or emailing a paper application, or visiting a local OFI district office. Applications are processed within 45 days under federal rules.

Both standard MaineCare for children and CHIP-funded coverage use the same income table published by Maine DHHS. The practical difference is the funding source — MaineCare below a certain threshold is Medicaid-funded, while coverage above that threshold draws on the CHIP federal matching rate, which is higher than the standard Medicaid match. For families, both funding streams provide the same coverage and the same application process.

The "Cub Care" name itself is retired: a MaineCare rule effective May 26, 2024 replaced references to "Cub Care" with "CHIP" throughout the MaineCare eligibility rules, aligning Maine's terminology with the federal Children's Health Insurance Program name.

Eligible children can apply for coverage regardless of the immigration status of their parents. Parents do not need to provide their own immigration documents when applying only for a child's coverage. This is standard Maine DHHS policy.

CHIP — the Children's Health Insurance Program — is a federal-state partnership that covers children in families whose income is too high for Medicaid but too low to afford private insurance. Congress created CHIP in 1997 under Title XXI of the Social Security Act. Like Medicaid, CHIP is jointly funded by the federal government and each state, and each state administers its own program.

CHIP serves children up to age 19 (some states cover to 21 for children in foster care). It is not available to adults — CHIP is specifically designed to address the coverage gap for children in working families. Nationally, CHIP covers approximately 7 million children, according to CMS data.