Medicaid Office

Maine Medicaid Income Limits

Updated August 2026

Maine is an ACA expansion state, but not every age group uses the 138% expansion threshold. Adults ages 21–64 qualify at or below 138% of the Federal Poverty Level. Children and young adults ages 19–20 qualify at a much higher threshold — up to 300% FPL — since Maine expanded children's MaineCare eligibility in October 2023. Maine folds CHIP funding into MaineCare rather than running a separate CHIP program with its own limit, so there is no separate "Cub Care" tier above the children's MaineCare limit. The table below reflects the Office for Family Independence's official 2026 MaineCare income limits. For pregnant individuals, add one person to the household size for each baby expected when calculating the limit.

MaineCare income limits by coverage group (2026)

Children (all ages)

FPL %
Up to 300% FPL
Monthly limit (household of 1)
$4,057/mo
Monthly limit (household of 4)
$8,388/mo

Young adults ages 19–20

FPL %
Up to 300% FPL
Monthly limit (household of 1)
$4,057/mo
Monthly limit (household of 4)
$8,388/mo

Adults ages 21–64 (ACA expansion)

FPL %
138% FPL
Monthly limit (household of 1)
$1,836/mo
Monthly limit (household of 4)
$3,796/mo

Pregnant individuals

FPL %
209% FPL
Monthly limit (household of 1)
$2,847/mo
Monthly limit (household of 4)
$5,886/mo

No asset test for MAGI-based MaineCare

Maine does not use an asset test for MAGI-based MaineCare — the category covering most adults under 65, children, and pregnant women. Savings accounts, vehicles, and home equity do not affect eligibility. This is consistent with ACA expansion requirements, which prohibited asset tests for the expansion group.

Long-term care Medicaid programs — including nursing facility coverage and home-based waiver programs administered through DHHS's Office of Aging and Disability Services — do apply asset limits. The rules are complex and follow federal spousal impoverishment protections. Consult a Maine elder law attorney before making asset transfers if a family member may need MaineCare long-term care coverage.

How Maine counts income for MaineCare

Maine uses MAGI (Modified Adjusted Gross Income) methodology for most MaineCare categories. MAGI income is essentially the income you report on your federal tax return, with a few modifications.

  • Wages, salaries, tips, and self-employment income
  • Social Security benefits (for most adults; not SSI)
  • Unemployment benefits
  • Retirement and pension income

Maine counts the income of all household members when determining eligibility. Who counts as a household member follows IRS tax dependency rules — not simply who lives in the same house. A 5% income disregard applies — if gross household income is within 5 percentage points of the limit, an applicant may still qualify.

What does not count as income for MaineCare

  • Child support received
  • Child support paid out (does not reduce countable income under MAGI rules)
  • Supplemental Security Income (SSI)
  • Lump-sum payments, gifts, and inheritances

Maine's coverage expansions: 2019 for adults, 2023 for children

Before January 2019, Maine covered parents and caretakers up to a much lower income threshold, and adults without dependent children generally could not qualify for MaineCare at all. The ACA expansion — forced into effect after courts ruled the governor could not block it — extended coverage to adults 19–64 earning up to 138% FPL regardless of parental status or disability. Per Maine DHHS, roughly 70,000 Mainers gained coverage in the first year after expansion took effect.

Maine expanded eligibility again in October 2023, raising the income limit for children's MaineCare from a lower threshold to 300% FPL — one of the highest children's Medicaid limits in the country. Young adults ages 19–20 qualify at the same higher threshold as children, while adults 21 and older use the standard 138% FPL expansion limit.

Medicare Savings Programs (QMB) in Maine

MaineCare's expansion limits — 138% FPL for adults 21–64, up to 300% FPL for children and young adults — don't apply to Maine's Medicare beneficiaries, who are typically 65 or older or qualify for Medicare through disability. For that group, the relevant benefit is the Qualified Medicare Beneficiary (QMB) program and the related SLMB and QI tiers, administered through MaineCare rather than through the expansion categories described elsewhere on this page.

QMB

Situation
Individual
Monthly income limit
$1,350/mo

QMB

Situation
Married couple
Monthly income limit
$1,824/mo

SLMB

Situation
Individual
Monthly income limit
$1,616/mo

SLMB

Situation
Married couple
Monthly income limit
$2,184/mo

QI

Situation
Individual
Monthly income limit
$1,816/mo

QI

Situation
Married couple
Monthly income limit
$2,455/mo

QMB is the most valuable of the three: it pays the Part A premium if one is owed, the full Part B premium ($202.90/month in 2026), and all Medicare deductibles, coinsurance, and copayments, for individuals up to $1,350/month or couples up to $1,824/month. SLMB reaches $1,616/month individually ($2,184 couple) and QI reaches $1,816/month individually ($2,455 couple), but both cover the Part B premium only.

QI's funding is capped by Congress every year and awarded first-come, first-served, so unlike QMB and SLMB, QI recipients must reapply annually. Federal law prohibits any Maine provider from billing a QMB enrollee for Medicare cost-sharing, and QMB, SLMB, and QI members are all automatically enrolled in Extra Help, which limits Part D prescription costs to no more than $12.65 per covered drug in 2026.

These are MaineCare benefits, so Mainers apply through the Office for Family Independence, not through Medicare — the same office that determines eligibility for every other MaineCare category on this page, reachable through maine.gov/dhhs/oms.

MaineCare (Maine Medicaid)

  • MaineCare eligibility and income limits — Office for Family Independence: https://www.maine.gov/dhhs/ofi/programs-services/health-care-assistance
Visit the official Maine Medicaid website

Income Limits in Nearby States

Massachusetts New Hampshire New Jersey New York Pennsylvania

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