Previous| Item | Adult | 0 to 20 yrs. | PA | Flat Rate Reimburse | DME Reimburse | Sole Supplier | HCB Waiver Elder & Adult | HCB Waiver Pw/MR | HCB Waiver PD | Other |
|---|---|---|---|---|---|---|---|---|---|---|
| AAC Device/System | X | X | X | X | X | |||||
| AAC Accessories | X | X | X | X | ||||||
| Adaptive Aids | X | X | ||||||||
| Cochlear Implants | X | X | X | X | ||||||
| Eye Glass Frames | O | X | O | X | X | |||||
| Eye Glass Lenses | O | O | X | X | ||||||
| Eye Glass Repair | X | X | ||||||||
| Eye Glass Replacement | X | X | ||||||||
| Hearing Aid Accessories | X | X | X | X | ||||||
| Hearing Aid | O | X | X | X | X | |||||
| Home Mods | X | X | X | X | ||||||
| Hospital Beds | X | X | X | X | ||||||
| Lifts - Electric | O | O | X | X | ||||||
| Lifts - Hydraulic | X | X | X | X | X | |||||
| Lifts - Manual | X | X | ||||||||
| Lifts - Stairs | X | X | ||||||||
| Low Vision Aids | X | X | O | X | ||||||
| Orthodics | X | X | O | O | X | |||||
| PERS | X | X | X | X | ||||||
| POV | X | X | X | X | X | |||||
| Prosthetics | X | X | O | O | X | |||||
| Ramps | O | O | X | X | ||||||
| Safety Adaptations | X | X | X | |||||||
| Specialized Access | X | X | X | |||||||
| Wheelchair Accessories | X | X | X | X | ||||||
| Wheelchair standard | X | X | X | X | X | |||||
| Wheelchair customized | X | X | X | X | X | |||||
| Wheelchair powered | X | X | X | X | X |
| Previous |
This chart is designed as an overview to explain the types of Assistive Technology, also known as Durable Medical Equipment, Prosthetics or Orthotics that the Maine Care program would reimburse. This is a general overview. Specific provisions regarding coverage requirements can be obtained by viewing Section 60 for Durable Medical Equipment in the Maine Care Benefits Manual. A copy of this manual is available at either Department of the Secretary of State or Bureau of Medical Services. Paper copies of rules are available for a fee by calling 207-287-9368 or TTY 1-800-423-4331.
The Maine Care member services at 207-624-7539, Option 1 (Augusta area) or 1-800-321-5557, Option 1 (statewide) should be contacted directly with any specific questions or for further clarifications. It is important to remember the Maine Care benefits packages are different depending on the member’s age, medical condition, or income level.
In reviewing the information contained in the chart, you will note that there are two different symbols. A "O" alerts the reader to special considerations for that specific item and/or eligibility category. For further information, the reader is urged to refer to that specific section. If an "X" appears, it means that the item is covered for that eligibility category or service offering. Any time the “Other” category is checked, the reader is encouraged to refer to that specific section for additional information.
While this chart contains information regarding the provision of Assistive Technology Devices that are covered for the 0 to 20 age group, it is imperative to keep in mind the provisions of the Omnibus Budget Reconciliation Act (OBRA) of 1989. OBRA ‘89 requires that all Maine Care reimbursable services must be available to eligible children if they are “medically necessary to correct or ameliorate defects (and physical and mental illnesses and conditions) discovered by the screening services, whether or not such services are covered under the state plan.” Services must be covered under federal regulations governing the Maine Care Program and be prior-authorized by the Bureau of Medical Services. In essence, OBRA ’89 would make an individual 0 to 20 years eligible to receive all of the items listed in this chart, if the item is deemed medically necessary. Some items necessary for children may not be approved as DME. Instead, the requested item or service might be approved under non-traditional Preventive Health Program (PHP) services.
