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  • Mainecare Pdl

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FORM # FRX018 Prior Authorization Request Form for () Member Information Provider Information Patient Name Cardholder ID Provider Name DEA Number Date of Birth Address Address City, State and Zip.

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Does this mean that if I use any MaineCare programs, the State must be repaid? NO! Your estate will not be touched if you use certain MaineCare programs such as: Medicare Buy-In Benefits or Medicare Savings Programs that help pay for Medicare premiums and other Medicare costs.

Maine's Limited Family Planning Benefit is your source for free, confidential and convenient family planning services. You can enroll and receive health care services under this plan at any Planned Parenthood health center in Maine at no cost to you. Covered Services: Birth control (pills, implant, IUD)

Maine Family Planning provides affordable reproductive health care services for all Mainers, as well as primary care, help for new parents and families, and gender-affirming health services.

Who is eligible for Maine MaineCare (SCHIP)? Household Size*Maximum Income Level (Per Year) 1 $30,120 2 $40,880 3 $51,640 4 $62,4004 more rows

Family planning aids in population planning and control, which leads to positive community development, effective conservation and distribution of natural resources, more jobs, sufficient number of schools and healthcare and sanitation facilities, and other economic and environmental benefits.

Covered Services: Birth control (pills, implant, IUD) Breast and Cervical cancer screenings. STI testing and treatment, UTI testing and treatment.

Income & Asset Limits for Eligibility 2024 Maine Medicaid Long-Term Care Eligibility for Seniors Type of MedicaidSingle Income Limit Asset Limit Institutional / Nursing Home Medicaid $2,829 / month* $10,000† Medicaid Waivers / Home and Community Based Services $2,829 / month‡ $10,000†1 more row • Jan 16, 2024

Limited Family Planning Benefit This benefit covers services for members wishing to prevent or delay pregnancy or regulate the number of children and timing of pregnancies. To qualify, you must not be pregnant. To see more detail about who qualifies, including income guidelines, see the MaineCare Member Handbook (PDF).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232