Insurance · MaineCare / Medicaid
MaineCare coverage for addiction treatment
In-network provider
Portland Treatment is an enrolled, in-network MaineCare provider.
MaineCare is the closest thing to free addiction treatment that actually exists in Maine. Substance use services are a covered benefit, cost sharing is minimal or zero, and Maine's Medicaid expansion means far more working adults qualify than assume they do.
- Network status
- In-network MaineCare provider
- Typical cost to you
- $0 to minimal copay
- Levels covered
- IOP · OP · MAT · counseling
- Expansion income
- Up to 138% of federal poverty level
Accredited & Licensed
LegitScript Certified
Joint Commission Accredited
Maine DHHS Licensed
Psychology Today Verified
What's covered
What MaineCare (Medicaid) typically covers at Portland Treatment
MaineCare covers substance use disorder treatment as a core benefit. Coverage is broad, though specific levels of care require documented medical necessity.
Partial Hospitalization (PHP)
Our most structured outpatient level, full days of clinical programming. MaineCare plans typically cover PHP with prior authorization, which our admissions team requests for you.
More about partial hospitalization (php)Intensive Outpatient (IOP)
Three to five sessions a week, mornings or evenings, so you can keep working. IOP is the most commonly authorized level of care under MaineCare behavioral health benefits.
More about intensive outpatient (iop)Outpatient Program (OP)
Weekly individual and group therapy for step-down and long-term maintenance. Usually the lowest-cost level under a MaineCare plan.
More about outpatient program (op)Medication-Assisted Treatment (MAT)
Buprenorphine, naltrexone and related medications, billed through your medical and pharmacy benefits. Coverage and preferred formulary vary by MaineCare plan.
More about medication-assisted treatment (mat)Dual diagnosis care
Depression, anxiety, PTSD and bipolar disorder treated alongside substance use, one treatment plan, one set of clinicians, billed under your behavioral health benefit.
More about dual diagnosis careDetox placement
We don't run a detox unit. We coordinate placement with licensed Maine detox providers and confirm they take your MaineCare plan before you go.
More about detox placementPlan details
Know which MaineCare (Medicaid) plan you actually have
Most people who ask about MaineCare are really asking two questions: do I qualify, and how fast can I use it?
Medicaid expansion adults
Maine expanded MaineCare in 2019. Adults under roughly 138% of the federal poverty level qualify based on income alone, no disability or dependent children required.
Applying while in crisis
You can apply online through My Maine Connection or with help from our admissions team. Coverage can be retroactive up to three months in many cases.
MaineCare and MAT
MaineCare covers buprenorphine and naltrexone, and Maine has worked to reduce prior-authorization barriers for opioid use disorder medication.
If you don't qualify
We'll tell you plainly and walk through marketplace plans on CoverME.gov, state-funded options, and self-pay arrangements instead of leaving you stuck.
What you'll pay
What determines your out-of-pocket cost
MaineCare members typically pay little or nothing for treatment. What still affects access:
- Whether the provider accepts MaineCare for the level of care you need, not all do. We're an enrolled MaineCare provider for outpatient addiction treatment.
- Whether the service requires documented medical necessity or prior authorization.
- Whether you're currently enrolled, pending, or need to reapply after a coverage lapse.
- Whether retroactive coverage can be applied to care you've already received.
- Availability, MaineCare coverage doesn't help if the program has a six-week waitlist, which is why open access matters.
How verification works
- 1. You call or submit. We take your MaineCare (Medicaid) member ID and date of birth, nothing more invasive than that.
- 2. We call the plan. Our team gets the behavioral health benefit read directly from MaineCare (Maine Medicaid), in writing.
- 3. You get a real number. Deductible remaining, coinsurance, authorization requirements and an estimated cost per week, before you commit.
- 4. We handle the rest. Prior authorizations, concurrent reviews and appeals are our job, not yours.
Southern Maine
Using MaineCare (Medicaid) coverage close to home
Southern Maine has real gaps in MaineCare-accepting outpatient addiction care, especially in York County. People in Biddeford, Saco, Sanford and Old Orchard Beach routinely get told the nearest opening is in Portland or Lewiston. Our Biddeford location exists in part to close that gap.
If you're not enrolled yet, call anyway. Our admissions team can help you start a MaineCare application, explain likely eligibility, and in many cases begin the clinical assessment while your application is processing rather than making you wait.
MaineCare (Medicaid) coverage questions
- Does MaineCare cover drug and alcohol rehab?
- Yes. MaineCare covers substance use disorder treatment including outpatient counseling, intensive outpatient programming and medication-assisted treatment, with little or no cost sharing for members.
- Who qualifies for MaineCare?
- Maine expanded Medicaid in 2019, so adults with household income up to roughly 138% of the federal poverty level generally qualify on income alone. Children, pregnant people, parents and people with disabilities may qualify at different thresholds.
- Is addiction treatment free with MaineCare?
- For most members it's effectively free, copays for behavioral health services are minimal or zero. The honest caveat is access: coverage doesn't guarantee an open seat at every program.
- Can I get MaineCare coverage retroactively?
- In many situations MaineCare can cover eligible services up to three months before your application date. That's worth asking about if you've already had treatment or an ER visit.
- Does MaineCare cover Suboxone?
- Yes. MaineCare covers buprenorphine products and naltrexone for opioid use disorder, and the state has worked to reduce prior authorization barriers for these medications.
- How do I apply for MaineCare?
- Apply online through My Maine Connection, by phone with the Department of Health and Human Services, or with help from our admissions team, who do this several times a week.
Coverage details described here are general and change by plan year and plan design. Nothing on this page is a guarantee of benefits or payment. The only way to know your coverage is a benefit verification on your specific policy.
Other plans we work with
Keep exploring
Using MaineCare (Medicaid) at Portland Treatment
Programs your plan may cover
- Partial hospitalization program (PHP) in Biddeford
Our most structured day treatment, five days a week, home each night.
- Intensive outpatient program (IOP) in Southern Maine
Nine-plus clinical hours a week with day and evening tracks.
- Virtual IOP for anywhere in Maine
The same IOP curriculum by secure telehealth, statewide.
- Outpatient program (OP) for ongoing recovery
One to two sessions a week that fit around work and family.
Other plans we accept
- Anthem coverage for rehab in Maine
What Anthem BCBS typically covers for PHP, IOP and OP.
- Cigna coverage for addiction treatment
Verify your Cigna benefits in a few minutes.
- UMR coverage for addiction treatment
UMR/UnitedHealthcare plans and outpatient rehab.
- Harvard Pilgrim coverage for rehab
A common New England plan for Maine members.
Helpful reading
- Does insurance cover rehab?
Coverage, costs and what to ask your plan.
- Working during rehab
Evening IOP, FMLA and keeping your job in treatment.
- Maine recovery resources directory
Local meetings, crisis lines and state programs.
- All Southern Maine areas we serve
Every city and town within driving distance of Biddeford.
Find out what MaineCare (Medicaid) covers
today
855-449-7674Answered 24 hours a day, 7 days a week. Free and confidential.