Can Maine Withhold Workers' Compensation for Medicaid Recipients?

Answering the Question

Maine will not take a person's workers' compensation payments if that person is also receiving Medicaid. The state's Medicaid Work Incentive Program (WIP) protects workers' comp benefits, so injured workers can keep both incomes while still qualifying for Medicaid.

How the Work Incentive Program Works

The Maine WIP allows Medicaid beneficiaries who earn wages or receive workers' compensation to maintain coverage. The program automatically offsets the amount of Medicaid premium or cost‑share that would otherwise be due, based on the person's earned income.

Key Rules

• Workers' compensation is treated as earned income for WIP purposes.
• Medicaid eligibility is recalculated each month to reflect the new income level.
• There is no mandatory deduction of workers' comp from Medicaid benefits.

What Happens if You Receive Both Benefits

If you're injured and receive workers' compensation while enrolled in Medicaid, the WIP will:

• Adjust your Medicaid premium or cost‑share to reflect the additional income.
• Keep your Medicaid benefits active unless your total income exceeds the state's income limits.
• Provide a written notice of any changes to your coverage status.

Practical Steps for Injured Workers

To ensure smooth coordination between the two programs:

• Notify the Maine Department of Health and Human Services (DHHS) immediately after receiving a workers' comp award.
• Submit any required documentation, such as the workers' compensation award notice, to your Medicaid office.
• Review your monthly Medicaid statement for correct premium adjustments.

Common Misconceptions

Some workers worry that receiving workers' compensation will automatically terminate Medicaid. In Maine, this is not the case thanks to the WIP. However, if your total income (including other sources) pushes you above the Medicaid income threshold, your eligibility may end.

Table: Income Limits for Maine Medicaid (2024)

When to Seek Assistance

If you notice a discrepancy in your Medicaid benefits after receiving workers' compensation, contact the Maine DHHS Medicaid Helpline at 1‑800‑444‑2222. A Medicaid caseworker can verify your income calculations and ensure your benefits remain intact.