To apply for benefits and services online, visit My Maine Connection. Once there, you can:
Use this application if you would like to apply for:
This form allows DHHS to release or obtain a participant's medical, billing or other confidential records to or from another provider/agency.
To appoint an authorized representative to act on your behalf with DHHS.
Use this application if you would like to apply for a MaineCare program, including:
Use this application if you’d like to apply for assistance with the cost of medical services for individuals in a:
Use this application if you are MaineCare member seeking help paying for private health insurance premiums.
Complete this form if you would like to request a disability determination for MaineCare services.
Use this application if you had SNAP benefits stolen through card skimming, card cloning, phishing, or other electronic acquisition of the EBT card number and PIN and would like to have them replaced.
Use this application if you believe your children are eligible for SUN Bucks and they did not receive an eligibility notice.
Use this form to report a loss of food purchased with SNAP benefits if the loss was the result of a fire, flood, power outage, appliance failure, or other household misfortune. The report must be made within 10 days of the loss. You may submit the form by uploading it to MyMaineConnection.gov, e-mailing it to Farmington.DHHS@Maine.gov, mailing it to DHHS, OFI Farmington District Office, 114 Corn Shop Ln., Farmington, ME 04938, or dropping it at your local office. You may also report the loss by e-mailing farmington.dhhs@maine.govor calling 1 (855) 797-4357 . A completed form will still be required.
Use this form to verify a medical exemption from ABAWD work requirements. Exemptions include regular participation in substance use disorder treatment, or not being medically able to work 30 or more hours per week. The form must be completed by a licensed provider.
Use this form to verify sufficient hours volunteering to meet the ABAWD work requirement.
Use this form to verify enrollment in certain community college programs that qualify recipients for exemption from SNAP Ineligible Student rules.
Use this form to help determine if residents of a group home you administer may be eligible for SNAP Benefits.
Use this form to report changes to the address or licensing of a SNAP approved group home.
Use this application if you are a former TANF recipient and are applying for childcare assistance.
Use this application to apply for work related transportation assistance.
Use this application to apply for Emergency Assistance. Learn more about Emergency Assistance here.
Complete this form when applying for TANF or Parents as Scholars (PaS).
Use this form as a way to verify Good Cause related to domestic violence or sexual assault for the TANF and PaS programs.
Use this application if you would like to apply for the HOPE program and learn more information.