Long-Term Care Planning in Maine: Costs, Medicaid & Your Options (2026 Guide)

Maine's long-term care costs rank among the highest in the United States across all care types — nursing home care averages $13,976 per month, approximately 46% above the national average of $9,581, while assisted living averages $8,205 per month, approximately 32% above the national average of $6,200. Home care averages $8,485 per month, about 27% above the national rate. Maine Medicaid — known as MaineCare — is administered by the Maine Department of Health and Human Services (DHHS). The income limit for Nursing Home Medicaid is $2,982 per month. Maine has a unique asset limit of $10,000 for individuals (the standard $2,000 plus an extra $8,000 state exemption). Maine does not use Miller Trusts (Qualified Income Trusts) — instead, it offers a Medically Needy spenddown. This guide covers what care costs in Maine, how to qualify for MaineCare, and what options exist for veterans and family caregivers in Portland, Bangor, Lewiston, Augusta, and across the Pine Tree State.

Maine's Aging Population: The Numbers Behind the Need

Maine is one of the oldest states in the nation by median age, with more than 310,000 residents aged 60 or older. The senior population is concentrated in the Greater Portland metropolitan area (Cumberland County), Bangor (Penobscot County), Lewiston-Auburn (Androscoggin County), and Augusta (Kennebec County). Other significant aging communities include South Portland, Biddeford, Scarborough, Brunswick, Sanford, Westbrook, and Waterville.

Maine's geography — from the rocky coastline to vast rural interior — creates distinct challenges for long-term care delivery. Many northern and western counties have limited facility options, and Maine's harsh winters can affect care access. Home and community-based services are essential for keeping seniors in their communities, particularly in areas like Aroostook County (Presque Isle, Caribou), Hancock County (Ellsworth, Bar Harbor), and rural Washington County.

Unpaid Caregivers in Maine: Scale and Impact

An estimated 181,000 unpaid family caregivers in Maine provide care to aging relatives and adults with disabilities. According to AARP research, family caregivers nationwide spend an average of $7,242 per year in out-of-pocket costs related to caregiving.

Maine's Elderly and Adults with Disabilities HCB Waiver and Consumer Directed Attendant Services (CDAS) program offer support for unpaid caregivers, including personal care assistance, respite care, home-delivered meals, and home modifications. CDAS allows beneficiaries to select, train, and manage their own caregiver, including certain relatives such as adult children — though a spouse or legally responsible person is prohibited. The HCB Waiver has a waiting list, so early application is recommended.

What Long-Term Care Costs in Maine

Maine's care costs vary by type of care:

• Assisted Living: $8,205 per month — approximately 32% above the national average of $6,200
• Nursing Home (semi-private room): $13,976 per month — approximately 46% above the national average of $9,581
• Home Care (home health aide): $8,485 per month — approximately 27% above the national average of $6,673
• Adult Day Care: $2,492 per month — approximately 21% above the national average of $2,058

At these rates, a three-year nursing home stay in Maine costs approximately $503,000 — while home care totals roughly $306,000 over the same period. Assisted living, at $8,205/month, totals approximately $295,000 over three years. For a detailed breakdown of care costs by type and how Maine compares to other states, visit our Maine Care Costs page.

How to Qualify for MaineCare: Eligibility Rules for 2026

MaineCare is administered by the Maine DHHS. While jointly funded by the state and federal government, it is administered by the state within federally set parameters. In addition to nursing home care, MaineCare pays for non-medical services and supports to help frail seniors live in their homes or the home of a loved one. Consulting with a Maine elder law attorney or Certified Medicaid Planner early can help families avoid costly mistakes. Eligibility rules vary by program type:

• Nursing Home Medicaid (Institutional): Income limit of $2,982/month. All of a beneficiary's monthly income, with the exception of a $40/month Personal Needs Allowance, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must go towards nursing home costs (Patient Liability). Asset limit of $10,000 (single) or $15,000 if sharing a room / $20,000 if in separate rooms or facilities (married couple, both applying) — Maine allows an extra savings exemption of $8,000 for an individual and $12,000 for a couple beyond the standard $2,000/$3,000 asset limit. When only one spouse applies, the non-applicant spouse may retain up to $162,660 in assets. This is an entitlement — anyone who qualifies receives benefits.
• HCBS Waivers / Home and Community Based Services: Income limit of $2,982/month. Asset limit of $10,000 (single). This is not an entitlement — the number of participant slots is limited and wait lists exist. Services are intended to delay nursing home admissions.
• Regular Medicaid / Aged, Blind, and Disabled: Income limit of $1,330/month (single) or $1,803.33/month (couple). Asset limit of $10,000 (single) or $15,000 (couple). This is an entitlement. In Maine, persons eligible for SSI are automatically approved for Regular Medicaid, including long-term care given functional need requirements are met.

Maine applies a 60-month (5-year) look-back period for Nursing Home Medicaid and HCBS Waiver applications. Asset transfers during this period — including gifts to family members and transfers by one's spouse — can trigger a penalty period of Medicaid ineligibility. The federal $19,000 Gift Tax exclusion (2026) does NOT apply to Medicaid's look-back rules. There is no Look-Back Period for Regular Medicaid. For the full Maine Medicaid eligibility breakdown, see our Maine Medicaid Guide.

Spousal Protections and Community Spouse Resource Allowance

When one spouse applies for Nursing Home Medicaid or an HCBS Waiver in Maine, only the applicant spouse's income is counted. The Community Spouse Resource Allowance (CSRA) allows the non-applicant spouse to retain up to $162,660 in countable assets. The minimum CSRA is $32,532. If the community spouse's half of the couple's assets is under $32,532, up to $32,532 can be retained.

Maine sets the Monthly Maintenance Needs Allowance (MMMNA) at $2,643.75 per month (eff. 7/1/25 – 6/30/26). If the non-applicant spouse's income falls below this amount, income can be transferred from the applicant spouse. A non-applicant spouse can increase their Spousal Income Allowance if housing/utility costs exceed a shelter standard of $793.13/month, but the total cannot exceed $4,066.50/month. For Regular Medicaid, both spouses' income is counted and there is no MMMNA or CSRA.

Maine Medicaid Programs: HCB Waiver, CDAS, and More

Maine offers several Medicaid-funded long-term care programs:

• Elderly and Adults with Disabilities HCB Waiver: Also called the Home and Community Benefits Waiver, this program pays for home care, home modifications, personal emergency response systems, respite care, home-delivered meals, and other supportive services. Personal care services can be self-directed, allowing one to select a caregiver including certain relatives such as adult children. Wait lists exist for this program.
• Consumer Directed Attendant Services (CDAS): Beneficiaries receive assistance with daily living activities (bathing, dressing, mobility, meal preparation, light housecleaning) in their homes. Assistance is participant-directed, allowing beneficiaries to select, train, and manage their caregiver — while this can be a relative, a spouse or legally responsible person is prohibited.
• Money Follows the Person (Homeward Bound): A federal program that helps institutionalized Medicaid-eligible persons transition back home or into the community. Known in Maine as Homeward Bound.

Qualifying When Over the Limits: Medically Needy Spenddown and Asset Strategies

Maine does not use Miller Trusts (Qualified Income Trusts). Instead, the state offers the following pathways for applicants who exceed income or asset limits:

• Medically Needy Spend Down: Maine has a Medically Needy pathway with a protected income level (MNIL) of $315/month for an individual and $341/month for a couple. The spend-down is calculated for a 6-month period. The Medically Needy asset limit is $2,000 for an individual and $3,000 for a couple. Applicants with income above these limits "spend down" by applying medical expenses to the difference. Once met, MaineCare benefits begin for the remainder of the coverage period.
• Asset Spend-Down: Spend excess assets on non-countable items — home modifications (wheelchair ramps, stair lifts, walk-in showers), prepaying funeral/burial expenses (up to $18,432 in Maine), and paying off debt. Keep documentation as proof Medicaid's look-back rule was not violated.
• Medicaid Planning: Work with a Medicaid Planning Professional to employ legal strategies for eligibility and protect your home from Medicaid's Estate Recovery Program.

Asset Rules: What Counts and What Doesn't

Countable assets in Maine include cash, stocks, bonds, investments, cryptocurrency, bank accounts (money market, savings, checking), and real estate in which one does not reside. In Maine, IRAs and 401Ks are counted as assets. Non-countable (exempt) assets include personal belongings, household furnishings, two automobiles (one must be needed for a specific purpose such as medical transportation), prepaid burial contracts up to $18,432, and generally one's primary home. Maine allows an extra savings exemption of $8,000 for an individual and $12,000 for a couple beyond the standard $2,000/$3,000 asset limit, bringing the effective limit to $10,000/$15,000. All assets of a married couple are considered jointly owned regardless of the Medicaid program.

The CSRA allows the non-applicant spouse to retain up to $162,660 of the couple's assets. There is no CSRA for Regular Medicaid. In Maine, the VA Aid & Attendance Pension (above and beyond the Basic VA Pension) does not count as income — a state-specific exemption. Nationally, Holocaust restitution payments are not counted as income. In Maine, persons eligible for SSI are automatically approved for Regular Medicaid, including long-term care given functional need requirements are met.

Veterans and Long-Term Care in Maine

Maine has a proud veteran community, with facilities including the Togus VA Medical Center in Augusta — the first VA hospital in the United States. The Maine Veterans' Homes system operates six facilities in Augusta, Bangor, Caribou, Machias, Scarborough, and South Paris, providing nursing home, residential, and rehabilitative care. The VA Aid & Attendance benefit provides additional monthly income to veterans and surviving spouses who require assistance with activities of daily living.

Notably, Maine exempts the VA Aid & Attendance Pension from MaineCare income calculations — meaning veterans receiving this benefit have an advantage when applying for Medicaid. For a comprehensive overview of veteran long-term care benefits, see our Veterans Long-Term Care Guide.

Planning Ahead: How to Pay for Nursing Home Care in Maine

Understanding how to pay for nursing home care in Maine — or any long-term care setting — requires evaluating multiple funding sources. With nursing home costs at $13,976/month (46% above the national average), a 60-month look-back period, and a $2,982/month income limit, advance planning is essential. Maine long-term care insurance policies, personal savings, veterans benefits, and MaineCare each play a role. Key steps include:

• Understanding your current financial position relative to Maine MaineCare eligibility thresholds
• Knowing that Maine's income limit is $2,982/month for Nursing Home Medicaid — and the state does not use Miller Trusts, relying instead on Medically Needy spenddown ($315/month MNIL for individuals, $341/month for couples)
• Recognizing Maine's unique $10,000 individual asset limit ($8,000 extra exemption beyond the standard $2,000)
• Exploring the HCB Waiver or CDAS to remain at home — but applying early for waiver programs due to waiting lists
• Taking advantage of Maine's MMMNA ($2,643.75) to protect the non-applicant spouse's income
• Investigating veterans benefits — especially since Maine exempts VA Aid & Attendance from MaineCare income calculations
• Researching Maine long-term care insurance options while still healthy enough to qualify
• Consulting with a Maine elder law attorney or Certified Medicaid Planner to protect assets and avoid look-back penalties

Estate Recovery: Protecting Your Home in Maine

Maine operates a Medicaid Estate Recovery Program, which allows the state to seek reimbursement from a deceased Medicaid beneficiary's estate for long-term care costs paid by MaineCare. This can include the family home if proper protections are not in place. The primary home is automatically exempt if the applicant's spouse, child under 21, or permanently blind or disabled child (of any age) lives in it.

If no qualifying family member lives in the home, there is a home equity interest limit of $1,097,000 (in 2026) — Maine uses the higher federal option. Home equity is the value of the home after subtracting outstanding debt. Equity interest is the amount of equity owned by the applicant. If neither the applicant nor qualifying family live in the home, the applicant must demonstrate Intent to Return. There is no home equity interest limit for Regular Medicaid. The home is NOT exempt from estate recovery — families should consult a Maine elder law attorney to explore legal protections.

Regional Cost Variations Across Maine

Long-term care costs in Maine vary by region. The Greater Portland area (Cumberland County — Portland, South Portland, Scarborough, Westbrook) typically sees higher costs for assisted living and nursing home care. Midcoast Maine (Brunswick, Bath, Rockland) and Kennebunk-Biddeford-Saco along the southern coast are also higher-cost markets. Bangor (Penobscot County) and Lewiston-Auburn (Androscoggin County) represent mid-range markets. In contrast, northern Maine (Aroostook County — Presque Isle, Caribou) and Downeast Maine (Washington and Hancock Counties) generally have lower costs, though availability of facilities and home care providers may be more limited.

Application Timeline and Process

MaineCare applications can be submitted through several channels:

• Apply online at My Maine Connection (mymaineconnection.gov)
• Apply in person at a district Office for Family Independence (OFI) office
• Download applications from the DHHS website — separate applications exist for Regular Medicaid (MaineCare Application) and Nursing Home / HCBS Waivers (Long Term Care Application)
• Call an OFI Representative at 1-855-797-4357 for application assistance

MaineCare eligibility is determined by DHHS's Office for Family Independence (OFI). It is vital that applicants are confident they meet all eligibility criteria before submitting a MaineCare application. For seniors who don't meet the requirements, Medicaid Planning is strongly recommended. Processing times vary but typically take 45–90 days.

Federal Policy Update: One Big Beautiful Bill Act (OBBBA)

The One Big Beautiful Bill Act (OBBBA) includes approximately $1 trillion in Medicaid cuts over 10 years. While Nursing Home Medicaid is largely protected from future funding reductions, Home and Community Based Services (HCBS) — including Maine's HCB Waiver and CDAS — are likely targets for cuts. This law is still facing legal challenges. Families relying on or planning to use HCBS should monitor developments and consider applying early.

Last updated: September 2026. Data sources: Maine Department of Health and Human Services, CareScout 2025 care cost survey (updated March 2026). All Medicaid figures reflect 2026 eligibility thresholds. This guide is for informational purposes only and does not constitute legal or financial advice.