Medicaid Long-Term Care Guide in Maine
Long-term care eligibility, benefits, and how to apply through the State of Maine Department of Health and Human Services (DHHS).
What makes Maine Medicaid different
Medicaid in Maine is called MaineCare. 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.
Administered by the State of Maine Department of Health and Human Services (DHHS).
Program Types
Institutional / Nursing Home Medicaid
An entitlement; anyone who is eligible will receive assistance. Benefits are provided in Medicaid-certified nursing homes.
Level of care: Nursing Home
Medicaid Waivers / Home and Community Based Services
Not an entitlement; there are a limited number of participant slots. Intended to delay nursing home admissions, benefits are provided at home and in adult day care.
Level of care: Nursing Home
Regular Medicaid / Aged Blind and Disabled
An entitlement; meeting the eligibility requirements guarantees one will receive benefits. While Regular Medicaid is not Long-Term Care Medicaid, some long-term care services, such as personal care assistance or adult day care, may be available.
Level of care: Help with ADLs
2026 Maine Medicaid Long-Term Care Eligibility for Seniors
Institutional / Nursing Home Medicaid*
Medicaid Waivers / Home and Community Based Services‡
Regular Medicaid / Aged Blind and Disabled§
*All of a beneficiary's monthly income, minus a monthly Personal Needs Allowance of $40, Medicare premiums, and potentially a Needs Allowance for a non-applicant spouse, must go towards nursing home costs. This is called a Patient Liability.
†While the asset limit is technically $2,000 for an individual and $3,000 for a couple, Maine allows an extra exemption of $8,000 in savings for an individual and $12,000 for a couple.
‡Based on one's living setting, a program beneficiary may not be able to keep monthly income up to this level.
§Another pathway to Medicaid eligibility is through SSI. In Maine, persons eligible for SSI are automatically approved for Regular Medicaid, including long-term services and supports given functional criteria are met.
Explore Maine Medicaid Programs
Compare programs, see caregiver pay rates, get step-by-step application guidance, and check your eligibility — all specific to Maine.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Compare Medicaid Programs — Maine
How the main LTC programs available in Maine compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $16–20/hr | Hourly wage | No | Usually no | Often |
| Structured Family Caregiving (SFC) | Not in Maine | Daily stipend | Yes | Usually no | Often |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
Maine Medicaid programs
HCBS Waiver
Consumer-Directed Option
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in Maine
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Consumer-directed care — hourly pay
Available in MaineHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: MaineCare · maine.gov/dhhs/oms
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in Maine
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in Maine. The process typically takes 45–90 days from application to first paycheck.
Apply in Maine: MaineCare · maine.gov/dhhs/oms
Medicaid Eligibility Screener — Maine
Answer 7 quick questions — we'll check the financial and care requirements for Maine and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
Key Rules at a Glance
- Nearly any income from any source is counted, including employment wages, alimony, pension payments, SSDI, SSI, IRA withdrawals, and stock dividends.
- Nationally, Holocaust restitution payments are not counted as income.
- In ME, the VA Aid & Attendance Pension, which is above and beyond the Basic VA Pension, does not count.
- When only one spouse applies for Nursing Home Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,643.75 (eff. 7/1/25 – 6/30/26). If a non-applicant's income falls under 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 (eff. 7/1/25 – 6/30/26), but the total cannot exceed the Maximum MMMNA of $4,066.50 / month.
- For Regular Medicaid, both spouses' income is counted. There is no MMMNA for a non-applicant spouse.
- In Maine, persons eligible for SSI are automatically approved for Regular Medicaid, including long-term care given functional need requirements are met.
- Countable assets include cash, stocks, bonds, investments, cryptocurrency, bank accounts (money market, savings, checking), and real estate in which one does not reside.
- In Maine, IRAs / 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.
- All assets of a married couple are considered jointly owned regardless of the Medicaid program.
- The CSRA allows the non-applicant spouse of a Nursing Home or Waiver applicant to keep up to $162,660 of the couple's assets (2026).
- There is no CSRA for Regular Medicaid.
- The 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 this is not the case, 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 minus any outstanding debt against it. 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 have Intent to Return.
- There is no home equity interest limit for Regular Medicaid.
- The home is NOT exempt from Medicaid's Estate Recovery Program. After a beneficiary's death, Maine's Medicaid agency attempts reimbursement of care costs through the deceased's estate.
- Maine has a 5-year (60-month) Look-Back Period for Nursing Home Medicaid and Medicaid Waiver applications.
- During the look-back, Medicaid checks to ensure no assets were transferred for less than fair market value, including gifts.
- Violations result in a Penalty Period of Medicaid ineligibility for long-term care.
- There is no Look-Back Period for Regular Medicaid.
- The U.S. Federal Gift Tax Rule ($19,000 per recipient in 2026) does not extend to Medicaid eligibility — gifting under this rule still violates the Look-Back Period.
- MMMNA: $2,643.75 · CSRA: $162,660 · CSRA Min: $32,532
- When only one spouse applies for Nursing Home Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,643.75 (eff. 7/1/25 – 6/30/26). Income can be transferred from the applicant spouse if the non-applicant's income is below this level.
- A non-applicant can increase their Spousal Income Allowance if housing/utility costs exceed the shelter standard of $793.13 / month, up to a maximum of $4,066.50 / month.
- The CSRA allows the non-applicant spouse to keep up to $162,660 of the couple's assets (2026).
- For Regular Medicaid, both spouses' income is counted and there is no MMMNA or CSRA.
- Medically Needy Pathway — Maine has a Spend-Down Program for seniors over the income limit. The medically needy income limit (MNIL) / protected income level is $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.
- Asset Spend-Down — Spend excess assets on non-countable items such as home modifications (wheelchair ramps, stair lifts), prepaying funeral/burial expenses, and paying off debt. Keep documentation as proof the Look-Back Rule was not violated.
- Medicaid Planning — Work with a Medicaid Planning Professional to employ strategies to become eligible and protect your home from Medicaid's Estate Recovery Program.
Maine does not use Qualified Income Trusts (Miller Trusts). The Medically Needy Pathway is available for persons over the income limit.
Maine Medicaid Programs
Elderly and Adults with Disabilities (HCB) Waiver
Also called the Home and Community Benefits Waiver for the Elderly and Adults with Disabilities, 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.
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 from filling this role.
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.
How to Apply
- Apply online at My Maine Connection
- Apply in person at a district OFI (Office for Family Independence) 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). Before submitting an application, it is vital that seniors be certain all eligibility requirements are met. Medicaid Planning is strongly suggested for those unsure of eligibility.
More Maine Long-Term Care Resources
Take the Next Step for Maine Medicaid
Find out if you qualify or see how Medicaid fits into your overall long-term care plan.
Sources & references
Verified May 2026- Centers for Medicare & Medicaid Services — Long-Term Services & Supports
- Administration for Community Living — State Medicaid Agencies
- Centers for Medicare & Medicaid Services — Medicaid Eligibility
- American Council on Aging — About Medicaid Planning Assistance
- State of Maine Department of Health and Human Services (DHHS) — Maine Medicaid — Official site