Maine

What Is Maine Medicaid and Who Is It For?

Known as MaineCare, Maine Medicaid is a joint state and federally funded program for low-income individuals, including seniors aged 65 and older. It covers nursing home care and also supports non-medical services that help frail seniors remain in their own homes or the homes of loved ones.

What Long-Term Care Medicaid Programs Are Available in Maine?

What Is Institutional / Nursing Home Medicaid?

This entitlement program guarantees coverage for all who are eligible, offering services exclusively in nursing homes.

What Are Medicaid Waivers / Home and Community Based Services?

These are not entitlement programs and are limited in the number of participants. Designed to delay institutionalization, they offer care in home settings and adult day care centers.

What Is Regular Medicaid / Aged Blind and Disabled?

Also an entitlement, this program offers services such as personal care and adult day support to individuals who meet eligibility criteria.

What Are the Financial Eligibility Requirements for Medicaid in Maine?

What Are the 2025 Income and Asset Limits?

Eligibility varies by marital status and program type. For a single Nursing Home Medicaid applicant in 2025:

• Income under $2,901/month
• Assets under $10,000
• Must require a Nursing Home Level of Care

*These figures include additional savings allowances allowed by Maine beyond federal standards.

Eligibility Summary Table

*All of a beneficiary’s monthly income, minus a $40 Personal Needs Allowance, Medicare premiums, and possibly a Needs Allowance for a spouse, must go toward nursing home costs.
†Maine adds savings exemptions of $8,000 for individuals and $12,000 for couples.
‡Monthly income caps may differ depending on living arrangement.
§SSI recipients automatically qualify for Regular Medicaid if they meet functional requirements.

What Income Is Counted and Are There Exceptions?

What Income Is Considered Countable?

Most income types are countable, including wages, pensions, Social Security, and IRA distributions. Holocaust restitution payments and VA Aid & Attendance benefits are excluded.

How Is Income Treated for Couples?

If only one spouse applies, only their income is counted. The non-applicant may be eligible for a Minimum Monthly Maintenance Needs Allowance (MMMNA), which is $2,643.75 (7/1/25–6/30/26), up to $3,948/month if additional shelter costs apply.

For Regular Medicaid, both spouses’ incomes are counted, and no spousal income allowance applies.

What Assets Are Counted or Exempt in Maine?

What Are Countable vs. Exempt Assets?

Countable assets include savings, investments, and non-residential property. Exemptions cover personal belongings, two vehicles (one with medical need), prepaid burial funds up to $18,432, and the primary home.

How Are Assets Handled for Married Couples?

Assets are jointly considered. The community spouse can retain up to $157,920 (2025) under the Community Spouse Resource Allowance. Regular Medicaid does not offer a CSRA.

What Is Medicaid’s Look-Back Rule in Maine?

How Does the 5-Year Look-Back Period Work?

Medicaid checks all asset transfers within the past 5 years to ensure none were improperly gifted or undervalued. Violations can result in a period of ineligibility for long-term care benefits.

Do Federal Gift Tax Rules Protect Assets?

No. Gifting up to $19,000 under federal tax law still violates Medicaid’s Look-Back if not properly planned.

When Is a Home Exempt Under Maine Medicaid?

What Are Home Equity Limits?

A home is exempt if lived in by the applicant or spouse. Without a spouse, equity must be under $1,097,000 (as of 3/1/25). The applicant must also have Intent to Return if not residing in the home.

Can the State Recover Costs from the Home?

Yes. Maine may seek reimbursement from the estate, including the home, after the beneficiary’s death unless prior planning was done.

What Are the Medical and Functional Criteria?

What Functional Needs Must Be Met?

Nursing Home Medicaid and Waivers require a Nursing Home Level of Care (NHLOC). Regular Medicaid requires assistance with Activities of Daily Living (ADLs), though not necessarily NHLOC.

Can Someone Qualify If Over the Limits?

What Is the Medically Needy Pathway?

This allows seniors with high income to qualify by spending excess on medical costs. In 2025, the MNIL is $315/month for singles and $341/month for couples. Eligibility applies after a 6-month spend down.

What Is Asset Spend Down?

Applicants may become eligible by converting excess assets into non-countable ones—such as home modifications or prepaid burial plans. Gifting is prohibited under the 60-month Look-Back.

How Can Medicaid Planning Help?

Professional Medicaid Planning helps seniors who are over-income or over-asset to qualify legally and protect key resources like their home.

What Maine Medicaid Programs Help Seniors ?

Elderly and Adults with Disabilities Waiver

This waiver offers home care, emergency response systems, respite care, and more for nursing home-qualified individuals wishing to remain at home.

Consumer Directed Attendant Services (CDAS)

This program lets seniors choose and manage their own caregivers—including hiring certain family members—for in-home care services.

Money Follows the Person

Called Homeward Bound in Maine, this federal initiative helps institutionalized individuals transition back to home or community-based settings.

How Do You Apply for Maine Medicaid?

What Is the Application Process?

MaineCare applications are handled by the Office for Family Independence (OFI). Apply online via My Maine Connection, in person, or download paper applications:

• Regular Medicaid: Use the MaineCare Application
• Long-Term Care: Use the Long-Term Care Application

Applications can be submitted by mail, fax, or in person. Details are provided on each form.

What Should Applicants Know Before Applying?

It’s crucial to confirm eligibility before applying. Those who are uncertain or do not meet criteria should seek help through Medicaid Planning to avoid delays or denials.