In Maine, "home care" and "home health" are two separately licensed services, and the difference decides who pays. Home health is the skilled nursing and therapy a doctor orders, delivered by an agency the Maine DHHS Division of Licensing and Certification licenses under rule 10-144 C.M.R. Chapter 119, and it's the care Medicare can cover.
Non-medical home care is everyday personal help, delivered by a personal care agency the same division licenses under a different rule, Chapter 129. This guide draws the line so a Maine family doesn't pay out of pocket for care a program would have covered, or wait on Medicare coverage that was never coming. What matters isn't the word on the agency's sign, it's whether the care is skilled or non-medical, and which program pays.
In This Guide
- Key Takeaways
- The Two Services, Defined
- Home Health: What Medicare Covers
- What It Costs and Other Ways to Pay
- How to Choose and Vet an Agency
- Frequently Asked Questions
The Two Services, Defined
The split is skilled versus non-medical, and Maine puts each on its own license rule. The skilled side runs under Chapter 119; the non-medical side runs under Chapter 129. Both are issued by the Maine DHHS Division of Licensing and Certification, so the licensing authority is the same, but the rule and the kind of care are not.
A home health agency provides skilled, physician-ordered care: professional nursing and physical, occupational, or speech therapy ordered because the person has a medical need only a licensed professional can meet. Wound care after surgery, IV medication, injections a patient can't manage alone, therapy to rebuild strength after a stroke or a fall. The care is part-time and intermittent, not round-the-clock. In Maine, that agency is licensed under 10-144 C.M.R. Chapter 119.
A personal care agency provides non-medical personal support: everyday help with bathing, dressing, grooming, meals, and homemaking, the tasks that keep someone safe at home. The person can be medically stable and still need this help every day. This is the work most people mean when they say "home care." In Maine, a personal care agency is licensed under a separate rule, 10-144 C.M.R. Chapter 129.
That two-rule split is the Maine distinctive. In many states non-medical home care carries no license of its own, which leaves families to vet a provider with no state credential to check. Maine licenses the personal care agency under Chapter 129, so a family hiring non-medical help in Maine can confirm a state license on both tracks, not just the skilled one.
The license rule is one thing; who pays is another. Medicare certification, layered on top of the Chapter 119 license, is the step that lets a home health agency bill Medicare for the skilled care it delivers. Non-medical personal care is care Medicare doesn't pay for at all. So when a Maine family hears "home health," that points to the skilled, often Medicare-certified track under Chapter 119, and "personal care" or "homemaker" points to the non-medical one under Chapter 129.
The same person often needs both at once. Someone discharged after a hip replacement might need home health, a nurse and a physical therapist for a few weeks, and also personal care, an aide for bathing and meals over the months that follow. Those run on separate payment tracks: Medicare pays for the skilled piece, and something else pays for the personal-care piece.
Home Health: What Medicare Covers
Skilled home health in Maine comes from an agency licensed under Chapter 119, and to bill Medicare that agency must also be Medicare-certified. The agency employs the clinical staff, registered nurses and therapists, who carry out the plan of care a physician has ordered. The state license is the floor; Medicare certification is the additional step that lets the agency bill Medicare for those services.
Medicare's home health benefit covers this care only when a beneficiary meets every condition. The two that trip families up most:
- Homebound. Leaving home takes considerable, taxing effort, and the person generally needs help or an assistive device to do it. Short, occasional trips out, to a medical appointment or to religious services, don't disqualify someone.
- Intermittent skilled need. A physician certifies that the person needs skilled nursing or therapy on a part-time or intermittent basis, under a plan of care the physician reviews, and the care comes from a Medicare-certified agency.
When those conditions are met, Medicare pays for the covered skilled services: the nursing visits, the therapy, and the home health aide help attached to that skilled care. What Medicare home health will not do is staff an aide in the home for general daily help with no skilled-care purpose. That's personal care, and it's the next section.
What It Costs and Other Ways to Pay
Non-medical personal care covers help with bathing, dressing, grooming, meals, and homemaking. Because it isn't skilled medical care, the payer picture looks nothing like home health, and the cost question lives almost entirely on this side.
Per the Genworth/CareScout 2024 Cost of Care Survey, the most recent state-level data, a home health aide in Maine ran about $86,800 a year, and homemaker services ran higher still, with Maine ranking among the most expensive states in the country for homemaker care. Both annual figures are built on a roughly 44-hour week. That matters: a family hiring an aide for only a few hours a day pays a fraction of the annual figure, which assumes a near full-time schedule. The aide figure works out to roughly $38 an hour, so a few hours of help two or three days a week runs in the hundreds of dollars a month, not the tens of thousands. These are industry-survey medians, not government rates and not a ceiling, so what a specific Maine agency charges can land above or below them, and costs rise as care needs grow.
Who pays for personal care comes down to a few routes:
- Private pay. Many families pay out of pocket, by the hour. This is the default when no one qualifies for a public program and the need is non-medical.
- MaineCare's Section 19 waiver. For eligible lower-income older Mainers, MaineCare's Section 19 home- and community-based waiver, formally the Home and Community Benefits for the Elderly and Adults with Disabilities, funds personal care and supports in a person's own or family home, the path that helps a person stay out of a nursing home. It does not cover residence in an assisted living facility.
- Long-term care insurance. A private policy, if the person holds one, may reimburse personal-care hours.
One line is worth stating plainly. Medicare does not pay for non-medical personal care. A family expecting Medicare to cover an aide for daily help will find it won't, no matter how much that help is needed. The ways to pay are private funds, long-term care insurance, or, for eligible lower-income older Mainers, MaineCare's Section 19 waiver.
How to Choose and Vet an Agency
Start with the need, not the brochure. The table maps the two services across the dimensions that decide what the care is and who pays. Whether the care is skilled is your first clue: skilled, physician-ordered care points to home health under Chapter 119, and everyday non-medical help points to personal care under Chapter 129.
| Home Health (Skilled) | Home Care (Non-Medical) | |
|---|---|---|
| Maine license | Home health agency licensed under 10-144 C.M.R. Chapter 119; bills Medicare only if also Medicare-certified | Personal care agency licensed under 10-144 C.M.R. Chapter 129 |
| Licensing authority | Maine DHHS Division of Licensing and Certification | Maine DHHS Division of Licensing and Certification |
| What it is | Skilled, physician-ordered care: nursing and physical, occupational, or speech therapy under a plan of care, part-time or intermittent | Everyday non-medical help with daily living (bathing, dressing, grooming, meals, homemaking) |
| Who pays | Medicare (when homebound + intermittent skilled need) | Private pay, long-term care insurance, or MaineCare's Section 19 waiver for eligible lower-income older Mainers |
A quick way to place a situation: if a physician has ordered skilled care and the person is homebound, you're looking at home health, and Medicare is the payer to check first. If the need is ongoing help with everyday tasks and there's no skilled medical component, you're looking at personal care, and the question becomes whether to pay privately or qualify through MaineCare.
Once you know which service you need, the checks differ by track. For skilled home health, the license and the certification are the substance, not the marketing:
- Confirm the Chapter 119 license and Medicare certification. A skilled home health agency must hold a Chapter 119 license from the Division of Licensing and Certification, and for Medicare billing it must also be Medicare-certified. Ask to see the license and confirm the agency is Medicare-certified before assuming Medicare will pay.
- Match the agency to the doctor's order. Medicare coverage hinges on a physician's plan of care and the homebound and intermittent-skilled tests, so confirm the agency will work from your doctor's order and bill Medicare directly.
For non-medical personal care, Maine gives you a license to check that many states don't, so use it, then add the diligence a license alone won't cover:
- Confirm the Chapter 129 license. A personal care agency in Maine should hold a license under 10-144 C.M.R. Chapter 129 from the Division of Licensing and Certification. Ask to see it; an unlicensed provider is a flag.
- Ask how caregivers are screened. Confirm the agency runs criminal background checks and verifies credentials on the aides it sends, and ask whether caregivers are employees the agency covers for liability and workers' compensation or independent contractors you'd be responsible for.
- Get a written care plan and rate. Insist on a written plan that lists the specific tasks, the hours, the hourly rate, and any minimums, so expectations and cost are clear before care starts.
- Check the MaineCare path early if money is tight. If private pay isn't sustainable, ask about MaineCare's Section 19 waiver before a crisis, because home- and community-based eligibility takes time to establish.
Frequently Asked Questions
Yes, but only skilled care. Medicare's home health benefit covers physician-ordered nursing and physical, occupational, or speech therapy for a person who is homebound and needs that care on a part-time or intermittent basis, delivered by a Medicare-certified agency. It does not pay for non-medical personal care, the help with bathing, dressing, meals, and everyday support an aide provides, on its own.
Home health is skilled medical care a physician orders and a licensed clinician delivers, covered by Medicare when the person is homebound and needs intermittent skilled care. Non-medical home care is everyday help with daily living that Medicare does not cover. In Maine, the skilled home health agency is licensed under 10-144 C.M.R. Chapter 119 and a non-medical personal care agency under 10-144 C.M.R. Chapter 129, both by the Division of Licensing and Certification.
Per the Genworth/CareScout 2024 Cost of Care Survey, a home health aide in Maine ran about $86,800 a year, with homemaker services higher still, placing Maine among the most expensive states for homemaker care, each figure on a roughly 44-hour week. The aide figure works out to roughly $38 an hour, so a family hiring an aide for only a few hours a day pays far less than the annual number. These are survey medians, not fixed rates, so a given agency can charge above or below them.
Yes. For eligible lower-income older Mainers, MaineCare's Section 19 home- and community-based waiver, the Home and Community Benefits for the Elderly and Adults with Disabilities, funds non-medical personal care in a person's own or family home for people who would otherwise need a nursing-facility level of care. It funds care at home; it does not cover residence in an assisted living facility.
Yes. Unlike many states, Maine licenses non-medical personal care agencies under their own rule, 10-144 C.M.R. Chapter 129, issued by the Maine DHHS Division of Licensing and Certification. That means a Maine family can ask to see a state license on the non-medical track too, not only on the skilled home health side licensed under Chapter 119.
Learn More
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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.