Paid family caregiving in Maine runs through MaineCare personal care services and select waiver programs. Whether a family member can be hired as the paid personal care worker under MaineCare Sections 17, 18, or 19 depends on the specific program; confirm family-member eligibility with MaineCare at 1-800-977-6740 before counting on it. For veteran families, VA programs are the most clearly grounded route to compensating a family caregiver, spouse included.
The Program of Comprehensive Assistance for Family Caregivers pays a federally tax-free monthly stipend to designated family caregivers of eligible veterans, with no spousal exclusion. VA Aid and Attendance provides up to $2,874 per month for a married veteran with one dependent in 2026.
The Short Version
If the care recipient is a wartime veteran, VA programs are the strongest route. PCAFC pays spouses and other family members a federally tax-free monthly stipend. Veteran-Directed Care lets the veteran hire any caregiver, including a spouse, from a flexible monthly budget. Aid and Attendance adds pension income the veteran can use to pay a family member privately.
If the care recipient qualifies for MaineCare LTSS, Sections 17/18/19 personal care may allow family members as paid providers, but rules should be confirmed with MaineCare at 1-800-977-6740. The Section 21 waiver for I/DD covers family-member payment only for Shared Living and Non-Medical Transportation.
If neither VA benefits nor MaineCare applies, a private personal services contract is the fallback. It needs to be written before care begins, at a fair-market rate, with proper documentation to protect against Medicaid look-back scrutiny.
What Maine Offers
MaineCare Personal Care (Sections 17, 18, and 19)
MaineCare Sections 17, 18, and 19 cover home and community-based personal care services for eligible adults. The Section 19 waiver, in particular, serves elderly adults and adults with physical disabilities who would otherwise require a nursing home level of care.
Family members may be eligible to be hired as paid personal care providers under these programs, but this is not explicitly guaranteed across all program components. Whether the specific family relationship you have in mind is permitted, and whether a spouse can be the paid worker, should be confirmed with MaineCare directly at 1-800-977-6740.
MaineCare Section 21 Waiver (I/DD)
Maine's Section 21 waiver serves adults with intellectual disabilities or autism. It does allow family-member payment, but only for two specific services: Shared Living (where a family provider lives with or near the person served) and Non-Medical Transportation. Other services under Section 21 cannot be provided by a family member as a paid worker.
If a family member is interested in the Shared Living option under Section 21, contact Maine OADS at 1-877-353-3771 for enrollment information.
Care Partner Supports and NFCSP
Maine's Care Partner Supports program, administered through Maine's five Area Agencies on Aging, provides respite and supplemental services to help caregivers continue in their role. This is a support for caregivers, not a wage-paying arrangement.
Similarly, the National Family Caregiver Support Program (NFCSP) channels federal Title III-E funds through Maine DHHS to the five AAAs, covering respite care, individual counseling, caregiver training, and supplemental services. There is no income test for most NFCSP services. Services are available to caregivers of adults age 60+, grandparents and relative caregivers of children under 18, and caregivers of people with Alzheimer's or related dementias at any age. NFCSP does not pay a wage to the family caregiver.
To connect with Maine's AAA network for either program, call the Maine ADRC at 1-877-353-3771 or use the Eldercare Locator at eldercare.acl.gov.
The Six Pathways
Pathway 1: MaineCare Sections 17/18/19 Personal Care
For MaineCare-eligible adults, personal care services under Sections 17, 18, or 19 may allow a family member to be hired as the paid personal care provider. The enrollment steps:
- The care recipient applies for MaineCare LTSS eligibility through Maine OADS (1-877-353-3771).
- A care needs assessment determines whether the applicant qualifies for the Section 19 waiver or another personal care benefit.
- If approved for self-directed personal care, the enrollee identifies a personal care provider. Confirm with MaineCare at 1-800-977-6740 whether a specific family relationship, including spousal care, is permitted under the program.
- Payroll runs through a fiscal management service, handling tax withholding and W-2 issuance.
- The family caregiver receives regular pay at the authorized rate.
Pathway 2: MaineCare Section 21 Waiver (Shared Living)
For adults with intellectual disabilities or autism who qualify for the Section 21 waiver, a family member can be paid for Shared Living, where the family provider lives with or near the person and provides daily support and supervision. Non-Medical Transportation is also covered for family providers.
Contact Maine OADS at 1-877-353-3771 for current enrollment status and waitlist information for Section 21.
Pathway 3: VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)
The Program of Comprehensive Assistance for Family Caregivers pays a monthly stipend to a designated Primary Family Caregiver of an eligible veteran. Spouses, adult children, parents, siblings, and other family members all qualify, with no spousal exclusion.
Eligibility requires the veteran to have a service-connected disability rating of at least 70% (single or combined) and a need for at least six months of personal care assistance. The monthly stipend is calculated from the OPM General Schedule grade 4, step 1 annual salary for the veteran's geographic locality, divided by 12, then multiplied by a care-level factor (0.625 for Level 1, 1.00 for Level 2).
The stipend is federally tax-free under 38 U.S.C. § 1720G and not reported on a W-2. Primary caregivers also receive CHAMPVA health coverage (if otherwise uninsured), mental health counseling, and respite care support. Contact the Togus VA Medical Center's Caregiver Support Coordinator for current Maine locality figures and enrollment guidance.
Pathway 4: VA Veteran-Directed Care (VDC)
VA Veteran-Directed Care is the VA's self-direction program, operated jointly with the Administration for Community Living through Area Agency on Aging partnerships. The veteran receives a monthly care budget and can hire any caregiver, including a spouse, at a rate set within that budget.
VDC availability depends on whether the veteran's VAMC offers the program. Contact the Caregiver Support Coordinator at the Togus VA Medical Center to confirm current VDC enrollment in Maine. If available, the hired family caregiver receives payroll through a Financial Management Services contractor and is issued a W-2.
Pathway 5: VA Aid and Attendance
VA Aid and Attendance is a pension enhancement for wartime veterans who need help with daily living, and for surviving spouses with similar needs.
2026 Aid and Attendance rates (effective December 1, 2025 through November 30, 2026):
- Single veteran: up to $2,424 per month
- Married veteran with one dependent: up to $2,874 per month
- Surviving spouse (no dependents): up to $1,558 per month
The net worth limit is $163,699. VA pension is subject to a 36-month look-back on asset transfers under 38 CFR 3.276 for transfers made on or after October 18, 2018.
The veteran receives the pension. Families can direct those funds toward a family caregiver through a private arrangement or a personal services contract. Aid and Attendance has no MaineCare enrollment requirement.
Pathway 6: Private Personal Services Contract
For families outside both VA and MaineCare systems, a personal services contract documents and compensates caregiving work. Requirements:
- Written and signed before care begins
- Specific about services, schedule, and rate
- Priced at or below what local home care agencies charge for the same services
- Supported by ongoing service logs
Maine applies a 60-month Medicaid look-back on asset transfers. Undocumented cash payments to family members can appear as gifts and trigger a penalty period. A written contract at a fair-market rate executed before care begins provides a defensible paper trail. Confirm current Maine look-back rules with a Maine elder-law attorney.
Spouses are generally not recommended as parties to a personal services contract for Medicaid planning purposes, because inter-spousal transfers receive different treatment under Medicaid rules.
| Pathway | Administered by | Spouse eligible? | Typical monthly value | Key requirement |
|---|---|---|---|---|
| MaineCare Sections 17/18/19 personal care | Maine DHHS / MaineCare | Confirm with MaineCare at 1-800-977-6740 | Authorized hours x provider rate | MaineCare LTSS financial eligibility |
| MaineCare Section 21 (Shared Living) | Maine OADS / MaineCare | Confirm with OADS at 1-877-353-3771 | Shared Living rate | I/DD diagnosis; Section 21 eligibility |
| VA PCAFC | VA (federal) | Yes | Varies by locality; tax-free | 70%+ service-connected disability |
| VA Veteran-Directed Care | VA + AAA | Yes | Monthly budget set by VA team | VAMC VDC availability |
| VA Aid and Attendance | VA (federal) | Veteran pays family member | Up to $2,874/mo (married veteran) | Wartime service; net worth under $163,699 |
| Personal Services Contract | Private | Not recommended for Medicaid planning | Negotiated rate | Written contract before care begins |
How to Choose
Veteran household: If the veteran has a 70%+ service-connected rating and needs daily personal care, start with PCAFC. The stipend is tax-free, spouses qualify, and the primary caregiver also receives health coverage. Layer Aid and Attendance pension on top if the veteran qualifies for both. Ask the Togus VAMC Caregiver Support Coordinator about Veteran-Directed Care as a flexible supplement.
Non-veteran MaineCare household: Call MaineCare at 1-800-977-6740 and confirm whether the care recipient qualifies for personal care under Sections 17/18/19 and whether the specific family relationship is permitted. For adults with I/DD, contact OADS at 1-877-353-3771 about Section 21 Shared Living.
Private-pay household: A personal services contract is the right structure for families outside both systems. Involve a Maine elder-law attorney if the care recipient might apply for MaineCare within the next five years.
Not sure which pathway fits? Brevy's care navigator can help you work through Maine's options. Chat at brevy.com.
IRS Notice 2014-7 and Taxes
If MaineCare personal care programs authorize payments to a live-in family caregiver, those payments may qualify for the IRS Notice 2014-7 difficulty-of-care income exclusion. When the caregiver and care recipient share a household and the payments come from a qualifying Medicaid program, the income may be excludable from federal gross income. Maine uses federal AGI as the basis for state income tax, so excluded federal income is generally also excluded for Maine purposes, but families should verify with a tax professional.
PCAFC stipends are excluded from federal gross income under 38 U.S.C. § 1720G and are not reported on a W-2.
Personal services contract income is ordinary taxable income.
Common Misconceptions
"Section 21 lets my family member be paid for any service." Only two Section 21 services allow family-member payment: Shared Living and Non-Medical Transportation. Other supports under Section 21 must be provided by agency or independent workers.
"Care Partner Supports pays family caregivers a wage." Care Partner Supports provides respite and supplemental services to support the caregiver's wellbeing. It does not pay the caregiver a regular wage for personal care work.
"Medicare pays for ongoing personal care." Medicare does not cover long-term personal care or custodial care. It covers short-stay post-hospital skilled nursing and home health for homebound patients with a skilled need. MaineCare and VA programs are the relevant routes for ongoing ADL support.
"A verbal arrangement with a family member is enough for Medicaid purposes." Maine's 60-month look-back treats undocumented payments as potential gifts. A written contract, executed before care begins and priced at a fair-market rate, is what differentiates legitimate compensation from a transfer that triggers a penalty.
Frequently Asked Questions
Possibly, through MaineCare personal care services under Sections 17, 18, or 19, if your parent qualifies for MaineCare LTSS. Family members may be eligible as paid providers, but eligibility rules vary by program. Confirm current rules with MaineCare at 1-800-977-6740. If your parent is a veteran, PCAFC and Veteran-Directed Care are often the more direct route.
Whether a spouse can be the paid personal care worker under MaineCare Sections 17/18/19 should be confirmed with MaineCare at 1-800-977-6740. For veteran households, PCAFC and VA Veteran-Directed Care both permit spouses to be paid without restriction.
The 2026 VA Aid and Attendance rate for a veteran with one dependent is $2,874 per month (effective December 1, 2025 through November 30, 2026). For a single veteran, the rate is $2,424 per month. Surviving spouses with no dependents can receive up to $1,558 per month. Rates are updated annually by cost-of-living adjustment.
No. The PCAFC monthly stipend is excluded from federal gross income under 38 U.S.C. § 1720G and is not reported on a W-2. By contrast, wages paid through state Medicaid personal care programs are generally subject to payroll taxes and federal income tax, though the IRS Notice 2014-7 exclusion may apply for live-in caregivers receiving qualifying Medicaid waiver payments.
Learn More
- How to Get Paid as a Family Caregiver in Massachusetts
- Caregiver Burnout: Signs and Support
- VA Aid and Attendance in Maine
- Medicaid Planning Strategies
Find personalized help choosing the right Maine paid-caregiver pathway at brevy.com.
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.