To get paid as a family caregiver in Maine, the programs to check are MaineCare's Section 19 home and community benefits waiver and, for veteran families, VA's caregiver programs. Section 19 covers personal care at home. Under a rule Maine has already adopted, a spouse can be paid as a Personal Support Specialist for a member who needs extraordinary care, and DHHS's proposed 2026 waiver text would let other qualified relatives be paid. Confirm with MaineCare Member Services at 1-800-977-6740.,

The Program of Comprehensive Assistance for Family Caregivers pays a monthly stipend to an approved Primary Family Caregiver of an eligible veteran, and a spouse can be that caregiver. VA Aid and Attendance is capped at $34,488 a year for a veteran with one dependent in 2026, a ceiling reduced by the veteran's countable income rather than a flat award.

The Short Version

If the care recipient is a veteran, start with VA. PCAFC pays an approved Primary Family Caregiver, who can be a spouse or another family member, a monthly stipend. Under Veteran-Directed Care, enrolled veterans manage a flexible service budget and, according to the federal Administration for Community Living, may hire family, friends or neighbors to provide services. Aid and Attendance adds monthly payments to the VA pension of a veteran who already qualifies for that pension and needs another person's help with daily activities or meets one of VA's other conditions.

If the care recipient may qualify for MaineCare long-term care, Section 19 covers personal care at home, and Section 21 covers Shared Living for adults with intellectual disabilities or autism. Both pay some family members; apart from Section 19's adopted spouse route, those rules come from draft waiver text.,,

If neither VA benefits nor MaineCare applies, a private personal services contract is the fallback. Medicaid's transfer penalty reaches transfers for less than fair market value, so write it before care begins, at a fair-market rate, and keep records.

What Maine Offers

MaineCare Section 19 (Elderly and Adults with Disabilities Waiver)

MaineCare Section 19, Home and Community Benefits for the Elderly and Adults with Disabilities, is Maine's waiver for people age 65 or older and adults 18 or older with physical disabilities who meet a hospital or nursing facility level of care. Its services include care coordination, personal care, respite, attendant care, home-delivered meals, financial management services and skills training.

Section 19 has conditions a family should plan around. Every service needs prior approval, a member's projected monthly service cost must fit within the limits in Section 19.06, and services depend on available funding, with members accepted first-come, first-served from a wait list kept by the Office of Aging and Disability Services (OADS). A February 26, 2026 proposed amendment would update the monthly and annual caps on combined services and says service rates are contingent on available funding and subject to legislative approval. It was a proposal out for public comment, so confirm the adopted rule. Maine's 2026 income limit for the Waiver coverage group is $2,982 a month.

The spouse route is in force: CMS approved it, and Maine's adopted Section 19 rule, effective May 2, 2021, lets a spouse be reimbursed as a Personal Support Specialist for a member who needs extraordinary care. Section 19 does not cover respite delivered by the member's spouse.

The other details come from DHHS's February 26, 2026 draft waiver amendment, proposed to take effect June 30, 2026. As of October 2026, our sources show no CMS approval or sign it took effect, so treat them as proposals, not current law. Under that draft, a relative qualified as a Personal Care Attendant or Personal Support Specialist may be paid when employed by a Personal Care Agency or Nursing Facility, or, unless a guardian or Representative, as a self-directed Attendant. The draft also requires a paid spouse to work for a Personal Care Agency, never as a self-directed Attendant, and says extraordinary care includes activities of daily living but not instrumental activities of daily living. It caps one worker at 40 hours a week per participant, though a participant at risk of institutionalization may seek an exception. Confirm with MaineCare Member Services at 1-800-977-6740 (TTY 711) or your case manager.

MaineCare Section 21 Waiver (I/DD)

Maine's Section 21 waiver serves adults 18 or older with intellectual disabilities or autism who meet an ICF/IID level of care.

Under DHHS's February 2025 draft renewal, a family member, or a guardian who is a parent, step-parent, sibling, step-sibling or other biological relative, may be paid for only Shared Living and Non-Medical Transportation, meeting the same qualifications as an unrelated worker. A guardian is paid for Shared Living only if they are the member's parent, sibling or other biological family member. Transportation pay requires that the relative cannot transport at no charge or has no other viable option, plus a planning-team recommendation. The draft's family-payment section does not set out a separate rule for paying a spouse; confirm the current rule with OADS.

Care Partner Supports and NFCSP

Maine's five Area Agencies on Aging, designated by OADS, administer federal and state programs for the care partners of older people and of people living with dementia, including Alzheimer's., Their care partner support services may include respite, caregiver training, support groups, helpful information and individual support. Those are services for the caregiver, not a wage.

The National Family Caregiver Support Program (NFCSP), funded under Title III-E of the Older Americans Act, pays for services delivered through area agencies on aging: information about services, help gaining access to them, individual counseling, support groups and caregiver training, respite care, and supplemental services on a limited basis.

Eligible caregivers include adult family members or other informal caregivers of people 60 and older or of people of any age with Alzheimer's disease or a related disorder, and relatives age 55 or older caring for a child under 18 (other than the child's parent) or for an adult age 18 to 59 with a disability. For a family caregiver of an older person, respite and supplemental services are limited to cases where that person is frail: unable to perform at least two activities of daily living without substantial help, or needing substantial supervision because a cognitive or other mental impairment makes their behavior a serious health or safety hazard.

To reach Maine's AAA network, call the statewide ADRC line at 1-877-353-3771 and select your county, or use the Eldercare Locator at eldercare.acl.gov.,

Six Ways to Get Paid as a Family Caregiver in Maine

Pathway 1: MaineCare Section 19 Personal Care

The Section 19 enrollment steps:

1
Step 1

Apply for MaineCare

Apply online at MyMaineConnection.gov or through the DHHS Office for Family Independence, which processes MaineCare applications.

2
Step 2

Complete the medical eligibility assessment

The Department or its Assessing Services Agency completes a face-to-face Medical Eligibility Determination to confirm the applicant meets the nursing facility level of care.

3
Step 3

Get the plan of care approved

Every Section 19 service needs prior approval and must fit within the member's monthly cost limit, and when funding is short OADS keeps a first-come, first-served wait list.

4
Step 4

Ask about the provider

Under Maine's adopted rule, a spouse can be paid only as a Personal Support Specialist, for extraordinary care. Under the proposed 2026 waiver text, a family member (not a guardian or Representative) could be a self-directed Attendant, and a paid spouse would have to work for a Personal Care Agency.

Pathway 2: MaineCare Section 21 Waiver (Shared Living)

Section 21 covers Shared Living, and Non-Medical Transportation, for adults with intellectual disabilities or autism who meet an ICF/IID level of care. Under a draft 2025 renewal, a family member meeting unrelated-provider standards may be the paid Shared Living provider; confirm with OADS.

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. The caregiver must be at least 18 and either a spouse, son, daughter, parent, stepfamily member or extended family member of the veteran, or someone who lives full time with the veteran (or is willing to if VA designates them).

Veteran eligibility: VA publishes four conditions, and they are the first screen rather than the decision. The veteran must meet all four:

  • A VA disability rating, individual or combined, of 70 percent or higher.
  • Discharge from the U.S. military, or a date of medical discharge.
  • A need for at least six months of continuous, in-person personal care services.
  • Enrollment in VA health care.

Meeting those four is necessary, not sufficient. You and the veteran apply together, and the binding test is 38 CFR 71.20(a), which states seven requirements and requires every one of them. Four of the seven have no counterpart in the four above, and VA assesses them during the application process:

  • Participating in the program is in the veteran's best interest.
  • The personal care services the family caregiver would provide are not simultaneously and regularly provided by or through another individual or entity.
  • The veteran receives care at home, or will do so if VA designates a family caregiver.
  • The veteran receives ongoing care from a primary care team, or will do so if VA designates a family caregiver.

The no-other-provider condition is the one most likely to surprise a family, because a household already receiving regular personal care through another program or entity can fail PCAFC on that ground alone.

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 factor of 0.25, 0.625 or 1.00, and which one applies depends on whether the veteran qualifies under the current program or as a legacy participant or legacy applicant.

  • Current program: 0.625 (VA's Level 1), or 1.00 (Level 2) when VA determines the veteran is unable to self-sustain in the community.
  • Legacy participant or legacy applicant: the factor comes from the sum of the veteran's 2019 clinical ratings, with no self-sustain determination required. That sum pays 1.00 at 21 or higher, 0.625 at 13 to 20, and 0.25 at 1 to 12.
  • Both routes: a veteran who qualifies under each is paid at whichever factor is higher, and a legacy participant's stipend cannot fall below what the caregiver was eligible for on September 30, 2020, while the veteran stays at the address VA has on record. The legacy rules end on October 1, 2028.

Ask which factor VA has applied to your case.

VA has described the monthly stipend as a nontaxable benefit, and an approved Primary Family Caregiver must enroll in direct deposit through the VA customer engagement portal to get it. Primary Family Caregivers can also get CHAMPVA health care benefits if they don't already qualify for care under another health plan, along with caregiver education and training, mental health counseling and at least 30 days of respite care a year. For help and referrals, call the VA Caregiver Support Line at 1-855-260-3274.

Pathway 4: VA Veteran-Directed Care (VDC)

VA Veteran-Directed Care is for veterans who need personal care services and help with activities of daily living, such as bathing, dressing or fixing meals. According to the federal Administration for Community Living, enrolled veterans manage a flexible service budget and may hire family, friends or neighbors to provide services. VA medical centers deliver VDC through aging and disability network agencies, such as area agencies on aging.

VDC providers serve veterans referred by their local VA medical center. Our sources do not establish whether a spouse can be the paid worker, so ask your VA medical center about that and whether it can refer you to VDC.

Pathway 5: VA Aid and Attendance

VA Aid and Attendance adds monthly payments to a VA pension for qualified veterans and survivors. At least one of VA's conditions must be true: the person needs another person's help with daily activities such as bathing, feeding and dressing, has to stay in bed (or spend a large part of the day in bed) because of illness, is a nursing home patient because of a loss of mental or physical abilities related to a disability, or has severely limited eyesight. It requires that the veteran or survivor already qualify for a VA pension.

2026 Aid and Attendance maximum annual pension rates (effective December 1, 2025 through November 30, 2026) are ceilings, not flat awards: VA pays the difference between the claimant's countable income and the applicable maximum, then divides that yearly award by 12 for the monthly payment. The 2026 ceilings are:

  • Veteran with no dependents: capped at $29,093 per year, less countable income
  • Veteran with one dependent: capped at $34,488 per year, less countable income
  • Surviving spouse (no dependents): capped at $18,697 per year, less countable income

Countable income is not the same as gross income. Unreimbursed medical expenses may reduce it, but you may deduct only the amount above 5% of your MAPR amount, which VA prints as $1,141 for a veteran with one dependent and $872 for a veteran with no spouse or child.

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 pension goes to the veteran, who can pay a family caregiver through a personal services contract (Pathway 6).

Pathway 6: Private Personal Services Contract

For families outside both VA and MaineCare systems, a personal services contract documents and compensates caregiving work. Make it:

  • Written and signed before care begins
  • Specific about services, schedule, and rate
  • Priced at a fair-market rate for the same services
  • Supported by ongoing service logs

Maine applies a 60-month look-back to uncompensated transfers by long-term-care applicants. The penalty reaches transfers for less than fair market value, so undocumented cash paid to a relative is hard to defend; a written fair-market contract made before care begins is the paper trail. Confirm current Maine look-back rules with a Maine elder-law attorney.

A spouse is different: any asset can pass to a spouse penalty-free, and Maine counts both spouses' assets together, so ask an elder-law attorney first.

Pathway Administered by Spouse eligible? Typical monthly value Key requirement
MaineCare Section 19 personal care Maine DHHS / MaineCare As a PSS for extraordinary care only (adopted rule); agency employment in proposed 2026 text Set by the approved plan of care, within monthly cost limits Nursing facility level of care; MaineCare financial eligibility
MaineCare Section 21 (Shared Living) Maine DHHS / MaineCare No spouse-specific rule in the family-payment section; relatives paid for Shared Living and transportation (draft) Not stated in our sources Intellectual disability or autism; ICF/IID level of care
VA PCAFC VA (federal) Yes Varies by locality; VA has called it nontaxable 70%+ rating plus VA's other conditions
VA Veteran-Directed Care VA + aging network agencies Not established; ask the VA medical center Flexible service budget managed by the veteran Referral from the local VA medical center
VA Aid and Attendance VA (federal) Veteran pays family member Ceiling of $34,488/yr (veteran with one dependent), reduced by countable income Qualify for VA pension; net worth under $163,699
Personal Services Contract Private Works differently for spouses; ask an elder-law attorney Negotiated rate Written contract before care begins

How to Choose

Veteran household: If the veteran has a 70%+ rating and needs at least six months of continuous, in-person personal care, check PCAFC first. A spouse can be the caregiver, and VA's application process decides the full eligibility test. If the veteran also qualifies for a VA pension and meets one of VA's need conditions, Aid and Attendance can add monthly payments to it. Ask your VA medical center whether it can refer the veteran to Veteran-Directed Care.

Non-veteran MaineCare household: Call MaineCare Member Services at 1-800-977-6740 to ask whether a service is covered, and confirm the family-pay rules above.

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 long-term care 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

Payments a MaineCare waiver program makes to a family caregiver may qualify for the IRS Notice 2014-7 difficulty-of-care exclusion, but the co-residence condition is strict. The exclusion covers qualified Medicaid waiver payments for care given in the caregiver's own home where the care recipient lives under their plan of care, and payments for care outside the home where the caregiver resides do not qualify. The test is where the caregiver actually lives: a caregiver who moved into a parent's home and has no separate home can qualify, while one who keeps a separate home cannot.

Payments a care recipient makes from their own funds under a private personal services contract cannot be excluded under Notice 2014-7.

Common Misconceptions

"Section 21 Shared Living means a family member will be paid." A draft 2025 renewal pays a family member for Shared Living only if they meet the same qualifications as an unrelated provider. Confirm with OADS.

"Maine's caregiver support programs pay family caregivers a wage." The care partner services Maine's Area Agencies on Aging offer may include respite, caregiver training, support groups, information and individual support. A wage for personal care work is not among them.

"Medicare pays for ongoing personal care." Medicare does not cover custodial care, such as help bathing or dressing, when that is the only care a person needs. It covers skilled care in a skilled nursing facility or through home health.

"A verbal arrangement with a family member is enough for Medicaid purposes." Maine looks back 60 months at transfers by long-term-care applicants, and an undocumented payment can be penalized as a transfer for less than fair market value.

Frequently Asked Questions

Can I get paid to care for my parent in Maine?

Possibly. If your parent qualifies for MaineCare long-term care, Section 19's proposed 2026 waiver text, not shown in effect, would let a qualified family member be paid through a Personal Care Agency or as a self-directed Attendant; confirm with MaineCare Member Services at 1-800-977-6740., If your parent is a veteran, PCAFC, where a son or daughter can be the caregiver, is another route to check.

Can a spouse be paid as a caregiver in Maine?

Yes, within limits. Under MaineCare Section 19's adopted rule, a spouse can be paid as a Personal Support Specialist only for a member who needs extraordinary care, and Section 19 does not cover respite delivered by a spouse., DHHS's proposed 2026 waiver text, not shown in effect, would also require the spouse to work for a Personal Care Agency. For veteran households, a spouse can be the PCAFC Primary Family Caregiver. For Veteran-Directed Care, our sources do not establish spouse pay, so ask the VA medical center.

What is the 2026 Aid and Attendance rate?

For December 1, 2025 through November 30, 2026, the maximum is $34,488 a year for a veteran with one dependent, $29,093 with none and $18,697 for a surviving spouse with no dependents, reduced by countable income and paid monthly.

Is the PCAFC stipend taxable income?

Not according to VA, which described the monthly stipend as a nontaxable benefit in its 2020 proposed PCAFC rule. MaineCare pay is different. The IRS Notice 2014-7 exclusion may apply to qualified Medicaid waiver payments for care in the caregiver's own home where the care recipient lives. Where a MaineCare program is not a waiver, the IRS has said whether the exclusion applies depends on the nature of the payments and the purpose and design of the program, so confirm with a tax professional or the program administrator before reporting the pay as taxable.

Where to Get Help in Maine

MaineCare Member Services Call to ask whether a service you need is covered, and whether a family member or spouse can be the paid worker under Section 19 or Section 21. 1-800-977-6740 (TTY 711) maine.gov MaineCare options
Maine Aging and Disability Resource Centers (ADRC) Call the statewide line and select your county to reach your local Area Agency on Aging. Maine's five AAAs are also ADRCs and offer care partner supports. 1-877-353-3771 maine.gov Area Agencies on Aging
VA Caregiver Support Line Open weekdays, 8 a.m. to 8 p.m. ET. VA's national line for family caregivers of veterans, offering help, support and referrals. It is not a crisis line: in a crisis, call 988 and press 1. 1-855-260-3274 caregiver.va.gov
Eldercare Locator Open weekdays, 8 a.m. to 9 p.m. ET. Call or text to be connected to services in your community, including your local Area Agency on Aging. 1-800-677-1116 eldercare.acl.gov

Learn More

CaregiverHow to Get Paid as a Family Caregiver: The 50-State GuideHow to get paid to care for a family member in 2026: Medicaid self-direction, VA caregiver programs, personal care agreements, plus all 50 state guides. CaregiverHow to Get Paid as a Family Caregiver in MassachusettsYes, you can be paid to care for a family member in Massachusetts. How the MassHealth PCA program and Adult Foster Care pay family caregivers, and who can't be. CaregiverCaregiver Burnout: Signs and SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. VA BenefitsVA Aid and Attendance in MaineVA Aid and Attendance in Maine for 2026: who qualifies, the $34,488 yearly rate for a veteran with a spouse, how to apply, and free help from Maine VSOs. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.

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.

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