Maine caregiver programs can pay family, and MaineCare's Section 19 waiver can pay a spouse who works as a Personal Support Specialist when the member needs extraordinary care. Maine adopted that spouse route by rule in 2021 after CMS approved it, and the waiver text Maine proposed in February 2026 would also let a qualified relative be paid through a Personal Care Agency or as a self-directed Attendant. Beyond that paycheck route, help runs through MaineCare, the state's five Area Agencies on Aging, and, for veteran families, VA, whose PCAFC stipend goes to an approved caregiver who can be a veteran's spouse, son or daughter.,,

If you are caring for an aging parent, a spouse, or an adult child with a disability in Maine, the hard part is rarely whether help exists. It is knowing what is there and where to start. This guide maps every major caregiver program in the state.

You don't have to figure this out alone, and you don't have to fund all of it from your savings.

In This Guide

Maine Caregiver Programs at a Glance

Program What It Offers Pay a spouse? Cost to You
MaineCare Section 19 waiver Personal care and respite; the proposed 2026 waiver text would pay a relative through an agency or self-direction As a Personal Support Specialist, for extraordinary care only Covered by MaineCare; prior approval required
NFCSP and Caregiver Respite Program Information, counseling, training, support groups, respite N/A Ask your Area Agency on Aging
VA PCAFC Monthly stipend VA has described as nontaxable; a spouse can be the caregiver Yes, if approved Paid by VA
VA Aid and Attendance Pension ceiling of $29,093/yr, less the veteran's countable income Pension to veteran No-cost help from Maine VSOs

Which Maine Caregiver Programs Pay Family Members?

MaineCare's primary home and community-based services waiver for older adults and adults with physical disabilities is Section 19, Home and Community Benefits for the Elderly and Adults with Disabilities. It covers personal care, respite and other services for adults 65 or older, and adults 18 or older with physical disabilities, who meet a hospital or nursing facility level of care. Maine's separate waiver for adults with intellectual disabilities or autism spectrum disorder covers a different group, people 18 or older who meet an ICF/IID level of care, and its services include shared living and non-medical transportation.

Section 19 can pay family caregivers. For relatives other than a spouse, the detail comes from the waiver application text the Maine Department of Health and Human Services posted with its February 2026 proposed amendment. Our sources do not show whether CMS approved that amendment, so treat it as the proposed version and confirm with your Service Coordination Agency. Under that proposed text, a family member who qualifies as a Personal Care Attendant or Personal Support Specialist and is employed by a Personal Care Agency or nursing facility may be paid for personal care or in-home respite. A family member may also be paid for Attendant Care or respite when the participant uses self-directed services.

The rules for a spouse are narrower, and their core is settled. Maine's Section 19 rule adopted in 2021 (filing 2021-090, effective May 2, 2021) permits a spouse to be reimbursed as a Personal Support Specialist for a member who needs extraordinary care, and DHHS reported that CMS approved the waiver amendment behind it. Maine's Legislature directed this change in Resolve 2019, chapter 102, which limits a spouse to extraordinary care and services the spouse is not normally expected to provide. The proposed 2026 waiver text, which our sources do not show CMS has approved, would add details: a spouse would have to work for a Personal Care Agency, extraordinary care would cover activities of daily living but not instrumental activities of daily living, and a spouse could not be paid as a self-directed Attendant. Under that proposed text, the need for extraordinary care would be identified, documented and regularly evaluated in Person-Centered Planning and authorized by the Service Coordination Agency, so raise it there and confirm which rules apply now. Section 19 respite is not covered when the member's spouse provides it.

The same proposed text would set a few more limits, so confirm them with MaineCare or your case manager. A guardian could be paid only through an agency, not as a self-directed Attendant, and a Representative who directs services on the participant's behalf could not be paid to provide care. One Personal Care Attendant or Personal Support Specialist could not be paid for more than 40 hours a week of services to one participant, though a participant at risk of institutionalization could ask for an exception. For the intellectual disabilities and autism waiver, our sources do not say whether a family member can be paid, so ask MaineCare Member Services at 1-800-977-6740.

Section 19 also carries conditions a family should plan around: every service needs prior approval, the projected monthly cost of a member's services must fit within the limits set in Section 19.06, and services depend on available funding, with members accepted first-come, first-served from a wait list. Its Participant-Directed Option uses a Financial Management Service. For more on who can be paid and how, see the Maine paid family caregiver guide, and for the hiring steps and hour limits, our guide to how MaineCare Section 19 pays family caregivers.

Separate from MaineCare, the Care Partner Supports services offered by Maine's Area Agencies on Aging may include respite, caregiver training, support groups, information, and individual support. If a paycheck is what you need, the Section 19 routes above are the MaineCare place to start. If the person you care for is a veteran, also ask VA about the PCAFC monthly stipend, which goes to an approved Primary Family Caregiver.

Not everyone is approved on the first try. If MaineCare denies, ends or reduces a covered service, in most situations you have the right to a Fair Hearing, and you can ask for one up to 60 days from the date of your letter by calling MaineCare Member Services at 1-800-977-6740.

Where Can You Get Respite Help in Maine?

Caring for someone around the clock wears you down, and stepping away for a few hours or a few days is not a luxury. It is part of what keeps you able to keep going. Maine has more than one way to pay for that break.

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, flows through Maine's Area Agencies on Aging. Its services include information about available help, assistance gaining access to services, individual counseling, support groups, caregiver training, respite care, and supplemental services on a limited basis. Respite and supplemental services carry a condition: for a family caregiver of an older person, that person must be frail, meaning unable to perform at least two activities of daily living without substantial human assistance, or needing substantial supervision because a cognitive or other mental impairment makes their behavior a serious health or safety hazard. To reach your regional Area Agency on Aging, call Maine's statewide ADRC line at 1-877-353-3771 and select your county, or use the national Eldercare Locator at 1-800-677-1116.,

If you care for someone with Alzheimer's or a related dementia, Maine's Area Agencies on Aging also run a state-funded Caregiver Respite Program targeted to families caring for someone living with dementia and related diseases, including Alzheimer's.

MaineCare's Section 19 waiver can also cover respite, in the member's home or in a licensed nursing facility, for someone who qualifies. It needs prior approval, it is capped each year at the cost of 30 days of nursing facility respite, which counts against the member's monthly program cap, and it is not covered when the member's spouse provides it. For the full respite guide, see Respite Care in Maine.

What If You Are Not on Medicaid or Caring for a Veteran?

Some help sits outside MaineCare and has nothing to do with a military connection. NFCSP eligibility turns on who you care for: adult family members or other informal caregivers of someone 60 or older, or of someone of any age with Alzheimer's disease or a related disorder, plus some relatives 55 or older raising a child or caring for an adult with a disability. Maine's five Area Agencies on Aging, which are also its Aging and Disability Resource Centers, offer care partner support services that may include respite, caregiver training, support groups, helpful information, and individual support. Start with the ADRC line at 1-877-353-3771.

Who Should You Call in Maine?

These are the front doors for Maine caregiver programs.

Maine Aging and Disability Resource Center (ADRC) Helps with reaching your local Area Agency on Aging, NFCSP respite, and caregiver support. 1-877-353-3771
MaineCare Member Services Helps with MaineCare coverage questions and Fair Hearing requests. 1-800-977-6740
Office for Family Independence (OFI) Processes MaineCare applications and answers questions about eligibility or your application. 1-855-797-4357 www.maine.gov/dhhs/ofi/programs-services/health-care-assistance
VA Caregiver Support Line Help, support, and referrals for family caregivers of veterans, weekdays 8:00 a.m. to 8:00 p.m. Eastern Time. If you are in crisis or having thoughts of suicide, call the Veterans Crisis Line at 988 and press 1. 1-855-260-3274 www.caregiver.va.gov
Eldercare Locator Helps with finding local aging and caregiver services anywhere in Maine. Call or text weekdays, 8 a.m. to 9 p.m. ET. 1-800-677-1116 eldercare.acl.gov

What VA Caregiver Benefits Can You Get in Maine?

If the person you care for is a veteran, VA runs caregiver programs that are separate from MaineCare.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. VA has described it as a nontaxable benefit, a spouse can be the caregiver, and VA pays it only to a caregiver enrolled in direct deposit through the VA customer engagement portal.

If you are at least 18 and a veteran's spouse, son or daughter, or you live with the veteran full time, you may be able to apply as the Family Caregiver. VA publishes four conditions for the veteran, and they are the first screen rather than the decision:

  • 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.

38 CFR 71.20(a) adds further requirements that VA assesses during the application. The one most likely to surprise a family: the personal care you would provide must not already be simultaneously and regularly provided by or through another individual or entity, so a household already receiving regular personal care through another program can fail on that ground alone.

The stipend is based on the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12. Under the current program VA multiplies that monthly rate by 0.625 (Level One), or by 1.00 (Level Two) when it determines the veteran is unable to self-sustain in the community. Legacy participants and applicants follow separate rules that end on October 1, 2028. The VA caregiver stipend guide walks through every requirement and the legacy factors.

VA Aid and Attendance Pension

Aid and Attendance adds monthly payments to a VA pension for qualified veterans and survivors, such as those who need another person's help with daily activities like bathing, feeding, and dressing, and it requires that the veteran or survivor already qualify for a VA pension. The pension's net worth limit is $163,699 from December 1, 2025, to November 30, 2026, and the calculation includes the claimant's and dependents' assets and income for VA purposes. A single veteran's Aid and Attendance pension is capped at $29,093 per year in 2026, and for a veteran with one dependent at $34,488 per year. These are ceilings, not flat awards: VA bases the payment on the difference between the claimant's income for VA purposes and the applicable maximum and pays it monthly, so a veteran with other income receives less than the amount shown. Some expenses, like medical expenses not covered by insurance, may reduce your income for VA purposes, though you may deduct only the amount above a threshold VA prints as $872 for a veteran with no spouse or child.

Veteran Service Officers at the Maine Bureau of Veterans' Services help Maine veterans and their families apply for VA benefits, including pensions, at no cost. If VA denies a pension claim, VA offers three decision review options: a Supplemental Claim with new evidence, a Higher-Level Review, or a Board Appeal, and the deadline for the last two is one year from the date on the decision letter.

How Are Maine Caregiver Wages Taxed?

Getting paid to care for someone you love raises an obvious worry: how much will you owe back in taxes? The answer depends on how you are paid and where you live.

Are MaineCare Waiver Payments Taxable? (IRS Notice 2014-7)

If you are paid through a Medicaid waiver program such as Section 19, the IRS treats qualified Medicaid waiver payments as difficulty of care payments excludable from your federal gross income under IRS Notice 2014-7, when the care recipient's home is also your home. If you keep a separate home where you reside, you may not exclude the payments. Talk to a tax preparer familiar with the rule before filing.

What About Your Maine Return?

Notice 2014-7 is a federal rule. Tax rules change and every family's return is different, so confirm how payments excluded under it are treated on your Maine return with Maine Revenue Services or a tax preparer before you file.

Is the VA PCAFC Stipend Taxable?

In the preamble to its 2020 proposed PCAFC rule, VA described the monthly stipend as a nontaxable benefit. Confirm your own treatment with a tax preparer.

Frequently Asked Questions

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

Through MaineCare's Section 19 waiver, yes, in one narrow way. Maine adopted a rule in 2021, after CMS approved the change, that lets a spouse be reimbursed as a Personal Support Specialist when the member needs extraordinary care. The waiver text Maine proposed in February 2026, which our sources do not show CMS has approved, would require working for a Personal Care Agency and being paid only for extraordinary care with activities of daily living, not as a self-directed Attendant. Under that proposed text, the need would be documented in Person-Centered Planning and authorized by the Service Coordination Agency, so confirm the current rules there and ask: "Is my spouse's care extraordinary care, and can I be hired as a Personal Support Specialist through a Personal Care Agency?" Section 19 respite is not covered when the member's spouse provides it., If your spouse is a veteran, you can also be a Family Caregiver under VA's PCAFC, and its monthly stipend goes to an approved Primary Family Caregiver.

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

Possibly, if your parent receives services through MaineCare's Section 19 waiver. The waiver text Maine proposed in February 2026, which our sources do not show CMS has approved, says a family member who qualifies as a Personal Care Attendant or Personal Support Specialist can be paid for personal care or in-home respite while employed by a Personal Care Agency or nursing facility, or can be paid as an Attendant if your parent uses self-directed services. Confirm what applies now with MaineCare or your parent's case manager. If your parent is a veteran, a son or daughter can also be a Family Caregiver under VA's PCAFC.

How do I apply for MaineCare's Section 19 waiver?

Section 19 serves adults 65 or older, and adults 18 or older with physical disabilities, who meet a hospital or nursing facility level of care. The person you care for must also be a Maine resident and meet Long Term Care MaineCare's income and asset requirements: for the waiver group, the 2026 income limit is $2,982 a month and the asset limit is $2,000 for an individual, with up to $8,000 of savings excluded, and a community spouse can keep up to $162,660., If your parent or spouse qualifies based on medical needs but is over the income or asset limits, they could be eligible for a deductible instead. Apply online at MyMaineConnection.gov or through the Office for Family Independence (OFI), which processes MaineCare applications. You can also mail, e-mail or fax an application, or apply in person at a district office, and OFI answers eligibility questions at 1-855-797-4357.

How are MaineCare in-home care rates set?

Maine's February 2026 notice of a proposed Section 19 waiver amendment says service rates for that waiver are contingent on available funding and subject to legislative approval. The notice was a proposal out for public comment, not settled rule, so ask MaineCare Member Services at 1-800-977-6740 what applies to you, and see the Maine paid family caregiver guide.

Can I get respite in Maine without Medicaid?

There is respite outside MaineCare. Maine's Area Agencies on Aging run the federally funded National Family Caregiver Support Program and a state-funded Caregiver Respite Program for families caring for someone living with dementia. For a family caregiver of an older person, NFCSP respite requires that person to be frail. Call Maine's Aging and Disability Resource Center line at 1-877-353-3771 to ask what your local agency offers and what it costs.

Which VA programs help families caring for a veteran in Maine?

The PCAFC stipend is paid to an approved Primary Family Caregiver (VA has described it as a nontaxable benefit; a spouse can be the caregiver; approval turns on all of VA's PCAFC conditions, of which a 70 percent or higher VA disability rating is only the first). Aid and Attendance is different: it adds monthly payments to a VA pension for qualified veterans and survivors, who must already qualify for a VA pension, which has a net worth limit, and must meet a need test such as needing help with daily activities. Call the VA Caregiver Support Line at 1-855-260-3274.,,,

How do I reach my Area Agency on Aging in Maine?

Call Maine's statewide Aging and Disability Resource Center line at 1-877-353-3771 and follow the instructions to select your county, or use the national Eldercare Locator at 1-800-677-1116., Maine's Area Agencies on Aging offer care partner support services that may include respite, caregiver training, support groups, helpful information, and individual support.

What if my MaineCare or VA application is denied?

You can challenge a denial. For MaineCare, in most situations you have the right to a Fair Hearing, and you can ask for one up to 60 days from the date of your letter by calling Member Services at 1-800-977-6740. If VA denies a pension claim, you can file a Supplemental Claim with new evidence, or, within one year of the date on the decision letter, ask for a Higher-Level Review or a Board Appeal. Do not treat a first denial as the end of the pathway.

Your next step Call Maine's Aging and Disability Resource Center at 1-877-353-3771 to find your local Area Agency on Aging and start a caregiver-support or respite request, or, if you care for a veteran, call the VA Caregiver Support Line at 1-855-260-3274.

Learn More

CaregiverCaregiver Programs: The 50-State GuideA directory of caregiver programs in all 50 states: paid family caregiver pathways, respite, NFCSP grants, and VA benefits. Find your state's complete guide. CaregiverMedicaid Self-Direction and Consumer-Directed ServicesHow Medicaid self-direction lets a family member be your paid caregiver: employer authority, budget authority, the 1915(j) spouse rule, and how to get started. CaregiverThe National Family Caregiver Support Program (NFCSP): A Complete GuideWhat the National Family Caregiver Support Program funds, who is eligible, and how to reach respite and caregiver support through your Area Agency on Aging. CaregiverHow to Get Paid as a Family Caregiver in MaineGetting paid as a family caregiver in Maine: what MaineCare Sections 19 and 21 cover, VA's PCAFC stipend for spouses and family, and Aid & Attendance limits. CaregiverMaineCare Section 19: How Family Caregivers Get Hired and PaidMaineCare Section 19 pays a spouse for extraordinary care, and Maine's proposed 2026 waiver text lets other relatives be paid, up to 40 hours a week per aide. CaregiverRespite Care in MaineFunded respite care in Maine can pay for your break: MaineCare Section 19 waiver respite, the state dementia respite program, NFCSP through 5 AAAs, and VA. CaregiverCaregiver Burnout: Signs, Stages, and How to Get 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 Caregiver Stipend (PCAFC): Who Qualifies, How Much, and How to ApplyThe VA caregiver stipend (PCAFC) pays an eligible veteran's Primary Family Caregiver monthly. See the real eligibility test, the 2026 math, and how to apply. VA BenefitsVA Benefits for Seniors 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.

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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