Maine Medicaid HCBS waivers pay for long-term care at home and in the community, mainly through the Elderly and Adults with Disabilities Waiver, known in state rules as Section 19. HCBS stands for home and community-based services, the Medicaid umbrella for care delivered at home or in the community instead of a nursing facility. Maine Medicaid, which the state calls MaineCare, offers the waiver to adults age 65 or older and to adults age 18 or older who have a physical disability, and only to those who need a hospital or nursing facility level of care. Its rule is issued by Maine's Department of Health and Human Services (DHHS), and it serves people who need that level of care but can be cared for at home or in the community.

In This Guide

What Maine Medicaid HCBS Waivers Are and the 1915(c) Authority Behind Them

A home and community-based services waiver is a tool that lets a state pay for long-term care outside an institution. Under Section 1915(c) of the Social Security Act, a state can ask the federal government for permission to "waive" some of the usual Medicaid rules so that people who would otherwise need a nursing facility can receive care at home instead. Maine uses that authority to run its Elderly and Adults with Disabilities Waiver, and it pairs the 1915(c) waiver with a concurrent 1915(b)(4) authority.

Here is the idea in plain terms. The waiver pays for the personal care, coordination, and supports that make staying home possible for someone whose needs are serious enough that, without help, a facility would be the alternative. The care has to be the kind a nursing facility would otherwise provide, which is why the level-of-care test matters so much, and we walk through that below.

Inside Maine's HCBS Waiver: Section 19 in Detail

Maine's waiver carries a few names, and it helps to know all of them because you will see them in letters, rules, and applications:

So when a MaineCare notice references "Section 19" and a federal document lists "ME.0276," both are pointing at the same program. DHHS sends members with waiver questions to OADS, so that is your anchor agency for questions about the waiver itself once you are in the system.

Who Qualifies for Maine Medicaid HCBS Waivers

Qualifying for Section 19 comes down to two tests that you have to clear together: a functional test about your level of care, and a financial test about your income and assets.

The functional test: nursing facility level of care. You have to need a hospital or nursing facility level of care. In practice, Maine describes this as needing the type of medical care usually available in a nursing facility while still being able to be cared for at home or in the community. You have to meet this level of care before you can enroll.

The financial test: income and assets. Because the waiver is long-term-care MaineCare, it uses long-term-care financial rules. Maine's published 2026 MaineCare Eligibility Guidelines set the monthly income limit for the waiver coverage group at $2,982 for a single applicant, the same limit Maine applies to the nursing facility group. That figure equals 300 percent of the 2026 SSI federal benefit rate of $994 a month for one person, which is the federal ceiling a state may set for this group. Being over the limits does not automatically shut you out, but the alternative comes with conditions. If you qualify for MaineCare based on medical needs and your income or your assets are over MaineCare's limits, you could be eligible for Maine's medically needy "deductible," also called the spend-down pathway. Note both conditions: the medical-needs qualification comes first, and it is either limit, income or assets, that can send you down the deductible route. Whether it applies to your situation is MaineCare's determination to make, so ask OFI rather than assuming it.

Maine also has asset (resource) limits for long-term-care MaineCare, which is why assets as well as income can send you to the deductible route. The eligibility rules that guide MaineCare are published in the MaineCare Eligibility Manual, Chapter 332 of the Department of Health and Human Services rules (listed under 10-144 on the Maine Secretary of State's agency-rules site). For how those asset rules work, including the protections for a spouse who stays in the community, see our Maine Medicaid eligibility and income limits guide and our Maine spousal impoverishment guide.

What Maine Medicaid HCBS Waivers Cover

The point of the waiver is to assemble the mix of services that lets someone stay home safely. Section 19's covered services include:

  • Care coordination
  • Personal care and attendant care services
  • Respite care
  • Financial management services
  • Skills training
  • Assistive technology
  • Environmental (home) modifications
  • Home-delivered meals
  • Home health services
  • Chronic-disease self-management (Maine offers this as "Living Well for Better Health")
  • Falls prevention (offered as "A Matter of Balance")
  • Non-medical transportation
  • Personal emergency response system (PERS) services

The list is what the waiver can pay for, not a package every member receives. Care coordination is itself one of the covered services, so ask your care coordinator which of these fit your needs.

Section 19 is not Maine's only 1915(c) waiver. A separate one, the Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Waiver (0159.R08.00), serves people 18 or older with autism or an intellectual disability who meet an ICF/IID level of care, the level of care of an intermediate care facility for individuals with intellectual disabilities. Its covered services include shared living and non-medical transportation. Under the draft renewal of that waiver, known as Section 21, that Maine posted for public comment in February 2025, a family member, or a legal guardian who is a parent, step-parent, sibling, step-sibling or other biological relative, may be paid to deliver only two services, shared living and non-medical transportation, and only when they are provided in line with state regulations and the waiver. They must meet the same qualifications as an unrelated worker. For shared living, a legal guardian is paid only if they are the member's parent, sibling or other biological family member, and adult adoption does not get around that rule. For non-medical transportation, which is arranged through transportation brokers, a relative or guardian is reimbursed only if they say they cannot transport at no charge or there is no other viable option, and the planning team recommends it. The draft's family-payment section does not set out a separate rule for paying a spouse. Because it is draft text, confirm the current rule with Maine's Office of Aging and Disability Services (OADS) before you plan around it.

The Interest List and How Enrollment Works

Enrollment follows the eligibility work: you have to meet MaineCare's medical and financial eligibility rules and a hospital or nursing facility level of care before waiver services can start.

Unlike a service in the regular state plan, a waiver lets a state cap enrollment, which is what produces interest lists (sometimes called waiting lists). Whether Section 19 has an interest list open at any given moment can change. The reliable move is to ask OADS directly whether an interest list applies to your situation before you plan around a wait, so you are working from the current status rather than an old assumption.

How to Apply for Maine Medicaid HCBS Waivers

You start by applying for MaineCare, because the waiver rides on top of MaineCare eligibility. Applications are handled by the Maine DHHS Office for Family Independence (OFI), the office that processes MaineCare eligibility.

You have several ways to apply. Federal rules require the state to take applications online, by phone, by mail, and in person. In Maine, you can apply online at MyMaineConnection.gov or through OFI; check OFI's own instructions for the phone, mail, and in-person options it runs. If you want to check whether a particular service is covered, you can call MaineCare Member Services at 1-800-977-6740 (TTY users dial 711).

Once you apply, the state is on a clock. Federal Medicaid rules require the agency to decide most applications within 45 days, and within 90 days when eligibility is based on disability. Those limits hold except in unusual circumstances, and the rule gives examples rather than a closed list, such as a delay by the applicant or by an examining physician, or an administrative emergency beyond the agency's control. The agency must document the reasons for any delay in your case record, and it may not use the time limits as a waiting period or as a reason to deny you. Because the waiver adds a level-of-care assessment on top of the financial determination, it is worth starting early and keeping your paperwork organized. For a full walkthrough of the application itself, see our how to apply for Maine Medicaid guide.

Frequently Asked Questions

Can I choose my own caregiver or self-direct my services under the waiver?

Yes, within limits. Section 19 covers attendant care and financial management services among its benefits. Maine's adopted Section 19 rule already lets a spouse be paid as a Personal Support Specialist for a member who needs extraordinary care. Wider family-payment rules appear only in a proposed amendment to the waiver that Maine posted in February 2026, and as of October 2026 we have not found a record that it was federally approved or took effect. Under that proposal, a family member who qualifies as a Personal Care Attendant or Personal Support Specialist could be paid for personal care while employed by a Personal Care Agency or nursing facility, or paid as an Attendant when the member uses self-directed services. A spouse could be paid only as a Personal Support Specialist working for a Personal Care Agency, only for extraordinary care with activities of daily living, and not as a self-directed Attendant or for respite. Because these are proposed rules, confirm what applies today with OADS or your care coordinator before you plan around them. For the hiring steps and hour limits, see our guide to how MaineCare Section 19 pays family caregivers.

How is the waiver different from MaineCare for a nursing home?

Both are long-term-care MaineCare, but they pay for care in different places. The nursing home benefit pays for care inside a facility, while the Section 19 waiver pays for the personal care, coordination, and home supports that let you receive a similar level of care at home instead. If you are weighing the two, our Maine Medicaid long-term care and nursing home guide compares them in detail.

Learn More

MedicaidMaine Medicaid (MaineCare) OverviewMaine Medicaid 2026: $2,000 asset limit plus $8,000 savings exclusion, medically needy spend-down, $40 PNA, spousal protections, estate recovery, how to apply. MedicaidMedicaid HCBS Waivers by StateMedicaid HCBS waivers pay for care at home instead of a nursing facility. How 1915(c) waivers work, who qualifies, why waitlists happen, and your state's guide. MedicaidMaine Medicaid Long-Term Care and Nursing HomesHow Maine Medicaid nursing home coverage works in 2026: MaineCare eligibility, the asset limit and savings disregard, patient liability, and estate recovery. MedicaidMaine Medicaid Eligibility and Income LimitsMaine Medicaid income limits for 2026: the $2,982 cap, the $8,000 savings exclusion on top of the $2,000 asset limit, the spend-down, and spousal rules. MedicaidHow to Apply for Maine MedicaidHow to apply for Maine Medicaid (MaineCare) in 2026: online via My Maine Connection, by mail, e-mail, or fax, or in person. Documents, spend-down, and appeals. 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.

Find personalized help applying for Maine Medicaid HCBS waivers 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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