Maine Medicaid HCBS waivers pay for long-term care at home and in the community through one main program: the Elderly and Adults with Disabilities Waiver, known in state rules as Section 19.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME HCBS stands for home and community-based services, the Medicaid umbrella for care delivered in your own home or a family home 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.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME It is run by Maine's Department of Health and Human Services (DHHS), and it exists so that someone who needs that level of care can stay in the community rather than move into a facility.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME
In This Guide
- What Maine Medicaid HCBS Waivers Are and the 1915(c) Authority Behind Them
- Inside Maine's HCBS Waiver: Section 19 in Detail
- Who Qualifies for Maine Medicaid HCBS Waivers
- What Maine Medicaid HCBS Waivers Cover
- The Interest List and How Enrollment Works
- How to Apply for Maine Medicaid HCBS Waivers
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.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME
Here is the idea in plain terms. Nursing facility care is expensive, and most people would rather stay in their own home. The waiver bridges that gap: it 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:
- Its federal name and ID is the Elderly and Adults with Disabilities Waiver (ME.0276).
- In state rules it is Section 19 of the MaineCare Benefits Manual, titled "Home and Community Benefits for the Elderly and Adults with Disabilities."
- The waiver is administered by the Maine DHHS Office of Aging and Disability Services (OADS), under the Office of MaineCare Services.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME
So when a MaineCare notice references "Section 19," a caseworker mentions "the EAD waiver," and a federal document lists "ME.0276," they are all pointing at the same program. OADS is the office inside DHHS that oversees it, and it 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.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME In practice this means your needs with daily activities, such as bathing, dressing, moving around, and managing medications, are serious enough that a facility would be the alternative if the waiver's supports were not available. Maine assesses this 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. Income is capped at 300 percent of the SSI federal benefit rate. With the 2026 SSI federal benefit rate at $994 a month for one person, that puts the income limit at $2,982 a month for a single applicant.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME If your income is above that limit, you are not automatically shut out: Maine has a medically needy "deductible," a spend-down pathway that lets you qualify by offsetting income against your medical costs.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME
Maine also applies a resource (asset) limit for long-term-care MaineCare. The specific figures are set out in the MaineCare Eligibility Manual (10-144 C.M.R. Chapter 332) rather than in the waiver rule itself.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME 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:Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME
- 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
Not every person receives every service. A care coordinator assesses your situation and builds a plan around the supports you actually need, so two people on the same waiver can have very different service packages.
The Interest List and How Enrollment Works
Once your care coordinator and the state agree on a plan, enrollment follows the eligibility work: MaineCare confirms your financial eligibility and the state confirms your level of care, and services begin under an approved plan.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME
Many 1915(c) waivers cap enrollment and keep an interest list (sometimes called a waiting list) when demand runs ahead of funded slots. Whether Section 19 has an interest list open at any given moment can change from year to year, and Maine's public waiver materials do not settle the question on their own. 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.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME
You have several ways to apply. Federal rules require the state to take applications online, by phone, by mail, and in person.U.S. Government Publishing Office. (n.d.). 42 CFR 435.907 — Application (eCFR, current). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.907 In Maine, the online route is MyMaineConnection.gov, and OFI's office handles the rest. 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).Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME
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.U.S. Government Publishing Office. (2024). 42 CFR 435.912 Timely determination and redetermination of eligibility (2024 ed.) — govinfo.gov. govinfo.gov. Retrieved Jun 25, 2026, from https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol4/pdf/CFR-2024-title42-vol4-sec435-912.pdf 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?
Section 19 covers attendant care and financial management services among its benefits, and financial management services are the kind of support that self-directed arrangements typically rely on.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME Whether you can self-direct your care or hire a specific person, including a family member, is governed by the program's rules, so ask OADS or your care coordinator how self-direction works for your plan.
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.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Maine Waiver Factsheet (State Waivers List). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ME If you are weighing the two, our Maine Medicaid long-term care and nursing home guide compares them in detail.
Learn More
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.