TABLE OF CONTENTS
There are two primary forms of care available for seniors who need assistance but wish to avoid being placed in an assisted living facility or nursing home. In-home care is non-medical care focused on helping with tasks such as personal grooming, household chores, transportation, meal preparation and medication routines. Home health care services require the supervision of medical professionals such as a doctor, registered nurse or nurse practitioner and may include skilled nursing care.
According to the latest data from the Genworth Cost of Care Survey, in-home care and home health care cost $5,720 monthly in Maine. Costs may vary based on the level of care you need, how many hours per day you need assistance and where you reside within the state.
Home health care services in the Northeast are considerably more expensive than the national average. While care in Maine costs almost $700 per month more than the national average of $4,957, it’s one of the least expensive states for care in the region. Home health care costs $6,197 in New Hampshire and $5,911 in Massachusetts, while costs in Vermont are about the same. Only New York offers cheaper care at $5,529 per month. Nationally and in each state, in-home care costs the same or slightly less than home health care.
|Home Health Care
When deciding whether to age in place at home or seek care in a residential senior living facility, it’s a good idea to compare costs. Home care is comparable to assisted living, but saves seniors around $145 per month. Adult day care is the least expensive option at $2,600. Seniors can be with peers in a supervised day program while getting the assistance they need with personal care as well as light medical support. For those who need more medical care than a home health nurse can provide a few hours a day, nursing home care is an option, but costs about $4,700 more than home health care each month.
Medicaid can reduce your cost of care by covering medical expenses, but it doesn’t pay for non-medical services that in-home care companies usually provide. The good news is that waivers are available to cover the cost of home care, including HCBS waivers, the Consumer Directed Attendant Services Waiver and coverage for personal care via the Family Provider Service Option.
To be eligible for the following waivers, you must qualify for Medicaid Maine. These waivers provide residents more control over how they choose to receive care and the option of selecting their care providers. Caregivers may benefit from waivers if they’re named as personal care providers.
|Home and Community-Based Services Waiver
|The Department of Health and Human Services manages several HCBS waiver programs for adults with disabilities and seniors who require a nursing level of care. To qualify for one of these waivers, you must have a condition that qualifies as a disability, such as an inability to perform normal day-to-day routines.
|Elderly and Adults with Disabilities Waiver
|The Elderly and Adults with Disability Waiver is an HCBS waiver that allows seniors to cover the cost of home alterations, assistive technology, the management of chronic illnesses and home health care.
|Consumer Directed Attendant Services
|The Consumer Directed Attendant Services waiver program is for adults over 18 years of age who require long-term care due to a disability and still have the ability to direct their care. Covered services include personal grooming, help with medications, assistance walking, transportation services and meal preparation. You can choose a personal care attendant, and the program will give that individual up to 14.25 hours of training each year.
|Family Provider Service Option
|The Family Provider Service Option is also offered through the Department of Health and Human Services and allows families that are caring for a loved one who requires a nursing level of care to receive compensation. You can name up to two family members as personal care providers, and they qualify for educational programs, reimbursement for material expenses and pay for the time they spend administering care.
There are income and asset restrictions you must consider before applying for Medicaid in Maine. To be approved, your income must fall under these limits, and your total sellable assets can’t exceed the allowance. You must also meet additional criteria to be eligible. A single applicant must make less than $30,276 per year and can’t have assets worth more than $10,000. For two people, this increases to $60,552 and $15,000. If only one person is applying for Medicaid, the spouse may hold up to $137,400 in assets.
|Two-Person Household with single applicant
|$30,276 for applicant
|$10,000 for applicant, $137,400 for spouse
|Two-Person Household with two applicants
You must also meet the following conditions:
Medicaid in Maine is called MaineCare, and you can apply online, mail your application or visit the Department of Health and Human Services to apply in person. You can also email your application to [email protected]. Mailed applications can be sent to:
Office for Family Independence
114 Corn Shop Lane
Farmington, ME 04938
What Information You Will Need
How to Get Help Applying for Medicaid
It’s important to fill out your application correctly to prevent delays in receiving your benefits, but the application may be confusing for some people. If you need assistance applying for Medicaid, several places offer help.
|State Health Insurance Assistance Program
|Your local Area Agency on Aging
|The SHIP program is a free service for seniors who need insurance and assistance paying for their medical care. You’re connected with a counselor who can help you determine which programs to apply for by reviewing your unique circumstances. The counselor can also help you apply for insurance, Medicare and Medicaid.
|Legal Services for the Elderly
|Legal Services for the Elderly connects seniors with lawyers and legal aides who can help them apply for aid, file complaints and educate them about their rights. The organization works closely with Maine’s SHIP program to help seniors access their benefits.
|Benefits.gov is a national website that works with all 50 state governments to connect seniors with local agencies and resources. You can call the hotline if you have questions about benefits and are having difficulty with your application.
Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.
Below is an overview of some of the services typically covered by Medicare for those who are eligible:
As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.
Read our guide to Medicare and Home Care Coverage for more information.
While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.
The choice to age in place helps preserve your independence and keep you connected with your community. There are local and state resources available to help you, and many of these programs are offered free of charge or affordably priced so you can access them on a limited budget or fixed income.
|My Maine Connection
|Online or 855-797-4357
|My Maine Connection connects residents of the state with local resources such as meal programs, benefit application assistance, cash assistance and education.
|Office of Aging and Disability Services
|Local Agency on Aging
|With offices located throughout the state, the Office of Aging and Disability Services helps all adults over the age of 18 in Maine who have a disability. The organization may be able to help with housing assistance, long-term care services and care for those suffering from Alzheimer’s disease or dementia.
|Maine Long-Term Care Ombudsman
|An ombudsman is someone who advocates on behalf of residents who need legal aid, financial assistance or help to find the right care providers. The Long-Term Care Ombudsman in Maine focuses on senior rights and advocacy to ensure seniors are treated with dignity and respect.
|Family Caregiver Alliance
|The Family Caregiver Alliance is a national program that helps people who act as caregivers for a loved one who needs long-term care. In addition to providing educational resources, support and counseling services and local events, the Family Caregiver Alliance also helps seniors who’re looking to manage their own care.
|The Alzheimer’s Association is a nonprofit organization that offers aid to those caring for someone with declining cognitive ability. You can volunteer for medical trials, which allow your loved one to be treated free of charge. The Association also offers support groups and educational resources to help your family care for someone with a neurological condition.
The federal government and individual states are constantly updating vaccine requirements and mandates, so it’s important to check with your local authorities for the latest information. Maine currently requires health care workers to be fully vaccinated against the COVID-19 virus and other transmissible diseases and to take measures to prevent the spread of the virus. Many home care agencies have their own policies in place that may exceed state requirements.
Measures may include the use of masks and personal protective equipment when interacting with patients. It’s okay to ask your agency directly what actions they’re taking to protect you and your loved ones.
The Department of Health and Human Services enforces regulations for home care in the state of Maine. These rules control how in-home care agencies and home health organizations may operate.
|What Types of Care Can Be Provided?
|Home care is defined by Maine as any service provided in someone’s home that may involve skilled nursing care, assisting with daily living activities and providing physical therapy, speech pathology or medical care.
|Are Care Plans Required?
|Before you can receive home care services, you must be provided with a written care plan, which you may have approved by your primary care physician. The treatment plan must state the goals and intended outcomes for treatment and identify who will provide routine care and to whom those individuals report. Each member of the treatment team must be identified and a title and job description provided.
|Can Home Care Providers Assist With Medication Management?
|Home care providers may assist with daily medications, but they may not prescribe new medications unless they’re licensed medical professionals.
|Are There Special Requirements for Screening Home Care Aides?
|Care aides are required to pass a background check to verify they haven’t committed any violent crimes.
|Are Home Care Aides Required to Undergo Special Training?
|Home health agencies in Maine must renew their licenses regularly and provide proof their employees have undergone training and received certifications in their areas of expertise. Employees must also recertify annually.
|Does Medicaid Cover Home Care in Maine?
|MaineCare doesn’t cover the cost of home care directly, but several waivers are available for Medicaid recipients that may help with these expenses.
|How Do I Report Abuse of Myself or a Loved One?
|If you suspect someone is being abused, neglected or exploited, you can contact the Long-Term Care Ombudsman, Legal Services for the Elderly or Adult Protective Services. APS offers a hotline for victims of abuse and their families at 800-624-8404.
Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.