MaineCare Section 19 Eligibility 2026: Income, Asset, and Medical Limits

MaineCare Section 19 — the Elderly and Adults with Disabilities Waiver — is the primary way Maine funds home and community-based care for seniors who would otherwise need a nursing home. The program covers personal care attendants, respite care, home modifications, assistive technology, and care coordination.

Unlike many state Medicaid waivers with years-long waitlists, Section 19 currently has zero waitlist slots for older adults. Once you're eligible, services can start almost immediately.

Here are the exact 2026 eligibility thresholds.

Medical Eligibility: The Maximus MED Assessment

Before financial eligibility matters, your parent must meet the clinical threshold: Nursing Facility Level of Care (NFLOC). This is determined by a Medical Eligibility Determination assessment conducted by Maximus (Maine's contracted assessing services agency, formerly known locally as "Goold").

To qualify under the physical pathway, the applicant must need daily skilled nursing or significant physical assistance with at least three of five Activities of Daily Living: bed mobility, transfer, locomotion, toileting, and eating.

The cognitive/behavioral pathway qualifies applicants with documented dementia or behavioral impairments who need assistance with at least one of those five ADLs.

Contact Maximus at 1-833-525-5784 to schedule an assessment. In-hospital assessments are completed within 24 hours by phone. Community assessments after discharge take up to 10 business days.

2026 Income Limits

Single applicant: $2,982/month (300% of the Federal Benefit Rate of $994/month)

If your parent's income exceeds $2,982/month, they can still qualify through Maine's Medically Needy Spend-Down program. Maine does not use Miller Trusts (Qualified Income Trusts). Instead, the applicant pays their excess income above the Medically Needy Income Limit toward their care costs each month.

The Medically Needy Income Limit is $315/month for a single individual and $341/month for a couple. The difference between total income and the MNIL becomes the monthly spend-down "deductible" — the amount the applicant must spend on medical and care expenses before MaineCare coverage kicks in for the remainder of the month.

2026 Asset Limits

Single applicant: $10,000 in countable assets

This is significantly more generous than the $2,000 standard Medicaid limit used in most states. Maine applies a base $2,000 SSI limit plus an additional $8,000 savings disregard, bringing the effective threshold to $10,000.

Married couple (both applying): $15,000

Countable assets include: checking and savings accounts, CDs, stocks, bonds, IRAs, 401(k)s.

Exempt assets include: personal belongings, household furnishings, one vehicle used for transportation, and the primary residence up to $1,130,000 in equity — provided the applicant lives there, has a documented "intent to return," or a spouse/dependent resides in the home.

Spousal Protections (When One Spouse Applies)

If only one spouse needs Section 19 services, federal spousal impoverishment rules protect the at-home spouse:

• Community Spouse Resource Allowance (CSRA): The at-home spouse can keep up to $162,660 of the couple's combined countable assets (2026 cap), with a minimum floor of $32,532
• Minimum Monthly Maintenance Needs Allowance (MMMNA): $2,705/month (effective July 1, 2026 through June 30, 2027). If the at-home spouse's own income is below this, the applicant spouse can divert income to bring them up to this floor
• Maximum income diversion: Up to $4,066.50/month if documented shelter costs exceed $811.50/month

Maine follows the "name on the check" rule: income received solely in the community spouse's name is not counted against the applicant spouse.

The Participant-Directed Option

Section 19 allows participants to direct their own care — hiring, managing, and terminating their own personal care attendants. Under this option, adult children or grandchildren can be hired as paid caregivers. However, spouses are excluded from receiving caregiver payment under the waiver.

A state-approved fiscal intermediary (Public Partnerships LLC) handles payroll, taxes, and withholding on behalf of the participant.

Applying for Section 19

Applications go through the Maine DHHS Office for Family Independence (OFI) at 1-855-797-4357, or online at MyMaineConnection.gov. Both the Maximus medical assessment and OFI financial determination must be completed before services begin.

The Hospital-to-Home Maine guide includes Section 19 financial eligibility worksheets, a Maximus assessment preparation checklist, and a step-by-step application timeline to coordinate the medical and financial tracks simultaneously.

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