How to Pay for In-Home Care
How to Pay for Home Care in Maine
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
This directory lists Maine-specific and federal payment sources that can pay for, reimburse, offset, or help plan for home care. Some are direct payment sources; others are indirect supports that reduce the amount of private home care a family must buy. Maine's strongest state-specific pathways include Section 19 HCBS for older adults and adults with physical disabilities, Section 12 Consumer Directed Attendant Services for those who can self-direct, the state-funded Sections 63 and 69 home supports and homemaker services, and caregiver respite and cost-offset programs layered around the primary care plan, and VA benefits are broken out because they can be one of the strongest payment pathways for eligible Maine veterans and surviving spouses. Start with the statewide Aging and Disability Resource Center and the Maximus assessment process to identify which MaineCare or state-funded track applies.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
MaineCare / Section 19
Section 19 Home and Community Benefits
YesHelps pay for: HCBS alternative to nursing-facility care for older adults and adults with physical disabilities; can authorize in-home and community supports.
Who qualifies: MaineCare financial eligibility, nursing-facility level of care and service-plan authorization. OADS reported no Section 19 waitlist as of March 31, 2026.
How to start: Apply for MaineCare long-term services and request a functional assessment.
Good to know: Family caregiver payment: Potentially, where an approved service model permits it; verify worker relationship rules
Section 19 Personal Support / Attendant Services
YesHelps pay for: Hands-on and supportive help with approved activities of daily living and instrumental activities in the home.
Who qualifies: Must be enrolled in Section 19 and have the service authorized in the person-centered plan.
How to start: Ask the care manager to assess personal-support needs.
Good to know: Family caregiver payment: Depends on the authorized delivery model and relationship rules
Section 19 Respite
Yes - respiteHelps pay for: Temporary relief for an unpaid caregiver when respite is authorized in the Section 19 plan.
Who qualifies: Section 19 eligibility, assessed caregiver need and plan authorization.
How to start: Ask the care manager to add respite if clinically appropriate.
Good to know: Family caregiver payment: No direct wage; pays an approved respite service
Section 19 Home-Delivered Meals
Indirect cost offsetHelps pay for: Can cover approved home-delivered meal supports when included in the waiver plan.
Who qualifies: Section 19 enrollment, assessed need and plan limits.
How to start: Request nutrition/meal screening through the care manager.
Good to know: Family caregiver payment: No
Section 19 PERS / Assistive Technology
Indirect cost offsetHelps pay for: Can help with approved personal emergency response and assistive-technology supports that reduce safety and supervision burdens.
Who qualifies: Medical/functional need and authorization under the waiver plan.
How to start: Ask the care manager about PERS or assistive technology.
Good to know: Family caregiver payment: No
Section 19 Environmental / Home Accessibility Modifications
Indirect cost offsetHelps pay for: Approved home modifications may reduce fall risk and help a person remain safely at home.
Who qualifies: Must meet waiver criteria and be authorized as necessary under the service plan; limits and documentation apply.
How to start: Discuss home-access barriers with the care manager before purchasing work.
Good to know: Family caregiver payment: No
MaineCare / Section 12
Section 12 Consumer Directed Attendant Services
YesHelps pay for: Consumer-directed attendant care for eligible adults who can direct their services or use an authorized representative.
Who qualifies: MaineCare eligibility plus functional/program criteria. Consumer-directed model makes the participant the employer of record for attendants.
How to start: Request Section 12 screening through OADS/MaineCare and complete consumer-direction enrollment.
Good to know: Family caregiver payment: Potentially; verify current relationship and worker qualification restrictions before hiring a relative
Section 12 Participant-Employer Self-Direction
YesHelps pay for: Lets an eligible participant recruit, hire, schedule and supervise attendants with required fiscal/support functions.
Who qualifies: Participant must meet Section 12 requirements and fulfill employer responsibilities or use an authorized representative.
How to start: Ask specifically for the consumer-directed Section 12 model.
Good to know: Family caregiver payment: Potentially; relationship restrictions must be confirmed
State-Funded Home Care
Section 63 Home Based Supports and Services (HBSS)
YesHelps pay for: State-funded in-home/community LTSS designed to help eligible older adults and adults with disabilities avoid or delay institutional care.
Who qualifies: Eligibility is based on functional and financial program rules and available state funding. OADS reported a 1,204-person waitlist as of March 31, 2026.
How to start: Apply for state-funded home care and complete the functional assessment.
Good to know: Family caregiver payment: Potentially under approved consumer-directed arrangements
Section 63 Consumer-Directed Personal Care
YesHelps pay for: Can support participant-directed personal assistance within the state-funded home-care system when authorized.
Who qualifies: Program eligibility, plan authorization, worker qualifications and any relationship restrictions apply; sliding-scale cost sharing may apply.
How to start: Ask OADS whether the consumer-directed option fits the care plan.
Good to know: Family caregiver payment: Yes, a qualified relative may be payable when not prohibited by applicable law/rule
Section 63 Respite / Adult Day Supports
Yes - respite/day supportHelps pay for: Can offset respite or structured daytime support when approved, reducing the number of privately paid caregiver hours needed.
Who qualifies: State-funded program eligibility, available funding and plan authorization; service limits apply.
How to start: Request caregiver-respite/adult-day screening during assessment.
Good to know: Family caregiver payment: No direct wage
Section 63 Meals / In-Home Supports
Indirect / YesHelps pay for: Can cover approved supportive services such as meals or other home-based assistance under the state-funded plan.
Who qualifies: Eligibility, assessment, funding availability and authorized service plan.
How to start: Ask the assessor which Section 63 services can substitute for private-pay tasks.
Good to know: Family caregiver payment: No
Section 69 Independent Support / Homemaker Services
Yes - homemakerHelps pay for: Homemaker/independent support can help with household tasks that are difficult because of age or disability.
Who qualifies: State-funded eligibility and available program capacity. OADS reported a 1,405-person waitlist as of March 31, 2026.
How to start: Contact Catholic Charities of Maine or the ADRC for screening/referral.
Good to know: Family caregiver payment: No
Caregiver Support
State Caregiver Respite Program
Yes - respiteHelps pay for: Respite and caregiver support targeted to families caring for a person with dementia or a related condition.
Who qualifies: Program targets unpaid care partners; local AAA assessment, service availability and funding rules apply.
How to start: Call the statewide ADRC and ask for caregiver respite.
Good to know: Family caregiver payment: No direct wage
National Family Caregiver Support Program (NFCSP)
Yes - respite/supportHelps pay for: Information, counseling, training, support groups and respite that can reduce unpaid caregiver burden and purchased-care needs.
Who qualifies: Target groups include caregivers of older adults, people with dementia, and certain older relative caregivers; local program rules apply.
How to start: Contact the local Area Agency on Aging through the ADRC.
Good to know: Family caregiver payment: No direct wage
Respite for ME
Yes - respiteHelps pay for: State-established caregiver respite program that can help eligible unpaid family caregivers obtain temporary relief services.
Who qualifies: Program is established in Maine law; current funding, award amount and service availability should be confirmed with the local AAA.
How to start: Ask the ADRC/local AAA about current Respite for ME availability.
Good to know: Family caregiver payment: No direct wage
Aging Network
Area Agencies on Aging / ADRC Services
Indirect / sometimesHelps pay for: No-wrong-door benefits counseling, caregiver support, nutrition, transportation referrals and local service coordination can reduce private-pay care costs.
Who qualifies: Availability varies by service, age, need, funding source and county. Maine has five Area Agencies on Aging.
How to start: Call the statewide ADRC for routing to the correct local AAA.
Good to know: Family caregiver payment: No
Home-Delivered Meals / Nutrition Programs
Indirect cost offsetHelps pay for: Meals and nutrition support can replace privately purchased meal preparation and provide regular safety contact for some older adults.
Who qualifies: Local AAA/provider criteria and funding availability apply; some services may request contributions.
How to start: Ask the local AAA about home-delivered meals and nutrition screening.
Good to know: Family caregiver payment: No
MaineCare State Plan
Section 40 Home Health Services
Yes - skilled/home healthHelps pay for: MaineCare home health can cover medically necessary skilled nursing, therapy and home health aide services when criteria are met.
Who qualifies: MaineCare eligibility, medical necessity, provider orders and Section 40 coverage rules.
How to start: Ask the treating provider and MaineCare whether Section 40 home health is appropriate.
Good to know: Family caregiver payment: No, except qualified parent-HHA pathway for eligible minors
Section 40 Qualified Parent Home Health Aide for Minor Child
YesHelps pay for: Eligible parents who become qualified/certified HHAs may provide reimbursable HHA services to certain MaineCare-enrolled minor children through a Section 40 provider.
Who qualifies: Child must qualify for covered HHA services; parent must meet HHA certification/qualification and provider requirements.
How to start: Ask the child's Section 40 home health provider about the parent-HHA pathway.
Good to know: Family caregiver payment: Yes - qualified parent can be reimbursed through the provider
Section 96 Private Duty Nursing & Personal Care Services
YesHelps pay for: Can cover private duty nursing and personal care services for eligible members with authorized needs.
Who qualifies: MaineCare eligibility, medical/functional criteria and service authorization. OADS reported a referral-management process due to limited care-coordination capacity as of March 31, 2026.
How to start: Ask MaineCare/OADS for Section 96 screening and service authorization.
Good to know: Family caregiver payment: Potentially only under specific program/worker rules; verify before assuming a relative can be paid
MaineCare Transportation
Section 113 Non-Emergency Transportation (NET)
No - cost offsetHelps pay for: Covers eligible non-emergency rides to MaineCare-covered medical services, reducing family transportation expense.
Who qualifies: Must be a MaineCare member and trip must meet NET rules; broker/region procedures apply.
How to start: Use the MaineCare NET broker/contact for the member's region.
Good to know: Family caregiver payment: No
MaineCare Cost Offset
Private Health Insurance Premium (PHIP)
No - premium offsetHelps pay for: Can pay a MaineCare member's share of qualifying work-based private health-insurance premiums when cost-effective.
Who qualifies: Must be a MaineCare member with qualifying private/employer coverage; MaineCare determines cost-effectiveness.
How to start: Complete the PHIP application or call Member Services.
Good to know: Family caregiver payment: No
MaineCare Eligibility
Medically Needy / Spenddown
PotentiallyHelps pay for: Allows some people over regular MaineCare income limits to qualify after meeting a medical-expense spenddown, which can unlock covered services.
Who qualifies: Must meet MaineCare medically needy rules and document countable medical expenses during the budget period.
How to start: Ask OFI whether a Spenddown category is available for the applicant.
Good to know: Family caregiver payment: Depends on the covered program used after eligibility
Children / MaineCare
Katie Beckett Option
PotentiallyHelps pay for: MaineCare pathway for certain children with serious disabilities/complex medical needs living at home even when parental income is too high for regular MaineCare.
Who qualifies: Child must be under 19 and meet disability, level-of-care and other Katie Beckett requirements; premiums may apply based on family income.
How to start: Apply through OFI and request Katie Beckett review.
Good to know: Family caregiver payment: May unlock covered parent-HHA and other home services if separately authorized
MaineCare / IDD
Section 21 Comprehensive Waiver
YesHelps pay for: Comprehensive HCBS for adults with intellectual disabilities or autism, including home support, community support, employment supports and other approved services.
Who qualifies: MaineCare and waiver eligibility; OADS reported 2,524 people on the Section 21 waitlist as of March 31, 2026, with Priority 1 receiving immediate offer.
How to start: Work with the case manager and submit/maintain the waiver application.
Good to know: Family caregiver payment: Possibly in approved provider arrangements; Section 21 is not the same as the Section 18/20/29 self-direction option
Section 21 Home Support / Shared Living
YesHelps pay for: Home support and shared-living models can substitute for substantial privately paid supervision and personal-support costs.
Who qualifies: Section 21 enrollment, assessment, person-centered plan and qualified provider arrangement.
How to start: Ask the case manager about home support and shared living.
Good to know: Family caregiver payment: May be possible depending on provider arrangement and relationship rules
Section 21 Respite / Assistive Technology
Yes - respite / indirectHelps pay for: Respite, assistive technology and related supports can reduce caregiver burden and improve independence at home.
Who qualifies: Section 21 enrollment and plan authorization; service-specific limits apply.
How to start: Request these supports through the person-centered planning process.
Good to know: Family caregiver payment: No direct wage
Section 29 Support Waiver
YesHelps pay for: HCBS support for eligible adults with intellectual disabilities or autism; includes home/community/work supports and other approved services.
Who qualifies: MaineCare and waiver eligibility. OADS reported a 15-person Section 29 waitlist as of March 31, 2026.
How to start: Apply through the case manager/waiver team and ask about current capacity.
Good to know: Family caregiver payment: Yes, for services available under self-direction when worker rules are met
MaineCare / Self-Direction
Section 29 Self-Directed Services
YesHelps pay for: Eligible Section 29 members can control who provides selected services, when and how, with support-broker/fiscal functions.
Who qualifies: Self-direction currently covers selected services such as Home Support (quarter hour), 1:1 Community Membership, IDGS, assistive technology and home accessibility adaptations.
How to start: Tell the case manager you want the self-directed option and complete enrollment.
Good to know: Family caregiver payment: Yes
Section 29 Paid Family / Friend Worker
YesHelps pay for: Under Maine OADS self-direction, participants can choose family members or friends as workers when requirements are met.
Who qualifies: Worker must pass required background checks and complete required training; verify any service-specific/legal-responsibility restrictions before hiring.
How to start: Name the proposed worker during the self-direction setup process.
Good to know: Family caregiver payment: Yes - family or friends may be selected
Section 20 Self-Directed Services
YesHelps pay for: Lets eligible Section 20 participants direct selected home/community services and choose workers.
Who qualifies: Selected services are eligible for self-direction; support-broker, fiscal and worker requirements apply.
How to start: Ask the case manager to enroll eligible services in self-direction.
Good to know: Family caregiver payment: Yes
Section 20 Paid Family / Friend Worker
YesHelps pay for: Participants using self-direction may select family members or friends as workers for eligible services.
Who qualifies: Background check, training, plan authorization and service-specific restrictions apply.
How to start: Identify the family/friend worker during self-direction setup.
Good to know: Family caregiver payment: Yes - family or friends may be selected
MaineCare / Section 29
Section 29 IDGS / Assistive Technology / Accessibility
Indirect / sometimesHelps pay for: Individual-directed goods and services, assistive technology and home-accessibility supports can reduce recurring supervision and safety costs.
Who qualifies: Only available when authorized and consistent with the waiver/self-direction service plan; limits apply.
How to start: Discuss needs with the case manager/support broker before purchase.
Good to know: Family caregiver payment: No
MaineCare / Brain Injury
Section 18 Brain Injury Waiver
YesHelps pay for: HCBS for eligible adults with acquired brain injury, supporting community living instead of institutional care.
Who qualifies: MaineCare, clinical/functional and waiver criteria. OADS reported 286 people on the Section 18 waitlist as of March 31, 2026.
How to start: Apply through OADS/waiver channels and maintain current waitlist contact information.
Good to know: Family caregiver payment: Yes, for selected self-directed services when worker rules are met
Section 18 Self-Directed Services
YesHelps pay for: Eligible Section 18 members can self-direct selected supports, increasing control over workers and schedules.
Who qualifies: Self-direction is available for selected services; participant/representative, support-broker and worker requirements apply.
How to start: Ask the case manager about switching eligible services to self-direction.
Good to know: Family caregiver payment: Yes
Section 18 Paid Family / Friend Worker
YesHelps pay for: Self-direction can allow a participant to choose a family member or friend as the worker for eligible services.
Who qualifies: Worker must meet background-check, training and service-specific requirements; confirm any legal-responsibility limits.
How to start: Identify the proposed worker through the self-direction process.
Good to know: Family caregiver payment: Yes - family or friends may be selected
Section 18 Assistive Technology / Home Accessibility
Indirect / sometimesHelps pay for: Approved technology and accessibility changes can support independence and reduce recurring hands-on assistance.
Who qualifies: Must be an eligible/authorized waiver service with documented need and applicable limits.
How to start: Request assessment and authorization before purchase or construction.
Good to know: Family caregiver payment: No
MaineCare / Other Related Conditions
Section 20 HCBS Waiver
YesHelps pay for: HCBS for adults with other related conditions who meet waiver criteria and need community supports.
Who qualifies: MaineCare and Section 20 clinical/functional criteria. OADS reported a 14-person waitlist as of March 31, 2026.
How to start: Apply through the waiver team/case manager and maintain current contact information.
Good to know: Family caregiver payment: Yes, for selected self-directed services when worker rules are met
MaineCare / Section 20
Section 20 Assistive Technology / Home Accessibility
Indirect / sometimesHelps pay for: Approved AT and home-accessibility adaptations can reduce care burden and support community living.
Who qualifies: Section 20 enrollment and authorization; service caps/documentation rules apply.
How to start: Request assessment and approval through the case manager.
Good to know: Family caregiver payment: No
MaineCare Community Services
Section 26 Day Health Services
Indirect / day supportHelps pay for: Structured day-health services can provide supervision, health monitoring and therapeutic support, reducing daytime home-care hours for eligible members.
Who qualifies: MaineCare eligibility and Section 26 medical/service criteria; provider availability applies.
How to start: Ask MaineCare/care manager about authorized Day Health Services.
Good to know: Family caregiver payment: No
MaineCare Residential Alternative
Section 2 Adult Family Care Services
No - residential alternativeHelps pay for: Small residential/family-care setting may be a lower-cost alternative when remaining in a private home with extensive paid care is no longer practical.
Who qualifies: MaineCare eligibility, assessment and Section 2 service requirements; this is not in-home care in the participant's own residence.
How to start: Discuss with the care manager only if a residential alternative is being considered.
Good to know: Family caregiver payment: No
Medicare Cost Offset
Medicare Savings Program - QMB
No - frees incomeHelps pay for: MaineCare Medicare Savings Program can pay Medicare Part A/Part B premiums and Medicare cost sharing for eligible QMB members.
Who qualifies: Maine law sets QMB income eligibility up to 185% of FPL and removes the asset test; other eligibility rules apply.
How to start: Apply through OFI/My Maine Connection and request MSP screening.
Good to know: Family caregiver payment: No
Medicare Savings Program - QI
No - frees incomeHelps pay for: Can pay Medicare Part B premiums for eligible people above the QMB band, freeing monthly income for care needs.
Who qualifies: Maine law covers QI above 185% through 250% of FPL, with no asset test; federal/state program rules apply.
How to start: Apply through OFI/My Maine Connection.
Good to know: Family caregiver payment: No
Medicare Part D Extra Help
No - frees incomeHelps pay for: Federal subsidy reduces Part D premiums, deductibles and prescription copays for eligible Medicare beneficiaries.
Who qualifies: Income/resource rules apply; some Medicaid/MSP beneficiaries qualify automatically.
How to start: Apply with Social Security or screen through SHIP/AAA benefits counseling.
Good to know: Family caregiver payment: No
Prescription Cost Offset
Drugs for the Elderly and Disabled (DEL)
No - drug cost offsetHelps pay for: Maine prescription-assistance benefit can reduce covered drug costs for qualifying older or disabled residents above regular MaineCare income limits.
Who qualifies: Generally age 62+ or disabled and meets DEL financial/program rules; current benefit can substantially discount covered prescriptions.
How to start: Ask OFI/MaineCare about DEL eligibility and enrollment.
Good to know: Family caregiver payment: No
Maine Rx Plus
No - drug cost offsetHelps pay for: Prescription discount program that can reduce retail drug prices, leaving more household income available for care.
Who qualifies: Eligibility/program rules apply; discount is not the same as insurance coverage.
How to start: Ask MaineCare/OFI or review current Maine Rx Plus enrollment information.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health
Yes - limited/skilledHelps pay for: Medicare can cover intermittent skilled nursing, therapy and home health aide care when home-health eligibility requirements are met.
Who qualifies: Must meet Medicare home-health criteria, including need for covered skilled care and homebound requirements where applicable; not 24/7 custodial care.
How to start: Ask the clinician for a Medicare-certified home health referral/order.
Good to know: Family caregiver payment: No
Medicare Caregiver Training Services
Indirect cost offsetHelps pay for: Medicare may cover caregiver training when needed to help a caregiver safely support a patient's treatment plan.
Who qualifies: Medicare coverage and clinical necessity rules apply; training must meet covered-service requirements.
How to start: Ask the treating clinician whether caregiver training can be billed to Medicare.
Good to know: Family caregiver payment: No wage; training benefit
Medicare Hospice Benefit
Yes - hospice/respiteHelps pay for: Hospice can cover interdisciplinary end-of-life care, equipment, medications related to the terminal illness and limited respite, reducing private-pay care costs.
Who qualifies: Medicare hospice eligibility requires terminal-illness certification and election of the hospice benefit.
How to start: Ask the physician or a Medicare-certified hospice for an eligibility evaluation.
Good to know: Family caregiver payment: No
Medicare Dementia Support
CMS GUIDE Dementia Care Model
Yes - respite in participating modelHelps pay for: Participating GUIDE practices can provide care coordination, caregiver education/support and respite benefits for eligible people with dementia.
Who qualifies: Must be aligned with a participating GUIDE dementia-care program and meet model eligibility; availability is provider-specific.
How to start: Use CMS GUIDE participant information or ask local dementia providers whether they participate.
Good to know: Family caregiver payment: No direct wage
Medicare Advantage
Medicare Advantage Supplemental Benefits
SometimesHelps pay for: Some MA plans offer in-home support, meals, transportation, caregiver or OTC benefits beyond Original Medicare.
Who qualifies: Benefits vary substantially by plan, county and year and may have clinical/eligibility limits.
How to start: Review the member's Evidence of Coverage before buying services privately.
Good to know: Family caregiver payment: Usually no
Caregiver Wage Replacement
Maine Paid Family and Medical Leave - Family Leave
No - replaces caregiver wagesHelps pay for: Provides partial wage replacement when an eligible worker takes covered leave to care for a family member with a serious health condition. Benefits began May 1, 2026.
Who qualifies: Up to 12 weeks of covered leave in a benefit year subject to program eligibility, leave reason and benefit rules; job-protection rules are separate.
How to start: Apply through the Maine Paid Leave/Aflac worker claims process.
Good to know: Family caregiver payment: Yes - wage replacement to the family caregiver, not payment for care hours
Tax Credit
Maine Adult Dependent Care Credit
Indirect cost offsetHelps pay for: State income-tax credit can offset qualifying adult day care, hospice or respite expenses that meet Maine rules.
Who qualifies: Credit equals a Maine-defined percentage of qualifying adult dependent-care expenses; expense caps and refundable-credit limits apply.
How to start: Claim on the Maine individual income-tax return with required documentation.
Good to know: Family caregiver payment: No
Tax / Housing Cost Offset
Maine Property Tax Fairness Credit
No - frees incomeHelps pay for: Refundable state income-tax credit can return a portion of property tax or rent paid by eligible Maine residents, freeing cash for care.
Who qualifies: Income, residency and property-tax/rent rules apply; older adults can qualify for a higher statutory maximum than younger filers.
How to start: Claim on the Maine individual income-tax return.
Good to know: Family caregiver payment: No
Housing Cost Offset
State Property Tax Deferral Program
No - frees incomeHelps pay for: For eligible older or permanently disabled homeowners, the state can pay/defers property taxes, preserving cash flow for living and care expenses.
Who qualifies: Eligibility includes age/disability, income/assets and homestead requirements; deferred tax, interest and costs become a lien and must later be repaid. The 2026 filing window ended April 1.
How to start: Plan for the next annual application window through the local municipal assessor.
Good to know: Family caregiver payment: No
Municipal Property Tax Relief / Deferral
No - frees incomeHelps pay for: Some municipalities may offer locally adopted senior/property-tax assistance or deferral that reduces annual housing-cost pressure.
Who qualifies: Availability and rules vary by municipality; Maine law allows local programs and municipalities may set qualifying criteria within statutory authority.
How to start: Ask the municipal assessor which local relief programs are currently active.
Good to know: Family caregiver payment: No
Food Cost Offset
SNAP / Food Supplement
No - frees incomeHelps pay for: Monthly food benefits can reduce grocery spending and preserve household cash for home-care expenses.
Who qualifies: Household income, deductions and other SNAP rules apply; older/disabled households may have advantageous medical-expense deductions.
How to start: Apply through My Maine Connection/OFI.
Good to know: Family caregiver payment: No
Energy Cost Offset
Home Energy Assistance Program (HEAP)
No - frees incomeHelps pay for: Helps eligible homeowners and renters pay heating costs; can also connect eligible households with related energy supports.
Who qualifies: Eligibility depends on household income/size and program rules. Applications for the 2026-2027 heating season opened August 3, 2026.
How to start: Apply through MaineHousing/local Community Action Agency as early as possible.
Good to know: Family caregiver payment: No
Home Cost Offset
MaineHousing Weatherization Program
No - frees incomeHelps pay for: Grants can improve home energy efficiency, lowering recurring utility costs and sometimes addressing related health/safety issues.
Who qualifies: Income and housing eligibility apply; HEAP applicants are automatically considered for Weatherization and related assistance.
How to start: Apply for HEAP/Weatherization through MaineHousing/local CAA.
Good to know: Family caregiver payment: No
Private Insurance
Long-Term Care Insurance
Yes, if policy covers itHelps pay for: Existing LTC insurance may reimburse eligible home-care, personal-care, respite or care-management expenses under the policy.
Who qualifies: Benefit triggers, elimination periods, daily/monthly caps, inflation riders and covered-provider rules are policy-specific.
How to start: Request the policy's home-care benefit schedule and start a claim before services accumulate.
Good to know: Family caregiver payment: Depends on policy and assignment/payment terms
Home Equity
FHA Home Equity Conversion Mortgage (HECM)
Yes - private-pay cashHelps pay for: Eligible homeowners can convert home equity to cash that may be used for private-pay home care and other living expenses.
Who qualifies: Generally homeowner age 62+, eligible property, counseling and FHA loan requirements; loan balance grows and repayment events apply.
How to start: Compare HECM with alternatives and complete HUD-approved counseling before proceeding.
Good to know: Family caregiver payment: Can pay any chosen caregiver subject to personal/legal arrangements
Veterans
Veteran-Directed Care (VDC)
YesHelps pay for: Flexible VA self-directed budget may let an eligible Veteran arrange personal care and choose workers to remain at home.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local VDC availability. Maine is in VA CCN Region 1, administered by Optum Serve.
How to start: Ask the VA Maine care team/social worker whether VDC is locally available.
Good to know: Family caregiver payment: Yes, subject to program rules
VA Pension - Aid & Attendance / Housebound
Yes - cash can offset careHelps pay for: Additional monthly VA pension amount can increase cash available for eligible Veterans or survivors who need personal assistance or are substantially confined.
Who qualifies: Must first qualify for VA Pension or Survivors Pension and meet Aid & Attendance or Housebound criteria.
How to start: Apply to VA with medical/functional evidence and care-expense documentation as applicable.
Good to know: Family caregiver payment: Can indirectly support family-provided care expenses
Veterans / Caregiver
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Indirect / caregiver stipendHelps pay for: For eligible Veterans with qualifying service-connected disability and care needs, PCAFC may provide caregiver training, support and a monthly stipend to a designated Primary Family Caregiver.
Who qualifies: Detailed Veteran and caregiver eligibility, assessment and program participation requirements apply.
How to start: Contact VA Maine Caregiver Support or apply through VA caregiver programs.
Good to know: Family caregiver payment: Yes - monthly stipend for eligible Primary Family Caregiver
VA Benefits
VA Homemaker & Home Health Aide
YesHelps pay for: VA may authorize community-based aides to help an eligible Veteran with ADLs and selected daily tasks at home.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply. Ask VA primary care/social work for assessment and authorization.
How to start: Ask the VA social worker or care team about VA Homemaker & Home Health Aide.
Good to know: Family caregiver payment: No
Veteran-Directed Care
YesHelps pay for: Flexible self-directed budget for eligible Veterans needing personal care; participant can choose workers and services.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local VDC availability. Ask the VA care team whether VDC is available in the Veteran's Maine service area.
How to start: Ask the VA social worker or care team about Veteran-Directed Care.
Good to know: Family caregiver payment: Yes
VA Skilled Home Health
Yes - skilled careHelps pay for: VA may purchase skilled nursing, therapy and related home-health services from authorized community providers.
Who qualifies: Clinical need, VA eligibility/authorization and provider availability. Request through the VA care team.
How to start: Ask the VA social worker or care team about VA Skilled Home Health.
Good to know: Family caregiver payment: No
VA Respite Care
Yes - respiteHelps pay for: VA may provide in-home, adult-day or facility respite to give caregivers a break.
Who qualifies: VA enrollment, clinical need and local availability/authorization. Ask VA social work/caregiver support about respite.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No direct wage
VA Home Based Primary Care (HBPC)
Yes - clinical home careHelps pay for: Interdisciplinary VA primary care delivered in the home for Veterans with complex chronic conditions who have difficulty using clinic-based care.
Who qualifies: VA clinical eligibility and local HBPC availability. Ask the Veteran's VA primary care team for HBPC screening.
How to start: Ask the VA social worker or care team about VA Home Based Primary Care (HBPC).
Good to know: Family caregiver payment: No
VA Adult Day Health Care
Indirect / day careHelps pay for: Structured daytime health, rehabilitation and social services can reduce caregiver supervision hours and support community living.
Who qualifies: VA clinical eligibility, authorization and local/community availability. Ask VA social work about Adult Day Health Care options.
How to start: Ask the VA social worker or care team about VA Adult Day Health Care.
Good to know: Family caregiver payment: No
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Indirect / stipendHelps pay for: May provide training, enhanced support and a monthly stipend to an approved Primary Family Caregiver of an eligible Veteran.
Who qualifies: Veteran/caregiver must meet PCAFC eligibility, assessment and participation requirements. Apply through VA caregiver programs or contact the local Caregiver Support Team.
How to start: Ask the VA social worker or care team about Program of Comprehensive Assistance for Family Caregivers (PCAFC).
Good to know: Family caregiver payment: Yes
Program of General Caregiver Support Services (PGCSS)
Indirect supportHelps pay for: Coaching, education, peer support and resources for caregivers of enrolled Veterans; no requirement for a service-connected disability.
Who qualifies: Caregiver supports a Veteran enrolled in VA health care; program rules apply. Contact the VA Caregiver Support Line or Maine Caregiver Support Team.
How to start: Ask the VA social worker or care team about Program of General Caregiver Support Services (PGCSS).
Good to know: Family caregiver payment: No stipend
VA Pension - Aid & Attendance
Yes - cash offsetHelps pay for: Additional monthly pension amount for eligible Veterans/survivors who need help with daily activities or meet other A&A criteria.
Who qualifies: Must be eligible for VA Pension/Survivors Pension and meet A&A criteria; income/net-worth rules apply. File a pension/A&A claim with supporting medical and care-expense evidence.
How to start: Ask the VA social worker or care team about VA Pension - Aid & Attendance.
Good to know: Family caregiver payment: Indirectly
VA Pension - Housebound
Yes - cash offsetHelps pay for: Additional pension amount for eligible pension recipients who are substantially confined to home due to permanent disability.
Who qualifies: Must qualify for VA Pension and meet Housebound criteria; cannot receive A&A and Housebound at the same time. Apply with VA and submit medical evidence.
How to start: Ask the VA social worker or care team about VA Pension - Housebound.
Good to know: Family caregiver payment: Indirectly
VA Medical Foster Home
No - residential alternativeHelps pay for: Private-home residential arrangement with 24-hour supervision, coordinated with VA Home Based Primary Care; alternative to institutional care for some Veterans.
Who qualifies: Clinical eligibility, local program availability, approved home and private-pay room/board arrangement; VA may cover associated HBPC services. Ask VA Maine social work/HBPC if Medical Foster Home is locally available.
How to start: Ask the VA social worker or care team about VA Medical Foster Home.
Good to know: Family caregiver payment: No
VA Community Care Network - Region 1
Yes - when authorizedHelps pay for: Network access for authorized community care when VA eligibility and referral/authorization rules are met. Maine is in Region 1, administered by Optum Serve.
Who qualifies: Community care requires VA eligibility/authorization; network participation does not by itself create a benefit entitlement. Start with the VA care team before arranging non-VA care.
How to start: Ask the VA social worker or care team about VA Community Care Network - Region 1.
Good to know: Family caregiver payment: No
Where Maine Families Can Start
Not sure where to begin? Match your situation to a contact below.
No-wrong-door screening for aging/disability services, local AAA programs, caregiver support and home-care options
Maine Aging and Disability Resource Center (ADRC)
Functional assessment for Maine long-term services and supports/home-care programs
Maine Assessing Services Agency (Maximus)
MaineCare, SNAP, Medicare Savings Program, Spenddown and benefit applications/eligibility questions
Office for Family Independence (OFI)
Coverage questions, Section 96/40 navigation, PHIP and member benefit questions
MaineCare Member Services
Section 18, 20, 21 and 29 waiver application/status questions
OADS HCBS Waiver Team
Section 69 homemaker/independent support service access and referrals
Catholic Charities Maine - Independent Support Services
Free health-coverage navigation and MaineCare/Medicare affordability help
Consumers for Affordable Health Care
HEAP, Weatherization and related home-energy assistance
MaineHousing / Community Action Agencies
Family-care leave benefit claims and worker program information
Maine Paid Family and Medical Leave
Property Tax Fairness Credit, adult dependent-care credit and property-tax relief questions
Maine Revenue Services
Local VA caregiver programs, respite, PCAFC/PGCSS navigation
VA Maine Caregiver Support Team - Togus
National caregiver support, program navigation and connection to local VA caregiver teams
VA Caregiver Support Line
Before You Rely on Any Payment Source
Planning Point
Why It Matters
Section 19 had no reported waitlist as of March 31, 2026
OADS access measures reported 3,718 Section 19 participants and zero people on the waitlist at that snapshot. Capacity can change, so families should still complete eligibility and assessment promptly.
Sections 63 and 69 have substantial state-funded waitlists
As of March 31, 2026, OADS reported 1,204 people waiting for Section 63 and 1,405 for Section 69. Apply early and build a bridge plan rather than assuming these services can start immediately.
Section 21 has a large waitlist and uses priority rules
OADS reported 2,524 people waiting for Section 21 as of March 31, 2026. Priority 1 receives an immediate offer, so changes in health/safety risk should be documented and reported to the case manager.
Sections 18 and 20 also have waitlists
OADS reported 286 people waiting for Section 18 and 14 for Section 20 as of March 31, 2026. Keep contact information and clinical documentation current while waiting.
Section 29 capacity was much tighter but not unlimited
OADS reported 15 people waiting for Section 29 as of March 31, 2026. Do not treat the small waitlist as a guarantee of immediate enrollment.
Self-direction is specifically available in Sections 18, 20 and 29
Maine OADS currently identifies self-directed services in these three waivers. It states participants can choose family or friends as workers if background-check and training requirements are met; confirm service-specific restrictions before hiring.
Section 12 is a separate consumer-directed pathway
Do not confuse Section 12 Consumer Directed Attendant Services with waiver self-direction under Sections 18, 20 and 29. Eligibility, services and worker rules are program-specific.
Qualified-parent HHA payment is a narrow Section 40 pathway
A parent of an eligible minor child may be reimbursed for covered HHA services only when the parent satisfies certification/qualification requirements and works through a Section 40 home-health provider.
Maine Paid Leave is now a current caregiver wage-replacement option
Benefits began May 1, 2026. PFML replaces part of an eligible worker's wages during covered family leave; it does not reimburse home-care invoices or convert all unpaid caregiving into paid employment.
OADS paused new provider applications for Sections 18, 20, 21 and 29
Effective April 13, 2026, OADS temporarily paused initial applications from entities seeking approval as waiver providers in these sections. This is a provider-network constraint, not a cancellation of member waiver eligibility.
The HCBS Lifespan Waiver is still a future/reform item
Maine is developing the Lifespan Waiver, but it should not be counted as a currently enrollable home-care funding pathway until the state announces implementation and enrollment details.
VA community care must be authorized first
Maine is in VA CCN Region 1, administered by Optum Serve. Being near an in-network home-care provider does not itself guarantee VA payment; the Veteran generally needs VA eligibility, clinical need and authorization/referral.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in Maine to help you navigate the application process.
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