Assisted Living in Maine
By, Blake Lopez (SeniorHousingNet.com)
Covering the northeastern portion of the country, Maine is called home by over 1.36 million people, 21.2% of whom are seniors over the age of 65. That’s about a 28.5% higher density of seniors than most of the country. Throughout the state, older adults are spending an average of around 5.5% more for health care services than most Americans, but at $5,865 a month, Maine’s seniors are paying over 30% above the national average for assisted living.
Fortunately, different government agencies and nonprofits are offering seniors assistance with obtaining subsidized health care and learning how to evaluate long-term care facilities. Some organizations also offer free programs designed to help seniors maintain their physical and mental well-being throughout retirement.
This guide covers the cost of assisted living in Maine and how it’s covered by the state’s Medicaid program. In the end, we’ve included details about various low-cost assistance programs Maine’s seniors may find helpful while they consider their move to assisted living.
How Much Does Assisted Living Cost in Maine?
According to the 2021 Genworth Cost of Care Survey, the median monthly cost of assisted living in Maine is $5,865, which is $1,365 above the national average. In nearby New Hampshire, seniors pay about $188 more each month for assisted living than seniors in Maine, and in Massachusetts, the median cost of care is $635 higher. Among the nearby states, Vermont’s average cost of assisted living is the most affordable. Its seniors generally save about $615 a month compared to what most older adults in Maine’s assisted living communities pay for their care.
The Cost of Assisted Living Vs. Other Types of Care
For a month of homemaker services or care from a home health aide, Maine’s seniors will spend about the same amount, $5,720, which is just $145 less than a month of assisted living. Adult day care is less than half the cost of assisted living, making it the most affordable type of senior care, while nursing home care is the state’s most costly. On average, a month of care with semiprivate accommodations in a nursing home costs $4,629 more per month than care at an assisted living facility.
Can You Use Medicaid to Pay for Assisted Living in Maine?
Maine’s Medicaid program, MaineCare, pays for assisted living directly under its Residential Care Services program. To qualify for this benefit, seniors must demonstrate medical necessity in addition to meeting Medicaid’s financial requirements.
Being one of the state’s nine assisted housing programs, assisted living is similar to the state’s Residential Care Facilities and Private Non-Medical Institutions. Assisted living’s larger resident capacity and more comprehensive staffing requirements are among the most noticeable differences between the different types of care.
Medicaid’s Coverage of Assisted Living in Maine
Maine divides its assisted living communities into two categories: Type I and Type II. The main difference is that the second type also provides nursing services through a licensed nurse, either on staff or contracted. However, both types provide a range of services covered by the state’s Medicaid program:
- Personal care services, such as assistance with bathing, dressing and grooming
- Medication assistance, including reading labels and checking dosages
Since the state’s assisted living communities are required to complete care plans for their residents, the specific assistance seniors receive will be personalized to their needs and recommendations by their primary care physician.
Eligibility for Medicaid in Maine
Because MaineCare is intended to assist seniors who need financial assistance the most, the program limits who can participate based on their income and assets. For a single senior, as part of a one- or two-person household, their income must be below $13,596 a year to qualify, and their assets must be below $2,000. The asset limit for an older couple applying together increases by $1,000, and the annual income limit is raised to $18,312.
2022 Medicaid Income Limits for Seniors in Maine
(Only One Person Applying)
(Both People Applying)
In addition to meeting financial guidelines, qualifying for MainCare’s Residential Care Services program requires that seniors:
- Be at least 65 years of age
- Need long-term care services, as demonstrated by their functional assessment
- Be a current Maine resident, national citizen or have legal residency
- Complete a face-to-face assessment, if requested
Applying for Medicaid in Maine
Seniors can apply for MaineCare online through My Maine Connection or they can download and print a Long Term Care MainCare application and send it by mail. The physical application can also be delivered in person at a nearby Department of Health and Human Services office.
Before You Apply
For the quickest application processing, seniors should make sure they have some key information ready. If applicable, they should gather:
- Proof of all income sources and amounts, excluding Social Security
- Documentation showing values of all properties that aren’t the primary residence
- Copies of life insurance policies and health insurance cards, including Medicare
- Statement of contents of any safety deposit boxes and current statements for investment, savings and checking accounts.
- Copies of any Power of Attorney or Conservator documents
Where to Go to Get Help
The following resources can help seniors learn about and apply for Medicaid as well as assist those who are currently enrolled with information about their coverage and benefits.
|MaineCare Member Services
|Seniors already enrolled in MainCare can reach out to its Member Services department to get answers to their questions about pre-approved physicians and prescription drugs.
|Maine State Health Insurance Assistance Program
|Through S.H.I.P., Maine’s seniors can receive over the phone and in-person assistance learning about Medicaid and its long-term care coverage. All counseling is free and confidential.
|Aging & Disability Resource Centers
|Local A.D.R.C.s are an invaluable resource for seniors who need help applying for Medicaid and understanding its coverage. Workers at the agency can help seniors understand the differences in coverage between Medicaid and Medicare and answer questions they may have about eligibility.
Can You Use Medicare to Pay for Assisted Living in Maine?
Unfortunately, Medicare does not cover the cost of assisted living in Maine. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.
For more information about Medicare visit medicare.gov.
Are There Other Financial Assistance Options for Assisted Living in Maine?
|How to Apply
|How It Works
|Aid and Attendance
|Apply online at va.gov.
|If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
|Research and learn about the different types at ftc.gov
|If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
|Long-Term Care (LTC) Insurance
|Learn about how to receive LTC insurance benefits at acl.gov.
|While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.
Free and Low-Cost Resources for Seniors in Maine
The resources listed below can assist Maine’s seniors in finding and paying for an assisted living community that meets their needs. Some of the programs are aimed at seniors who still live at home, while others are focused on improving seniors’ overall well-being throughout retirement.
|Long-Term Care Ombudsman Program
|The Long-Term Care Ombudsman Program educates seniors about their rights and investigates complaints about their care. Complaints can also be filed by seniors’ loved ones. All the program’s services are free, including assisting seniors with care financing options and helping them appeal service denials.
|Area Agencies on Aging
|There are five Area Agencies on Aging in Maine serving as comprehensive information hubs where older adults and their families can find unbiased counseling navigating long-term care options. Workers at the AAAs are knowledgeable about assisted living services covered by Medicaid as well as in-home care and home-delivered meals, which could help some seniors save money and receive needed assistance until they can move into assisted living.
|Retired and Senior Volunteer Program
|The R.S.V.P. is an Americorps program offering Maine’s older adults opportunities to use their lifelong experiences and wisdom to improve their local communities. Program managers match volunteers with roles aligned with their skill sets and preferences. Most of the R.S.V.P. chapters provide some expense reimbursement and insurance while volunteering.
|Legal Services for The Elderly
|Legal Services for The Elderly is a nonprofit focused on helping seniors resolve legal matters involving subjects ranging from health care and retirement benefits to physical and financial abuse. The group has offices in five cities, but its services are available for free throughout the entire state.
|Senior Community Service Employment Program
|Through the SCSEP, Maine’s seniors can get paid to learn new skills while preparing themselves to re-enter the workforce and compete against other job seekers. Program participants work part-time at local government and nonprofit organizations and get paid a minimum wage. To qualify, seniors must be at least 55 years of age and have an income within 125% of the federal poverty level.
COVID-19 Rules for Assisted Living in Maine
The following information is based on research done on several government websites, including maine.gov and cdc.gov/coronavirus. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/8/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.
Visiting Loved Ones
|Can I visit my relative in person if he/she wants emotional support from me?
|Yes (Conditions Apply)
|Can I visit my relative in person for end-of-life compassion care?
|Will my loved one be required to self-quarantine after I visit him or her?
|Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?
|Are Hairdressers and other non-medical contractors still allowed in senior living facilities?
|Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?
|Are visitors being screened for elevated temperatures?
|Are visitors being asked questions about health, travel, and potential virus contact?
Outings and Group Activities
|Are residents allowed to leave the facility for non-medical reasons?
|Are residents of senior living facilities who leave and return required to self-quarantine?
|No (Conditions Apply)
|Are senior living facilities required to cancel all group outings?
|Are residents still eating together in the dining hall?
|Yes (Conditions Apply)
|Are facilities still allowed to host group activities within the community?
|Yes (Conditions Apply)
Safety Measures for Staff & Contractors
|Are staff members and contractors being screened for elevated temperatures?
|Are staff members and contractors being tested for Coronavirus?
|Yes (Conditions Apply)
|Are staff members and contractors being asked questions about health, travel, and potential virus contact?
Safety Measures for Residents
|Are staff members required to regularly screen residents for coronavirus symptoms?
|Are residents relied on to screen themselves and self-report potential coronavirus symptoms?
|Are staff members required to take residents’ temperatures?
|Are residents being tested for coronavirus?
|Yes (Conditions Apply)
Assisted Living Laws and Regulations in Maine
Maine’s Department of Health and Human Services is the agency responsible for regulating the state’s assisted living communities and other long-term care facilities. Altogether, the department oversees nine different types of facilities that fall under the umbrella term of assisted housing.