Most supports and services that will help you stay in your home are available on a fee-for-service. If you can pay for them, you just need to find the right service in your area. If you can't pay, you may qualify for state-funded or MaineCare covered services. Contact the ADRC to determine eligiblity for subsidized home care services at 1-877-353-3771..
If you need to move to senior housing and can't pay the full amount, some rental assistance is available through MaineHousing.
Nursing Home Eligibility
MaineCare, Medicare and other insurance (under certain conditions) may cover some or all of the costs of nursing facility care. A long-term care assessment is required for all individuals seeking admission to a nursing facility for long term care. The free assessment is completed by a nurse from a state-authorized agency.
In order to qualify for nursing home coverage under MaineCare, an individual has to meet both the financial and medical guidelines established by the Department of Health and Human Services. After applying for MaineCare benefits, a long term care assessment will be completed to evaluate the individual's medical needs.
The income and asset limits for MaineCare's nursing home benefits are much higher than for the program's other benefits. The individual's monthly income must be less than the nursing home's "private pay rate," (the cost for a month of care). If the person is married, DHHS does not count the spouse's income when deciding if the applicant qualifies for benefits. Even if the individual qualifies for MaineCare, they will have to pay most of their income towards the cost of their care. They are allowed to keep a "personal needs allowance" each month.
Sometimes people who have too many assets to qualify for MaineCare give away their money or property in order to qualify. This could make them ineligible for MaineCare. An individual should always seek the advice of an attorney who is knowledgeable about MaineCare and "elder law" before giving away or transferring any assets.
MaineCare rules protect a person’s spouse from impoverishment, if he or she is not also receiving MaineCare benefits. The rule allows the spouse to keep enough income and assets to meet basic living expenses. The spouse can keep all of his or her own income.
Long Term Care Assessments
Anyone applying for long-term care services in a nursing home or is requesting state-funded services at home is required to have a long-term care assessment. Goold Health Systems is the agency to contact for this free assessment. Goold employs nurses to meet with the consumer to assess his or her needs (physical, medical, emotional, financial, etc.) The assessment is a tool to determine the consumer’s eligibility for state-funded services in-home or entry into a nursing home.
Please inform the nurse assessor of all the consumer’s needs and concerns to best determine eligibility and type of care the person needs. Identify any difficulties the person may have managing the household, finances, healthcare, and/or personal care. Be thorough and complete.
Having afamily member and/or caregiver present during the assessment can help to ensure the individual receives appropriate services based on an accurate assessment of his or her abilities and needs.
Contact Goold Health Systems at 1-800-609-7893 or the ADRC for more information at 1-877-353-3771.