What is MaineCare?

MaineCare, the state of Maine’s Medicaid program, helps those with limited resources obtain healthcare. MaineCare is a federal/state program for those who meet the income, asset, age and family requirements. There are certain MaineCare services (nursing home care and in-home services to name two) which require the applicant to be medically and financially eligible.

To determine eligibility for these services, the Office of Aging and Disability Services handles the medical qualifications, while the Office of Family Independence handles the financial qualifications.

MaineCare and Long-Term Care

Many elderly people may one day need to move to a long-term care facility, and because few people have the necessary resources to pay for such a move, it is extremely important to plan carefully for such an event.

An experienced Maine estate planning attorney can help families plan so that MaineCare will be accountable for the cost for long-term care when the day comes. It is important to note that this does take some careful planning. The Department of Health and Human Services (DHHS) will review the 60 months prior to an application for MaineCare long-term care services to ensure neither the applicant nor his or her spouse gave away anything of value (without receiving something of equal value in return).

If DHHS finds that valuable assets were transferred to family members or other individuals within that 60 month lookback period, there could be penalties involved. The penalties are typically based on the value of the asset transferred and result in a specific number of months that MaineCare will not pay for long-term care expenses.

Eligibility for MaineCare Long-Term Care

To be eligible for MaineCare long-term care, the applicant must be a Maine resident and a citizen of the United States (or have proper immigration status). The applicant must be 65 or older, disabled or blind, and must meet the medical requirements associated with the requested level of care. A form known as the MED (Medical Eligibility Determination) is used for those applying for long-term care services.

The applicant must meet strict asset and income requirements in order to qualify for MaineCare benefits. The applicant’s assets are divided into Available vs. Exempt assets. Any asset not specifically listed as exempt must be liquidated and applied toward long-term care costs. Applicants are allowed to own one home with a limited equity value, but only if the applicant plans to return to the home within six months, or if a spouse, a disabled person or a child under the age of 21 currently resides in the house. Applicants may retain $10,000 or less in cash or non-exempt assets if single, as well as household goods and personal effects, and one motor vehicle, no matter the total value, so long as the vehicle is used for the long-term care applicant’s medical treatment or is the primary vehicle of the spouse. Some annuities are considered exempt, and burial spaces as well as pre-paid burial trusts up to $12,000 are also considered exempt.

What are the Advantages of Long-Term Care Planning?

Unfortunately, the statistics related to long-term care are rather dismal. According to caregiver.org, 8,357,100 people per year receive care from home health agencies, nursing homes, hospice care, residential care communities and adult day service centers. The majority of those needing long-term care are elderly—about 63 percent are 65 years old or older.

The lifetime probability of either being cognitively impaired or unable to complete at least two activities related to day-to-day living is 68 percent for those over the age of 65. At least one-fifth of older people will end up spending more than $25,000 in out-of-pocket long-term costs prior to their death. Because many seniors are unable to afford lifetime long-term care insurance coverage, Medicaid (MaineCare) could be their only option. With a knowledgeable, compassionate MaineCare attorney by your side to help, the process can be greatly simplified, with a much better final outcome.

How Can We Help?

Hodgkins Law can help those who want to plan for long-term care. We are the only estate planning firm in the area providing regular educational seminars focused on estate planning issues. We feel that educating our clients allows them to more fully understand the often complex issues associated with an estate plan and with long-term care planning in particular. We also understand that our clients in Maine can feel some anxiety about the estate planning process, and we want to put you at ease with our warm, welcoming atmosphere. For compassionate expertise in estate planning, and long-term care planning in particular, contact Hodgkins Law today.

Read What Clients Have to Say