Maine Medicaid Waivers & Home and Community Based Programs Overview

Maine, known as The Pine Tree State, has a well-developed Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.

Administered by the Maine Department of Health and Human Services (DHHS), Office of MaineCare Services (OMS), and the Office of Aging and Disability Services (OADS), the state’s Medicaid waiver programs allow participants to receive services in their homes or community settings rather than institutional care.

Key waiver programs include the Section 19 Elderly and Adults with Disabilities (EAD) Waiver, which provides personal care, home modifications, and assistive technology for seniors and adults with physical disabilities, and the Section 21 Home and Community Benefits for Members with Intellectual Disabilities or Autism Waiver, which offers residential, habilitative, and employment support services. Additional programs include the Section 29 Support Waiver for Adults with Intellectual Disabilities or Autism, the Brain Injury (BI) Waiver, and the Children’s Home and Community-Based Treatment (HCT) Waiver, all designed to provide specialized, person-centered services. Maine also offers Self-Direction options, allowing waiver participants to hire and manage their own caregivers.

Regulatory oversight in Maine is managed through DHHS, OMS, and OADS, with additional licensing and compliance enforcement by the Division of Licensing and Certification (DLC). The state operates under both a fee-for-service and managed care model, with MaineCare coordinating Medicaid waiver services to ensure cost-effective and high-quality service delivery. Maine has implemented Electronic Visit Verification (EVV) for personal care services, ensuring compliance and accountability in home-based care programs.

Providers must navigate Medicaid provider enrollment, strict prior authorization processes, and rigorous regulatory requirements to participate in the state’s HCBS system successfully. With a strong focus on rural healthcare access, person-centered planning, and community integration, Maine’s Medicaid waiver programs ensure that individuals receive high-quality, community-based supports while maintaining independence, dignity, and active participation in their communities.

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Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.

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