Maine offers health coverage, long-term care, and financial support for people with spinal cord injuries through MaineCare, Medicaid waivers, SSI, and other programs. Eligibility depends on income, assets, and disability status.
People with spinal cord injuries may qualify for federal benefits like Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). SSI is for those with limited income and resources, while SSDI is for those who have worked and paid into Social Security. Both programs use the Social Security Administration’s definition of disability, which includes spinal cord injuries that prevent substantial gainful activity. SSI recipients automatically qualify for Medicaid in Maine. SSDI recipients may also qualify for Medicare after a waiting period.
Federal law sets the standards for disability, but states manage Medicaid eligibility and benefits. Maine uses the SSA’s definition for disability, so if you qualify for SSI or SSDI, you likely meet Maine’s disability criteria for MaineCare.
In Maine, people with spinal cord injuries can qualify for MaineCare (Maine’s Medicaid program) if they meet income and asset limits and have a disabling condition as defined by the Social Security Administration. Those who receive SSI are automatically eligible for MaineCare. Others may qualify if they have a spinal cord injury that meets SSA standards.
MaineCare covers essential health services, including doctor visits, prescriptions, mental health, and long-term care. People with spinal cord injuries may also qualify for Medicaid waivers that provide personal care, home modifications, and other supports.
Step 1: Confirm your disability status. If you receive SSI or SSDI, you are automatically eligible for MaineCare. If not, you may need a MaineCare Disability Determination request to prove your spinal cord injury meets SSA standards.
Step 2: Gather documents. You’ll need proof of income (pay stubs, tax returns), assets (bank statements), and disability (medical records, SSI/SSDI award letter).
Step 3: Apply online at MyMaineConnection.gov or in person at a Department of Health and Human Services office.
Step 4: If you need home or community-based services, ask about Medicaid waivers during your application or contact the Office of Aging and Disability Services.
Step 5: Wait for a decision. You may be asked for more information. If denied, you can appeal.
Step 6: If eligible, you’ll get a MaineCare card and information about covered services.
Step 7: Report changes in income, assets, or disability status to avoid overpayments.
Apply for MaineCare (accessed 2025-11-06)
MaineCare Member Handbook (accessed 2025-11-06)
Supplemental Security Income (SSI): Monthly cash payments for people with disabilities and limited income/resources. SSI recipients automatically qualify for MaineCare.
Social Security Disability Insurance (SSDI): Monthly payments for those who have worked and paid into Social Security. SSDI recipients may qualify for Medicare after a 24-month waiting period.
Medicaid: Federal-state program for low-income people with disabilities. In Maine, it’s called MaineCare.
Medicare: Federal health insurance for people with disabilities after a waiting period.
Social Security Administration: SSI (accessed 2025-11-06)
Social Security Administration: SSDI (accessed 2025-11-06)
Medicaid.gov (accessed 2025-11-06)
Medicare.gov (accessed 2025-11-06)
MaineCare (Maine Medicaid): Provides free or low-cost health coverage for people with spinal cord injuries who meet income and asset limits. Covers doctor visits, prescriptions, mental health, and long-term care.
Medicaid Waivers (HCBS): Programs that help people with spinal cord injuries live at home or in the community. Services may include personal care, home modifications, and respite care.
Medically Needy Program: For those over income or asset limits, a deductible may apply. Once met, you get full MaineCare coverage for the rest of the period.
Long-Term Care Medicaid: For those who need nursing home care or home-based services. Income and asset limits apply.
MaineCare Eligibility Guidelines 2023 (accessed 2025-11-06)
Maine.gov: Older Adults and Adults with Disabilities (accessed 2025-11-06)
ABLE accounts let people with disabilities save money without losing SSI or MaineCare benefits. In Maine, you can open an ABLE account to pay for qualified disability expenses like medical care, education, and housing. Contributions are tax-free, and withdrawals for qualified expenses are not taxed. ABLE accounts do not count toward MaineCare asset limits.
MaineCare income limits for people with spinal cord injuries:
| Category | FPL | Individual | Couple | |---|---|---|---| | Aged/Disabled | 100% | $1,215 | $1,644 | | Working with Disability | 250% | $3,038 | $4,109 |
Asset limits:
Aged/Disabled: $2,000 individual, $3,000 couple
Working with Disability: $8,000 individual, $12,000 couple
MaineCare Eligibility Guidelines 2023 (accessed 2025-11-06)
If your income, assets, or disability status changes, you must report it to MaineCare. Not reporting changes can lead to overpayments and penalties. If you get an overpayment notice, you can appeal or set up a payment plan. Always keep records of your reports and communications with MaineCare.
Call (800) 965-7476 for free, local help from Consumers for Affordable Health Care. They can help you with your MaineCare application and answer questions about eligibility.
If you receive SSI, you automatically qualify for MaineCare. If not, you must meet Maine’s income and asset limits and prove your spinal cord injury meets SSA disability standards. You can apply online or get help from local agencies.
MaineCare covers doctor visits, prescriptions, mental health, substance use treatment, surgery, emergency care, and long-term care. It may also cover home and community-based services through Medicaid waivers.
Yes, if you are under 65 and have a disabling condition, you can earn up to 250% of the Federal Poverty Level and still qualify for MaineCare. Asset limits are higher for those working with a disability.
Medicaid waivers help people with spinal cord injuries live at home or in the community. They provide services like personal care, home modifications, and respite care. Eligibility depends on medical need and financial criteria.
You can apply online at MyMaineConnection.gov or in person at a Department of Health and Human Services office. You’ll need proof of income, assets, and disability. Call (800) 965-7476 for help.
If your income is over the limit, you may qualify for the Medically Needy Program. You’ll have a deductible to meet before MaineCare covers your services. Once met, you get full coverage for the rest of the period.
This guide is for informational purposes only and is not legal or financial advice. Always consult with a qualified professional for personalized guidance.
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Maine Medicaid Waivers (accessed 2025-11-06)
Yes, ABLE accounts let you save for disability expenses without losing MaineCare benefits. Contributions and withdrawals for qualified expenses are tax-free and do not count toward MaineCare asset limits.
Not reporting changes can lead to overpayments and penalties. Always report changes in income, assets, or disability status to avoid problems with your benefits.
Yes, MaineCare offers long-term care services, including nursing home care and home and community-based services through Medicaid waivers. Eligibility depends on medical need and financial criteria.
If your situation changes, you must report it. MaineCare will review your eligibility. If you no longer qualify, you may need to reapply when your situation changes again.
