Maine offers a range of benefits and supports for people living with Traumatic Brain Injury (TBI), including MaineCare (Medicaid), SSI/SSDI, and Home and Community-Based Services (HCBS) waivers. Eligibility depends on income, assets, disability status, and medical need. This guide explains how to apply, what’s covered, and where to get help.
To qualify for most federal disability benefits, you must have a severe physical or mental condition (like a Traumatic Brain Injury) that is expected to last at least 12 months or result in death, and prevents you from working. For SSI, you must also meet strict income and asset limits. SSDI is based on work history and disability.
In Maine, adults with a Traumatic Brain Injury may qualify for MaineCare if they meet the disability criteria of the Social Security Administration (SSA) and have income below 100% of the Federal Poverty Level (FPL): $1,215/month for an individual or $1,644/month for a couple in 2023[1]. Asset limits are $2,000 for an individual or $3,000 for a couple[1][2]. If you work despite your disability, you may qualify with higher income—up to 250% of FPL for certain groups—with an asset limit of $8,000 (individual) or $12,000 (couple)[2]. SSI recipients are automatically eligible for MaineCare[1]. For long-term care or HCBS waivers, you must also show a medical need for nursing facility level care, even if you want to stay at home[4]. If you are over the limits, a Medically Needy deductible may still allow you to get coverage by spending down your income on medical bills[6]. MaineCare uses a 60-month look-back period to review asset transfers for HCBS waiver applicants[4].
Get started with Maine disability benefits in three steps: 1) Gather proof of income, assets, medical records, and disability status. 2) Apply for SSI/SSDI if you haven’t already. 3) Apply for MaineCare online at MyMaineConnection.gov or contact your local Office of Family Independence for help—applications are processed quickly for SSI recipients[6].
Maine residents with Traumatic Brain Injury may open an ABLE account to save for disability-related expenses without affecting eligibility for SSI, SSDI, or MaineCare. Funds in an ABLE account (up to $100,000) do not count toward asset limits for these programs.
MaineCare income limits for people with disabilities are generally 100% of the Federal Poverty Level (FPL): $1,215/month (individual) or $1,644/month (couple) in 2023[1]. The "working disabled" group allows income up to 250% of FPL: $3,038/month (individual) or $4,109/month (couple), with a premium up to $20/month[1][2]. Asset limits are $2,000 (individual) or $3,000 (couple) for standard eligibility, and $8,000 (individual) or $12,000 (couple) for the working disabled group[1][2].
If you receive too much in benefits, you may have to repay the overpayment. Always report changes in income, assets, living situation, or health status right away to avoid overpayments and potential penalties. For help, see our guide on avoiding overpayments.
Free application assistance is available:
If you have a Traumatic Brain Injury and are working, you may qualify for MaineCare with higher income and asset limits. Contact MaineCare or a benefits counselor to see if you meet the “working disabled” group criteria[1][2].
MaineCare is Maine’s Medicaid program. People with a disability like TBI may qualify if their income and assets are below state limits, or if they receive SSI. Some working people with disabilities can qualify with higher incomes[1][3][6].
Apply online at MyMaineConnection.gov or visit your local Office of Family Independence. Gather proof of income, assets, residency, and medical documentation about your TBI. SSI recipients are automatically eligible[1][6].
You may still qualify by using the Medically Needy program, which lets you subtract medical expenses from your income to meet eligibility. A MaineCare representative can explain how this works[6].
Yes, Home and Community-Based Services (HCBS) waivers provide support like personal care, home modifications, and respite care. These programs have limited slots and require both financial and medical eligibility[4][6].
Yes, family members may qualify for MaineCare based on their own income and situation. Each person in the household is evaluated separately. Children under 18 may have higher income limits than adults[3][6].
Yes, MaineCare covers mental health services, therapy, and behavioral health supports that are medically necessary for a Traumatic Brain Injury[3].
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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SSI is based on financial need and disability; SSDI is based on work history and disability. Both can help you qualify for MaineCare, but SSI recipients get automatic approval[1]. See our SSI vs SSDI guide for details.
Yes, if you are under 65, have earnings, and meet disability criteria, you may qualify under the “working disabled” group, with higher income and asset limits[1][2].
ABLE accounts let you save for disability expenses without affecting benefit eligibility. Up to $100,000 in an ABLE account does not count toward SSI or MaineCare asset limits.
Consumers for Affordable Health Care offers free assistance at (800) 965-7476. You can also contact your local Office of Family Independence[3][6].
