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Special Benefit Waiver (SBW) Premium Amounts - Effective 1/1/26 Income Level (by FPL%) Monthly Premium Amount <150% $0 150-200% $39.61 200-250% $79.22 Long Term Care Programs Long Term Care MaineCare is a wide range of services provided to an individual based on their medical needs. Care may range from assistance within the home to advanced medical care provided in a nursing facility. Basic MaineCare eligibility criteria must be met. An individual must: • Be a Maine resident • Be age 65 or older, blind, or disabled • Meet income and asset eligibility requirements; and • Meet medical level of care requirements. A 60-month financial lookback is completed for applicants seeking Long Term Care MaineCare. The purpose of the lookback is to determine if the individual (or their spouse) transferred assets to another person or party for less than fair market value (FMV). When an individual transfers or disposes assets for less than FMV they are subject to a penalty or period of ineligibility.

Important Financial Figures Related to Long Term Care - Updated Annually $2,000/$3,000 Asset limit for an individual/couple.* $162,660 Asset limit for a community spouse. $13,339 The average cost of a nursing facility private rate in the State of Maine. Also, the penalty divisor. $18,985 Statewide average for burial and funeral costs. * Up to $8,000 of savings for an individual, $12,000 for a couple may be excluded. Any amount over the excluded amount is counted toward the asset limit. Long Term Care MaineCare will help with the cost of services provided in the following settings: • The individual’s home or the home of another person • An approved residential care facility; or • An approved nursing facility.