Home Modifications

Home Modifications are covered only for Maine Care members who are enrolled in either the Home and Community Based Waiver for Elders and Adults or the Home and Community Benefits for Persons with Mental Retardation.

For members in the Home and Community Based Waiver for Elders and Adults with Disabilities, there is an annual limit of $1500 per member, per year for home modifications. All Home Modifications must receive PA. Home Modifications for this waiver include the following:

ramps;
lifts such as porch or stair lifts and hydraulic, manual or other electronic lifts;
modifications/additions of bathroom facilities such as roll-in showers, sink, bathtub, toilet and plumbing modifications, water faucet controls, floor urinal and bidet adaptations and turn around space adaptations;
modifications/additions of kitchen facilities such as sink modifications, sink cutouts, water faucet controls, turn around space adaptations, surface adjustments/additions and cabinetry adjustments/additions.

For Members in the Home and Community Benefits for Members with Mental Retardation the following guidelines regarding Home Modifications apply.

All home modifications must be included in the Maine Care member’s Individual plan approved by the Department of Health and Human Services (DHHS). The member’s case record must include a written approval of the member’s physician. Home Modifications include the following:

installation of ramps and grab bars;
hydraulic lifts;
widening of doorways
modifications/additions of bathroom facilities;
installation of specialized electric and plumbing systems that are necessary to accommodate medical equipment and supplies essential for the welfare of the member.

The amount of money available for home modifications for a five year period for each individual Maine Care member is $10,000. Once that cap is reached, only $300 per year, per member, will be allowable for repair, replacement or additional modifications.

Home modifications may be reimbursed by DHHS or other approved providers. In order to receive reimbursement, providers must be able to verify that any applicable provider licensure or certification has been met and all modifications were made in accordance with federal, State and local building codes.

General house repairs are not included.