Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter II - Specific Policies By Service
Section 144-101-II-97 - Private Non-Medical Institution Services
Subsection 144-101-II-97.06 - NON-COVERED SERVICES

97.06-1 Private Room and Other Non-Covered Services

The PNMI may permit payment by a relative of an additional amount to enable a member to obtain non-covered services such as a private room, telephone, television, or other non-covered services. However, the additional charge for non-covered services shall not exceed the charge to private pay residents. The supplement for a private room shall be no more than the difference between the private pay rate for a semi-private room and a private room rate. There shall be a signed statement by the member and/or relative making the additional payment that he/she was notified and agreed to the payment for non-covered services before those services were provided. This provision shall not apply where the standard of care in the PNMI is for a private room.

Private rooms, as are all PNMI room and board costs, are non-covered services under MaineCare, but if there is a medical necessity for a private room, the PNMI must make one available.

97.06-2 Personal Care Services Provided by a Family Member

Personal care services provided by a family member are not a covered service, and may not be billed by the family or by any other provider.