Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 332 - MAINECARE ELIGIBILITY MANUAL
Part 14 - INDIVIDUALS IN MEDICAL INSTITUTIONS

The rules in this Part are used for individuals who are institutionalized. An institutionalized individual is one who applies for or receives Medicaid and is expected to stay at least thirty days in a hospital or nursing facility.

A Community Spouse is a person who, according to Maine state law, is married to an institutionalized spouse.

A spouse living in a AFH, FRBH, CRBH, RCF, or AFCH (as defined in Part 12, Section1), or receiving Home and Community Based Waiver services (see Part 13) is considered a Community Spouse.

Eligibility for an institutionalized individual requires that the individual:

* Meets the definition of Institutionalization

* Has a coverable group

* Has a medical need classification

* Meets asset criteria

* Meets income criteria If eligible, a cost of care will be determined based on the individuals income.

Individual who are changing from institutionalized status to community status must be given advanced notice if coverage is ending.