Updated August 27, 2026. Quick answer: Maine calls the excess-income obligation a deductible and measures it against the Protected Income Level. One provision is easy to miss and can decide a case: “An individual in this situation receives Medically Needy coverage without first having to incur any medical costs.”
What Maine requires
| What the state sets out | What it says |
|---|---|
| Maine’s name for it | deductible (10-144 C.M.R. Ch. 332, Part 10) |
| The comparison | “The countable income is compared to the Protected Income Level (PIL).” |
| When a deductible arises | “When the individual or family’s net countable income is above the PIL a deductible must be met.” |
| When it does not | “An individual in this situation receives Medically Needy coverage without first having to incur any medical costs.” |
| Deductible period | six months (with a 12-month review where income is stable) |
| Whose income counts | “income of a non-responsible relative is not counted when determining the deductible” |
How it works in practice
- The no-cost route exists because the two programmes count income differently. An applicant can be over the limit for a categorically needy group and still be under the Protected Income Level for Medically Needy — and then “An individual in this situation receives Medically Needy coverage without first having to incur any medical costs.”
- A responsible relative is defined narrowly: a spouse, or a biological or adoptive parent of a child under 19. For MAGI-based groups, income of anyone else in the household is not counted toward the deductible.
- Six months is the deductible period, but the review cycle can be longer. Where income is stable and sits between the categorically needy levels and the PIL, “a complete review is necessary once every 12 months rather than once every six months”.
The mechanism itself — why an income cap exists and what the trust must contain — is explained on the income-cap and Miller trust page. This page is the record for Maine.
What this page does not settle
- The PIL itself is a chart, not a sentence. Maine publishes it as Chart 5 of the same manual, and this page does not reproduce its figures.
- This page reads one source: 10-144 C.M.R. Chapter 332, MaineCare Eligibility Manual, Part 10 (Medically Needy Coverage). It is the state’s own publication on this rule, but no state puts its whole treatment of excess income in a single document, and a detail that decides your case may sit in one this page did not read.
- A spend-down fixes an income problem and nothing else. The resource test, the level-of-care test and the transfer-of-assets look-back are separate hurdles, each decided on your own file, and meeting this rule does not clear any of them.
- Every quotation here was read against the source on August 27, 2026. States revise these rules, and a figure or a section number can move without the page around it changing. Open the source before you rely on a detail.
Eligibility is decided by the state agency on the whole file, not by one rule on one page. Nothing here is legal advice, and no one should move, retitle or assign income on the strength of a web page.
Figures verified against 10-144 C.M.R. Chapter 332 (MaineCare Eligibility Manual, version effective April 29, 2025) on September 29, 2026; whether a later amendment exists was not re-checked.
Sources
The source above was retrieved and read against the state text on August 27, 2026. Every quotation on this page was checked against those bytes.
Spending down to the income limit is only half of what Maine Medicaid can do for a household that is already providing the care itself, and getting paid as a family caregiver in Maine names the Maine program that pays one and answers the family-member and the spouse question separately.
Related: Maine’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.
For your own numbers, run the Medicaid Spend-Down Calculator: Income Trust or Spend-Down, by State.
See Medicaid Estate Recovery by State: What Each State Can Reach (2026) for the full state by state breakdown.
Related: Maine’s Medicaid Personal Needs Allowance, the amount a nursing-facility resident keeps from their own income each month.