C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-97, subsec. 144-101-II-97.06
Please refer to Chapter I of the MaineCare Benefits Manual for additional non-covered services, including services that are for vocational, academic, socialization or recreational purposes.
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.
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.
C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-97, subsec. 144-101-II-97.06