Medicaid for nursing home and home care in Maryland

Who qualifies

You must live in Maryland, be 65 or older, blind or disabled, and need the level of care a nursing home gives. Then you must meet the money rules below.

For regular Medicaid at home, the limit for people 65 and over is only $350 a month and $2,500 in assets for one person. The long-term care rules are much easier to meet.

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How income is counted for a nursing home

Maryland does not have a fixed income cap for nursing home care. Instead:

1. Your local department of social services adds up your income and takes off allowed amounts: your personal needs allowance, health insurance premiums, and any allowance for a spouse or child at home.
2. If what is left is at or below the projected cost of your nursing home care, you qualify from the first day of the period.
3. If it is more than the cost of care, you can still qualify through a spend-down. Your unpaid medical bills are subtracted from the extra income. Coverage starts on the day your bills equal the extra amount.
4. Bills from up to 3 months before the month you apply can count.

The money left after these steps goes to the nursing home each month.

What you keep

• Personal needs allowance: a small monthly amount for clothing and personal items. Maryland rule raises it each year along with Social Security cost-of-living increases. Ask your local department for the 2026 amount.
• Guardian fees: If you have a court-appointed guardian, an extra amount can be kept to pay the guardian.
• Your home for a short stay: If you are single and a doctor expects you to go home, you can keep money to keep up your home for up to 6 months.
• Health insurance: Medicare and other premiums, deductibles and coinsurance are taken off first.

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What counts as an asset

Countable assets include cash, bank accounts, stocks, bonds and similar property. Ask your local department of social services which assets are not counted in your case. Tell them about any gifts or transfers of money or property you made in recent years, because giving things away for less than they are worth can delay Medicaid payment for long-term care.

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If you are married

When one spouse needs long-term care, the spouse at home is protected:

• Assets: The spouse at home can keep from $32,532 up to $162,660 of the couple's countable assets in 2026.
• Income: If the spouse at home has little income, part of your income can go to them. The total cannot go above $4,066.50 a month in 2026. The lower floor changes each July 1, so ask your local department.

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Programs that pay for care

Nursing facility care

Medicaid pays the nursing home for your care once you qualify. The nursing home's social worker can help you apply.

Home and Community-Based Options Waiver (Community Options Waiver)

For people 18 and over who need nursing-home-level care and can live safely at home with help, as long as the cost is not more than nursing home care. It covers all regular Medicaid services plus:

• Assisted living
• Case management
• Medical day care and Senior Center Plus
• Dietitian and nutrition services
• Family training and behavior consultation

There is a waiting list. Call Maryland Access Point at 1-844-627-5465 to join the registry. You are invited to apply when your turn comes. If Medicaid has paid for your nursing home care for at least 30 days, you can apply with no wait. Ask the nursing home social worker.

If your income is too high for the waiver, ask about the Increased Community Services Program.

Community First Choice

Personal care help at home for people who already have full Medicaid and need nursing-home-level care. The asset limit is $2,500 for one person or $3,000 for two.

PACE

For people 55 and over who need nursing-home-level care and live in a PACE service area. One team gives all medical and long-term care. Call the Maryland Department of Health at 410-767-6500 to ask if PACE serves your area.

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How to apply

1. Call Maryland Access Point (MAP) at 1-844-627-5465. MAP can explain your choices, put you on the waiver registry, and refer you to an options counselor who can help you apply.
2. Apply for Medicaid. People 65 and over, blind or disabled apply at marylandbenefits.gov, in person at the local department of social services, or by mailing the completed form to that office. Find yours at dhs.maryland.gov/local-offices.
3. Gather proof of income, assets and bank records for the look-back, health insurance, and any transfers.
4. Get the medical review. The state checks that you need nursing-home-level care.

Questions about the waiver: Office of Long Term Services and Supports, 410-767-1739. Maryland Department of Health: 410-767-6500 or 1-877-463-3464.

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After you apply

• Renewals: Watch for renewal mail from your local department and answer by the date given.
• Report changes in income, assets or where you live.
• If you are denied: Your notice explains why and how to appeal, and the date your appeal is due. Act quickly.
• Estate recovery: After a member aged 55 or older dies, Maryland must seek repayment for long-term care from the estate, but not while a spouse, a child under 21, or a blind or disabled child survives. Heirs can ask for a hardship waiver.

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Common mistakes

• Thinking income is too high. In a nursing home, income is compared with the cost of care, and spend-down can help.
• Waiting to join the waiver registry. The list is first come, first served. Call MAP early.
• Missing the 30-day route. After 30 days of Medicaid-paid nursing home care, you can apply for the waiver with no wait.
• Giving money to family before applying without asking how it affects Medicaid.

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Free help

• Maryland Access Point: 1-844-627-5465.
• State Health Insurance Assistance Program (SHIP): 1-800-243-3425, for Medicare questions.

See all benefits in Maryland and our guide to paying for a nursing home.

Phone numbers: Free help lines for Maryland agencies

Check what you may qualify for