Maryland Increased Community Services (ICS) Program
The Increased Community Services (ICS) Program is a Maryland Medicaid demonstration that helps nursing facility residents with income above 300% of the SSI benefit move home with waiver-type services. It is for people who were denied the Community Options Waiver because their income was too high. This page is part of our Maryland Long-Term Care Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Program for people moving out of a nursing home |
| Who runs it | Maryland Department of Health (MDH) |
| Age | 18 and older |
| Care need | Needs a nursing facility level of care |
| Maryland 2026 income rule (long-term care) | No fixed cap for nursing home care: medically needy route (income goes toward care) |
| Maryland 2026 asset limit (single applicant) | $2,500 (ICS, applicant only) |
| Waiting list | Referral only |
ICS in brief
In short, ICS is run by Maryland Department of Health (MDH). Its target group is 18 and older; on care need, the rule is: Needs a nursing facility level of care. Waiting list status in 2026: Referral only. More detail on each point follows, and the Maryland state guide covers the shared financial rules. Other Maryland programs, and general guides on care at home, are linked at the end of this page for comparison with ICS.
What the program is
ICS participants pay a monthly assessment fee equal to their income above 300% of the SSI Federal Benefit Rate. Financial eligibility is based on the applicant’s own income and assets only. People cannot apply directly; they must be referred by Medicaid’s Eligibility Determination Division.
ICS exists to help nursing facility residents return to the community with support in place. They often work alongside the federal Money Follows the Person program and can pay one-time moving costs as well as ongoing care.
Who qualifies in 2026
A person generally must meet all of these conditions:
- Is 18 or older
- Needs a nursing facility level of care
- Has lived in a nursing facility for at least the last six months
- Has been eligible for Medicaid for at least 30 days in a row
- Is not otherwise eligible for an HCBS waiver or PACE
- Has income above 300% of the SSI benefit and countable assets of no more than $2,500
- Has a community plan that costs no more than nursing facility care
Financial eligibility. ICS requires full Medicaid eligibility under Maryland’s long-term care financial rules. The table’s figures are Maryland’s 2026 long-term care numbers, taken from our state guide. Exempt items generally include the home within the equity cap, a car, household goods and a modest burial fund. Married couples get extra protection in Maryland: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.
How the care assessment works. The care test looks at how much help a person needs with everyday activities such as bathing, dressing, eating, using the toilet, moving around and taking medicines, and at memory problems and supervision needs. The visit is normally face to face, at home or in a hospital or facility. Before a ICS assessment, it helps to line up a family member who can describe a typical bad day, and to have a list of diagnoses and medications ready. See Nursing home level of care and Activities of daily living.
What services it can pay for
Services depend on the person’s assessed needs and written care plan. Depending on the plan, they can include:
- Assisted living
- Assistive technology
- Behavioral consultation
- Dietitian services
- Environmental adaptations
- Family training
- Home-delivered meals
- Medical day care
- Personal assistance
- Personal emergency response
- Respite
- Senior Center Plus
The menu is broad, but the plan is built from need, and unpaid family help is factored in. If needs change, ask for a new assessment.
How to apply
There are two tracks, a financial one and a care one, and both must say yes. The usual path for ICS is:
- Tell the nursing facility social worker or Maryland Access Point that the person wants to move home under ICS.
- The referral comes from Medicaid’s Eligibility Determination Division, often after a Community Options Waiver denial for high income.
- A plan of service is written and checked to make sure it costs no more than nursing facility care.
- After approval, the move home happens and the monthly contribution begins.
Before contacting Maryland Medicaid, see Applying for a waiver and the documents checklist for what to gather.
Waiting lists
ICS does not use a waiting list. People enter by referral once they meet its rules.
More on how lists work: Waiver waiting lists.
How it relates to nursing home Medicaid
ICS is only for people who are in a nursing facility now. It gives nursing home residents whose income is above the waiver limit a way to move home with waiver-type services. People who stay in the nursing home remain on nursing home Medicaid.
Rules shared with nursing home Medicaid. Most money rules carry over from nursing home Medicaid. The five-year look-back for gifts generally applies, so a gift or transfer for less than fair value can cause a period when Medicaid will not pay for long-term care services. Estate recovery also applies: the state can seek repayment from the estate of a person who received long-term care services after age 55. Some participants pay a monthly share of income toward services.
Personal needs allowance. If the person does move to a nursing home, Maryland’s 2026 personal needs allowance is $106 a month. Most of the rest of their income goes toward the cost of care. Our state guide covers the nursing home rules in detail.
Tips for families
- Start early. If there is a waiting list or a slow assessment, the clock usually starts when you ask, not when the crisis comes.
- Keep copies of every ICS form, notice and letter, and write down the name of each person you speak with and the date.
- Read every notice. If services are denied, cut or ended, the notice explains how to request a fair hearing and the deadline. Requesting one before the deadline often keeps services in place during the appeal.
- Tell Maryland Medicaid about changes in money, address or household as they happen.
- Mark renewal dates. Eligibility and the care plan are usually reviewed annually; see Renewals.
- Protect a spouse at home. Spousal protections must be claimed; a certified Medicaid planner or legal aid office can explain them for your family.
Common questions
Can I apply for ICS directly? No. Maryland requires a referral from Medicaid’s Eligibility Determination Division, usually after a Community Options Waiver application is denied because income is too high. A nursing facility social worker or Maryland Access Point can explain the steps.
What will I pay each month? Each month you pay the state a contribution equal to your income above 300% of the SSI benefit, after allowed deductions. Income up to that level stays with you to live on.
Do my spouse’s assets count? No. ICS looks only at the applicant’s own income and assets. Countable assets must be $2,500 or less.
How long must I have been in a nursing facility? At least the last six months before applying, with Medicaid eligibility for at least 30 days in a row.
Related pages
- Maryland Long-Term Care Medicaid guide
- Maryland Community Options Waiver
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.