Delaware
What Is Delaware Medicaid Long-Term Care?
Delaware Medicaid offers health coverage to qualifying low-income residents, including seniors aged 65 and older who need long-term care. What types of services are covered? In addition to nursing home care, Medicaid also pays for services provided in assisted living facilities, adult foster care, and even in a person’s own home to help seniors maintain independence.
What Types of Long-Term Care Medicaid Programs Are Available in Delaware?
What Is Institutional / Nursing Home Medicaid?
This is a guaranteed benefit for applicants who meet eligibility criteria. It covers care provided exclusively in licensed nursing facilities.
What Is the Home and Community-Based Services (HCBS) / Long-Term Care Community Services (LTCCS) Program?
Delaware transitioned from traditional HCBS waivers to a managed care model, LTCCS, under the Diamond State Health Plan Plus. Unlike the former waiver system, this model has no enrollment limits, meaning eligible individuals are not subject to waitlists. Services may be delivered at home, in assisted living, or adult day care settings.
What Is Regular Medicaid for the Aged, Blind, and Disabled?
This entitlement program provides limited long-term care assistance, such as help with personal care or access to adult day care, for those who qualify by income and functional need.
Who Administers Delaware Medicaid?
The Delaware Division of Medicaid & Medical Assistance (DMMA), under the Department of Health and Social Services (DHSS), oversees the program according to federal rules.
What Are the Income and Asset Limits for Delaware Long-Term Care Medicaid?
Each program—Nursing Home, HCBS, and Regular Medicaid—has its own financial and medical requirements. Limits also depend on whether a person is single or married.
What Are the 2025 Financial Eligibility Limits for Single and Married Applicants?
For example, a single applicant for Nursing Home Medicaid must have income under $2,417.50/month and assets under $2,000, along with a demonstrated need for a nursing facility level of care.
How Does Delaware Define Income for Medicaid?
What Types of Income Are Counted?
Most forms of income—such as wages, Social Security, pensions, and IRA withdrawals—are counted toward the limit. Some payments, including Holocaust restitution and VA Aid & Attendance, are exempt.
How Is Income Treated for Married Couples?
If only one spouse applies for Medicaid, only that spouse’s income is considered. The non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA), which helps prevent financial hardship.
How Does Delaware Define Countable and Exempt Assets?
What Assets Are Counted and Which Are Exempt?
Countable assets include cash, stocks, and investment property. Exempt assets may include a home (under specific conditions), a vehicle, personal belongings, prepaid burial arrangements, and small life insurance policies.
How Are Assets Handled for Married Couples?
All assets are considered jointly owned. However, the non-applicant spouse may retain a portion of the couple’s assets through the Community Spouse Resource Allowance (CSRA). In 2025, the protected amount is up to $157,920.
What Is the Medicaid Look-Back Period?
Delaware enforces a 5-year look-back period for applicants to Nursing Home Medicaid and LTCCS. What does this mean? Any assets transferred for less than fair market value during that time may result in a penalty and temporary Medicaid ineligibility.
How Does Medicaid Treat the Applicant’s Home?
When Is a Home Exempt from Asset Limits?
A home may be exempt if the applicant or their spouse lives there, or if the applicant expresses intent to return. The 2025 home equity limit is $730,000. This limit does not apply for Regular Medicaid.
Can the State Take the Home After Death?
Yes. Even if the home is exempt during the applicant’s lifetime, it may be subject to estate recovery after death to reimburse Medicaid for care costs.
What Are the Functional or Medical Requirements for Eligibility?
Applicants for Nursing Home Medicaid and HCBS must require a Nursing Facility Level of Care (NFLOC). For Regular Medicaid, a demonstrated need for help with Activities of Daily Living (ADLs) may be sufficient.
What If an Applicant Is Over the Income or Asset Limits?
There are several legal pathways to gain Medicaid eligibility even if financial thresholds are exceeded.
How Can a Qualified Income Trust (QIT) Help?
QITs (or Miller Trusts) allow individuals over the income limit to deposit excess income into an irrevocable trust, which can only be used for approved care expenses.
What Is an Asset Spend Down?
Spending excess assets on exempt items—such as home or vehicle modifications, medical debt, or prepaid burial plans—can bring asset levels into compliance. All spending must be documented to avoid violating the look-back rule.
What Is Medicaid Planning?
For those with complex financial situations, working with a professional Medicaid planner can provide strategies to qualify for benefits and protect assets like the family home from estate recovery.
What Specific Long-Term Care Programs Are Offered in Delaware?
DSHP Plus
Diamond State Health Plan Plus is Delaware’s Medicaid managed care program for long-term services, split into two components: nursing facility care and community-based care. It offers support services at home, in assisted living, or in adult foster care settings. Self-directed care is available for participants, including the option to pay family caregivers.
PACE (Program of All-Inclusive Care for the Elderly)
PACE integrates Medicaid and Medicare benefits and may include dental, vision, and other additional healthcare services, offering a comprehensive care solution for eligible seniors.
How Do Seniors Apply for Delaware Medicaid?
Applications can be submitted online through Delaware ASSIST, or help can be obtained by contacting DHSS or the Aging & Disability Resource Center.
What Should Applicants Know Before Applying?
It’s important to ensure eligibility requirements are met before applying. If you’re unsure or exceed the financial limits, it’s recommended to seek Medicaid planning assistance to avoid denial and improve the chances of approval.
