Delaware Diamond State Health Plan-Plus (DSHP-Plus) Long-Term Services and Supports

DSHP-Plus is Delaware’s managed care program for people who need long-term care Medicaid. It covers nursing facility care and home and community-based services through a managed care organization (MCO), with a case manager for each member. This page is part of our Delaware Long-Term Care Medicaid guide.

Figures change periodically. Double-check current amounts before relying on them.

At a glance

Item	Details
Type of program	Managed long-term services and supports (managed care)
Who runs it	Delaware Division of Medicaid and Medical Assistance (DMMA), through managed care organizations
Age	Older adults and adults with physical disabilities (and others in DSHP-Plus)
Care need	Nursing facility level of care (or at risk) for LTSS
Delaware 2026 income rule (long-term care)	$2,485 a month (250% of the SSI rate)
Delaware 2026 asset limit (single applicant)	$2,000
Waiting list	No general waitlist

DSHP-Plus in brief

Put simply, responsibility for DSHP-Plus sits with Delaware Division of Medicaid and Medical Assistance (DMMA), through managed care organizations. Its target group is older adults and adults with physical disabilities (and others in DSHP-Plus); on care need, the rule is: Nursing facility level of care (or at risk) for LTSS. On waiting lists, the current picture is: No general waitlist. The sections below repeat these points with more detail, and our state guide covers the Delaware rules that apply to every long-term care program. If DSHP-Plus is not the right fit, the related pages at the end point to other Delaware programs and general guides.

What the program is

Delaware’s Diamond State Health Plan is the state’s Medicaid managed care program. DSHP-Plus extends it to people who need long-term services and supports (LTSS). Once a person qualifies, they choose an MCO, which assigns a case manager to assess needs and arrange services at home, in assisted living or in a nursing facility. Members can also self-direct some attendant services.

DSHP-Plus works through managed care: instead of paying each provider directly, Delaware pays health plans, which arrange care at home, in residential settings and in nursing homes. Each plan gives members a coordinator who writes and updates the care plan, and members can usually choose among plans. Eligibility rules still come from the state, and members can appeal if a plan reduces or denies services. See Managed long-term services and supports.

Who qualifies in 2026

A person generally must meet all of these conditions:

Is 65 or older, or an adult with a physical disability
Meets Delaware Medicaid’s nursing facility level of care (or an at-risk standard for some services)
Qualifies for full Medicaid under Delaware’s long-term care financial rules (see the money test below) (2026 income rule: $2,485 a month, 250% of the SSI rate)
Lives in Delaware and is a U.S. citizen or qualified non-citizen

The money test. The person must qualify for full Medicaid under Delaware’s rules for long-term care. Figures shown above are the 2026 Delaware long-term care limits from our state guide. Exempt items generally include the home within the equity cap, a car, household goods and a modest burial fund. If only one spouse needs DSHP-Plus, spousal impoverishment rules protect assets and income for the other. 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. A nurse or social worker working with Delaware DMMA usually does it in person, wherever the person is living. Have a relative present to describe the hard days, and keep a medication and diagnosis list handy. See Nursing home level of care and Activities of daily living.

What services it can pay for

What a participant receives under DSHP-Plus follows the care plan. Possible services include:

Nursing facility care
Personal care and attendant services
Adult day services
Respite
Home-delivered meals
Personal emergency response systems
Minor home modifications
Assisted living services (resident pays room and board)
Case management
Self-directed attendant care

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 DSHP-Plus is:

Contact DMMA or the Delaware Aging and Disability Resource Center to start.
Apply for long-term care Medicaid with DMMA.
A nurse assesses the person’s level of care.
If approved, choose a DSHP-Plus MCO.
The MCO case manager plans and arranges services.

Our documents checklist and Applying for a waiver guide list the paperwork.

Waiting lists

DSHP-Plus LTSS does not have a general waiting list for people who qualify. Delays usually come from the financial review and assessment.

General advice is in Waiver waiting lists.

How it relates to nursing home Medicaid

DSHP-Plus covers both nursing home and community care, so the same program follows the person across settings. Delaware’s 2026 income rule for long-term care is $2,485 a month (250% of the SSI rate), lower than the 300% rule many states use, and the asset limit is in our state guide.

What is the same as 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. Delaware DMMA can also use estate recovery to seek repayment for long-term care services received after 55. Some participants pay a monthly share of income toward services.

Personal needs allowance. If the person does move to a nursing home, Delaware’s 2026 personal needs allowance is $75 a month. Most of the rest of their income goes toward the cost of care. The state guide explains the nursing home side.

Tips for families

Begin before it is urgent. Every step of DSHP-Plus takes time, and an early request protects your place.
Keep a paper trail: copies of forms and notices, plus the names and dates of every call to Delaware DMMA.
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.
Report changes promptly, including income, assets, a move or a new living arrangement.
Expect yearly reviews of both Medicaid eligibility and the care assessment. See Renewals.
Think about the spouse at home. Couples have extra protections, but they have to be claimed. A certified Medicaid planner or a legal aid office can explain how the rules apply to a particular family.

Common questions

Is Delaware’s income limit different? Yes. Delaware uses 250% of the SSI rate ($2,485 a month in 2026) rather than 300%.

Does DSHP-Plus pay for assisted living? It can pay for care services in assisted living. The resident pays room and board.

Can I direct my own care? Self-directed attendant services are available for some members.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.