Maryland

What Is Maryland Medicaid Long-Term Care?

Maryland Medicaid, also referred to as Medical Assistance (MA), is a health coverage program for low-income individuals of all ages. This guide focuses specifically on long-term care support available to seniors aged 65 and older. In addition to nursing home care, Medicaid also funds supportive services in assisted living, adult foster care, and at-home environments to help seniors remain independent.

What Are the Different Types of Medicaid Long-Term Care in Maryland?

What Is Institutional / Nursing Home Medicaid?

This is an entitlement program, which guarantees services to all who qualify. Care is delivered exclusively in licensed nursing homes.

What Are Medicaid Waivers / Home and Community-Based Services (HCBS)?

These are not entitlement programs. There are limited enrollment slots and waitlists. Services are aimed at helping individuals stay out of nursing homes and receive care in home or community settings.

What Is Regular Medicaid / Aged, Blind, and Disabled (ABD)?

This entitlement program offers limited long-term care services—such as help with daily living activities—for those who meet eligibility rules based on age or disability.

What Are the 2025 Income and Asset Limits for Long-Term Care Medicaid?

What Are the Basic Eligibility Requirements for a Single Applicant?

In 2025, a single applicant for nursing home Medicaid must:

• Contribute most of their income to nursing home costs.
• Have assets below $2,500.
• Require a Nursing Facility Level of Care (NFLOC).

What Does the 2025 Financial Eligibility Table Look Like?

How Does Maryland Count Income for Medicaid Eligibility?

What Income Is Counted and What Is Not?

Most income sources are countable, such as Social Security, wages, pensions, and dividends. Holocaust restitution is excluded. Maryland includes VA Aid & Attendance benefits as income.

How Is Income Treated for Married Couples?

For Nursing Home Medicaid and HCBS Waivers, only the applicant’s income is counted. The non-applicant may receive a Monthly Maintenance Needs Allowance (MMMNA) of up to $2,643/month, with a maximum of $3,948 if shelter costs are high. For Regular Medicaid, both spouses’ income counts, and no MMMNA is available.

How Does Maryland Count Assets for Medicaid Eligibility?

What Assets Are Counted vs. Excluded?

Countable assets include cash, investments, savings, and property not used as a primary residence. Exempt assets include one home, a car, personal items, and funeral arrangements. Maryland counts IRAs as assets.

How Are Assets Handled for Married Applicants?

Assets are considered jointly owned. Non-applicant spouses may keep up to $157,920 (or $31,584 if their share is less). This is known as the Community Spouse Resource Allowance (CSRA).

What Is the Medicaid Look-Back Period in Maryland?

Maryland enforces a 60-month look-back on Nursing Home Medicaid and Waiver applicants. Any gifts or under-market asset transfers can trigger a penalty. This rule does not apply to Regular Medicaid.

Are There Rules About Home Ownership and Medicaid Eligibility?

To exempt the home, the applicant or spouse must live in it. If not, there must be an intent to return, and home equity must be under $730,000 (2025). Regular Medicaid does not have a home equity limit.

What Are the Medical or Functional Requirements for Long-Term Care Medicaid?

Applicants must meet functional care needs. Nursing Home and Waiver applicants need a Nursing Facility Level of Care. Regular Medicaid (ABD) requires help with Activities of Daily Living (ADLs).

What If a Senior Is Over the Financial Limits for Medicaid?

How Does the Medically Needy Pathway Work?

Seniors can spend down excess income on medical costs until they reach income limits. In 2025, the limit is $350/month for individuals and $392/month for couples. The spenddown period is six months.

What Is the Asset Spend Down Option?

Applicants can become eligible by spending assets on exempt items—like home modifications, medical equipment, or debt repayment. Gifts or under-value sales within 60 months may trigger penalties.

Can Medicaid Planning Help Over-Income or Over-Asset Applicants?

Yes. Many seniors benefit from working with Medicaid planners to qualify while protecting assets. This can also help avoid estate recovery after death.

What Long-Term Care Programs Are Offered Under Maryland Medicaid?

 Community Options Waiver (CO / HCBOW)

Helps seniors live at home or in assisted living. Prioritizes nursing home residents transitioning back to the community. Others join a waitlist called a “registry.”

Community Personal Assistance Services (CPAS)

Offers personal care and nurse monitoring through Regular Medicaid. No waitlists. Care can be self-directed and provided by family, including spouses or adult children.

Community First Choice (CFC)

Includes personal assistance, home modifications, meals, and assistive tech. Participants can hire and manage their own caregivers. No waiting list applies.

Medical Day Care Services Waiver (MDCSW)

Offers adult day health services—including nursing care and therapy—for those who need institutional-level care but live at home.

Increased Community Services (ICS) Program

Assists institutionalized individuals in moving back home or into assisted living. Services include personal care, meal delivery, and safety improvements. Participation is limited to 100 people.

PACE (Program of All-Inclusive Care for the Elderly)

Combines Medicaid and Medicare services into one program. Includes long-term care and extra benefits like dental or vision. Offers full-service support to frail elders.

What Is the Money Follows the Person Program?

A federal program that helps nursing home residents transition back into the community with support from Medicaid.

How Can Seniors Apply for Long-Term Care Medicaid in Maryland?

Applications can be submitted online at myMDTHINK, or through local Social Services offices. Paper forms are available for Regular Medicaid or Long-Term Care Waiver applications. Applicants should ensure they meet all eligibility rules before applying. Consulting a Medicaid planner is recommended if there is uncertainty.