Elder Care Index

What Medicaid Actually Covers for Senior Care

Navigating senior care can feel overwhelming, but Delaware's Medicaid program, known as the Diamond State Health Plan Plus (DSHP+), is here to help. Delaware no longer uses traditional waivers; instead, long-term care services are managed through this comprehensive system. DSHP+ offers two main avenues: the Nursing Facility Program, which covers care in Medicaid-certified nursing homes, and the Long-Term Care Community Services (LTCCS) Program.

The LTCCS Program is designed to support seniors who wish to remain in their homes or other community settings, covering services like in-home care, assisted living services, adult day care, and adult foster care. This can include personal care assistance, and in some situations, even allows adult children to be paid caregivers. While Medicaid covers comprehensive care in nursing homes, including room and board, it's important to know that for assisted living or adult foster care, the LTCCS program primarily covers the services provided, not necessarily the full cost of room and board.

Do You Qualify?

For a single applicant in 2026, the income limit for Delaware Medicaid long-term care programs is $2,485 per month, and the asset limit is $2,000. Don't worry if these limits seem tight; there are ways to qualify even if you're over them.

If your parent owns a house, it's often not counted as an asset, especially if a spouse, a child under 21, or a blind or disabled child lives there, or if your parent intends to return home. There is a home equity limit of up to $752,000 or $1,130,000 for 2026, depending on the circumstances. Pension payments are counted as income, but a non-applicant spouse's IRA or 401K is generally exempt.

Delaware has "spend-down" rules if your parent exceeds the financial limits. For income, a Qualified Income Trust (QIT), also called a Miller Trust, can allow excess income to be used for care expenses. For assets, you can spend down by paying off debts, making home or vehicle modifications, or prepaying funeral expenses. Keep in mind, there's a 60-month (five-year) look-back period where asset transfers are reviewed, and gifting assets could lead to a penalty.

For married couples, if both apply, the combined asset limit is $3,000, and each spouse can have an income of up to $2,485 per month. If only one spouse applies, the applicant still has the $2,000 asset limit, but the non-applicant spouse can keep up to $162,660 in assets as a Community Spouse Resource Allowance.

Waitlists & How to Apply

Good news on waitlists! Delaware's Long-Term Care Community Services (LTCCS) managed care program currently does not have enrollment caps, meaning there are no waiting lists for benefits. Nursing Home Medicaid and Aged, Blind, and Disabled Medicaid also do not have waitlists.

When you're ready to apply, you have several options. You can apply online through Delaware ASSIST. If you prefer in-person help, you can visit a local Division of Social Services (DSS) office, though appointments might be needed. You can also apply by mail after requesting an application by phone. For long-term care applications, you can call the Medicaid Central Intake Unit at 1-866-940-8963. General inquiries can be directed to 1-800-372-2022 or 302-255-9500. Be prepared to provide documents proving identity, income, assets, and medical needs. While processing times aren't fixed, it involves gathering information, submitting documents, and waiting for a decision.

Last updated: March 2026. Sources: CMS, state Medicaid agency, Genworth 2024.