Maryland Medicaid & Elder Care
Maryland's senior Medicaid landscape offers a Community Options Waiver with a substantial waitlist, while the Community First Choice program provides immediate in-home support as an entitlement.
Medicaid Report Card
Overall State Performance Index
Based on CMS Nursing Home Compare + state Medicaid agency data
View Methodology arrow_forwardMaryland Monthly Costs
Maryland assisted living costs are approximately 15% higher than the national average (2026 figures).
Waiver Programs
Community Options Medicaid Waiver
Also called: Home and Community Based Options Waiver, Waiver for Older Adults
The Community Options Waiver provides home and community-based services for elderly and disabled individuals who require a nursing home level of care. It aims to help participants live independently at home or in an assisted living residence, prioritizing those transitioning from nursing facilities.
- check_circle Adult Medical Day Care
- check_circle Assisted Living Services
- check_circle Case Management
- check_circle Behavioral Consultation
- check_circle Family Caregiver Training
- check_circle Nutritionist Services
- check_circle Respite Care
- check_circle Transitional Services
- check_circle Personal Assistance
- check_circle Home-Delivered Meals
- check_circle Accessibility Adaptations
- check_circle Assistive Technology
- check_circle Support Planning
- check_circle Nurse Monitoring
- check_circle Home Health Services
warning Waitlist Alert
As of January 31, 2025, there were 24,015 individuals on the Community Options Waiver registry. Approximately 700 invitations are sent monthly, but the wait can be several years. Nursing home residents are prioritized for application.
2026 Eligibility Requirements
| Criteria | Individual Limit | Married (Both Applying) |
|---|---|---|
| Monthly Income | $2,982 | $5,964 |
| Asset Limit | $2,500 | $3,000 |
| Home Equity Limit | $752,000 | |
| Level of Care | Nursing Home Level of Care (NHLOC) | |
Estate Recovery Warning
Maryland's Medicaid Estate Recovery Program actively seeks reimbursement for long-term care costs from the estates of deceased beneficiaries, often targeting the primary residence. Protections exist for surviving spouses and disabled children.
Spend-Down & Asset Protection
PROTECTED ASSETS
COMMON PITFALLS
- warning Look-back Period: Gifts or asset transfers made within 60 months prior to applying for long-term care Medicaid can trigger significant penalty periods.
- warning Excess Income: Failing to establish a Qualified Income Trust (Miller Trust) if monthly income exceeds the state's income cap for long-term care, even with medical expenses.
- warning Joint Accounts: All assets of a married couple are considered jointly owned for Medicaid eligibility, regardless of whose name is on the account, potentially impacting eligibility if not properly planned.
First Steps for Families
Locate your ADRC
Contact your local Maryland Aging and Disability Resource Center.
Gather 5 years of records
Bank statements, deeds, asset transfers for the Medicaid look-back period.
Financial assessment
Consult a Medicaid planner if assets exceed $2,500.
How to Apply for Maryland Long-Term Care Medicaid
Assess Level of Care
Obtain a medical certification of Nursing Home Level of Care (NFLOC) through an Adult Evaluation and Review Services (AERS) assessment.
Gather Records
Collect at least 60 months of financial statements, income verification, and other personal and medical documents.
Setup Miller Trust (if applicable)
If your monthly income exceeds the Medicaid income cap for long-term care, establish a Qualified Income Trust (Miller Trust) to become income-eligible.
Submit Application
Apply online via Maryland Benefits (marylandbenefits.gov) or in person at your local Department of Social Services or Health Department.
Attend Interviews
Participate in required interviews and evaluations with caseworkers to verify eligibility.
Approval & Care
Receive a final eligibility determination and activate benefits for long-term care services.
Documents You'll Need
Financial Verification
- 5 years of bank statements
- Stock/bond certificates
- Retirement account information
- Proof of all assets (e.g., CDs, mutual funds, life insurance cash value)
Income Verification
- Social Security award letters
- Pension stubs
- VA benefit statements
- Other income sources
Medical/Identity
- Social Security card
- Medicare card
- Doctor's clinical assessments (e.g., Form 3871)
- Proof of U.S. citizenship or legal residency
- Photo ID
Property/Residency
- Home deed
- Vehicle registration
- Proof of Maryland residency
- Health insurance information
Frequently Asked Questions About Maryland Medicaid
Does Maryland Medicaid pay for assisted living?
Maryland Medicaid, primarily through the Community Options Waiver, can cover certain services provided in assisted living facilities, such as personal care, nursing support, and medication management. However, it does not cover the cost of room and board, which is typically the largest expense. The Senior Assisted Living Subsidy Program may offer additional financial assistance for eligible low- to moderate-income seniors.
What is the Maryland Medicaid income limit for seniors in 2026?
For seniors seeking long-term care through Nursing Home Medicaid or Home and Community-Based Services (HCBS) waivers like the Community Options Waiver, the individual income cap in Maryland for 2026 is $2,982 per month. For married couples where both apply, the limit is $5,964 per month. Maryland also has a Medically Needy pathway allowing individuals to 'spend down' excess income on medical expenses to qualify.
How long is the HCBS waiver waitlist in Maryland?
The Community Options Waiver in Maryland has a significant waitlist, formally known as the Service Registry. As of January 31, 2025, there were 24,015 individuals on this registry. While 700 invitations to apply are sent monthly, the estimated wait time can be several years. Nursing home residents are given priority for waiver slots.
Will Medicaid take my parent's house in Maryland?
Medicaid generally does not 'take' a parent's house while they are alive, and a primary residence is typically exempt from asset limits up to a home equity limit of $752,000 in 2026, especially if a spouse or dependent child lives there. However, after the Medicaid recipient's death, Maryland's Estate Recovery Program may seek reimbursement for long-term care costs from the estate, which can include placing a lien on the home.
Can I be paid to care for my parent through Maryland Medicaid?
Yes, Maryland Medicaid offers programs that allow family members to be paid caregivers. The Community First Choice (CFC) Program is a key option that enables eligible individuals to hire a trusted caregiver, including a family member, to provide in-home personal assistance services. Caregivers must meet certain requirements, including being at least 18 years old and passing a background check.
Medicaid vs Medicare for long-term care in Maryland?
Medicare is a federal health insurance program primarily for individuals aged 65 and older, covering acute medical care and limited short-term skilled nursing facility stays. It does not cover long-term custodial care. Maryland Medicaid (Medical Assistance), a joint federal-state program for low-income individuals, is the primary payer for long-term care, including extensive nursing home services and home and community-based services through programs like the Community Options Waiver and Community First Choice.
TOPICAL GUIDES — HOW MEDICAID WORKS
EXPLORE MARYLAND
Last updated: April 24, 2026. Sources: Maryland Department of Health, CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.