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The Wise Senior

Maryland Medicaid long-term care: who qualifies

Medicaid is the biggest payer of long-term care in the country — nursing homes, and increasingly care at home — and Medicare is not. Qualifying turns on two tests: a financial one, which is the tables below, and a functional one, which asks how much help you need with daily life. You have to pass both.

Read this before you read the numbers.

These figures are a starting point for a conversation, not a decision. Medicaid eligibility is decided by the Maryland Department of Health on the whole picture — income, assets, the look-back, your medical need, and rules that differ for a married couple in ways no table holds. Nothing here is legal advice.

The 2026 limits in Maryland

Income limits are monthly. Asset limits count only what Maryland treats as countable — a home you live in and one car usually sit outside that, within limits.

  1. Nursing facility (institutional) Medical Assistance

    Level of care needed: A doctor and the state must both agree you need the level of care a nursing home provides — help with daily activities such as bathing, dressing, eating or moving about, or skilled nursing care.

    One person applying

    Monthly income limit:
    Not published
    Countable asset limit:
    $2,500

    Married, both applying

    Monthly income limit:
    Not published
    Countable asset limit:
    $3,000

    Married, one applying — the other stays at home

    Monthly income limit:
    Not published
    Countable asset limit:
    $2,500
  2. Home and community based services waiver

    Level of care needed: You must need the same nursing-home level of care, but you get the care at home or in the community instead of moving into a facility.

    One person applying

    Monthly income limit:
    Not published
    Countable asset limit:
    $2,500

    Married, both applying

    Monthly income limit:
    Not published
    Countable asset limit:
    $3,000

    Married, one applying — the other stays at home

    Monthly income limit:
    Not published
    Countable asset limit:
    $2,500
  3. Medically needy Medical Assistance for the aged, blind and disabled

    Level of care needed: No nursing-home level of care is required. You qualify on age (65+), blindness or disability alone.

    One person applying

    Monthly income limit:
    $350 a month
    Countable asset limit:
    $2,500

    Married, both applying

    Monthly income limit:
    $392 a month
    Countable asset limit:
    $3,000

    Married, one applying — the other stays at home

    Monthly income limit:
    Not published
    Countable asset limit:
    Not published

"Not published" means Maryland does not publish a separate figure for that combination — not that there is no limit. Ask the Maryland Department of Health rather than assuming another row applies.

The look-back period

60 months

That is 5 years. When you apply, Maryland looks back over that window at money and property given away or sold for less than it was worth. Transfers found there can trigger a penalty period — a stretch of time during which Medicaid will not pay, calculated from the amount transferred. It is the single most common way a family gets a nasty surprise.

How the look-back actually works

If one spouse stays at home

When one spouse needs care and the other remains at home, the law does not expect the spouse at home to be left with nothing. They may keep a share of the couple's countable assets — the community spouse resource allowance — between $32,532 and $162,660, depending on the couple's circumstances.

There is a matching protection for income. This is the area where good advice pays for itself several times over, and where a form filled in wrongly is expensive to undo.

Particular to Maryland

  • Maryland does not use a fixed income ceiling for long-term care, and that makes it genuinely different from almost every other state. Your income is compared to the actual monthly cost of your care. If your available income is less than that cost you are eligible and the program helps pay; if it is more you may still qualify through spend-down but the program will not contribute to the cost of care.
  • For scale, Maryland publishes an average cost of care of $12,501 a month, or $411 a day, effective 7/1/25. That is a reference figure, not an eligibility limit.
  • Maryland's resource standard for an institutionalized person is $2,500 for one and $3,000 for two — not the $2,000 used by most states, because Maryland measures institutionalized applicants against its medically needy schedule. Its separate categorically needy standard is the familiar $2,000 and $3,000.
  • Waiver services are administered under the same cost-of-care framework as institutional care.
  • The at-home spouse keeps between $32,532 and $162,660, both effective 1/1/26, with a maximum monthly allowance of $4,066.
  • The personal needs allowance is $106 a month for an individual and $212 for a couple, and the home equity limit is $752,000.
  • The look-back period is 60 months.

Who to ask, and in what order

This page is not legal advice. It is a transcription of published limits, and limits are the easy part. Whether a particular house, annuity, trust or transfer counts — and what to do about it — depends on facts we cannot see.

  • the Maryland Department of Health decides

    Only the state agency can determine eligibility, and only their published materials are authoritative. If what you read here ever disagrees with what they say, they are right and we are wrong — please tell us.

    the Maryland Department of Health

  • An elder-law attorney is the right professional

    For anything involving a house, a transfer already made, a trust, a second marriage, or a spouse staying at home, this is a job for a lawyer who does Medicaid planning in Maryland — not for a form-filling service. The National Academy of Elder Law Attorneys ↗ keeps a directory. Many will do a paid first meeting for a fixed fee; ask what it costs when you book.

  • Free help first, if money is tight

    The free counseling program in Maryland will talk any of this through at no charge and sells nothing, and the Eldercare Locator (ACL): 1-800-677-1116 connects you to the area agency on aging for your county.

Estimate only — not financial, tax, legal, or insurance advice. Only the Maryland Department of Health can determine your actual amounts. Limits change — sometimes in January, sometimes on a schedule of the state's own — and a figure that was right last year may not be right today. The date we last checked these against the Maryland Department of Health is printed in the stamp above.

Common questions

What are the Medicaid long-term-care limits in Maryland?
Maryland sets a monthly income limit and a countable asset limit, and both depend on which program you are applying to and whether you are single or married. The figures on this page are transcribed from the state agency's own published materials, with the date we checked them printed beside the table.
Does the house count against the asset limit?
Usually not while you or a spouse live in it, and often not up to an equity limit — but the rules are specific, they differ by state, and estate recovery after death is a separate question. This is exactly the kind of thing to take to an elder-law attorney rather than settle from a web page.
Can I give money away to qualify?
No. Maryland looks back at transfers made in the years before an application and can impose a penalty period of ineligibility for gifts made during it. Get advice before moving any money.