For many Maryland families, Medicaid is an important source of support for nursing home care. The rules can seem complicated at first, but understanding the basics makes the process much easier. Here is how it works.
Quick takeaways
- Maryland Medicaid’s Long Term Care program helps eligible residents with nursing home care.
- Eligibility is based on medical need and on income and assets.
- Maryland reviews financial records from the five years before you apply, known as the look-back period.
- Baltimore residents can apply online through myMDTHINK, by mail or in person, and nursing facilities can often help with the process.
How Maryland Medicaid helps with nursing home care
Maryland’s Long Term Care Medical Assistance program helps eligible residents with the cost of care in a nursing facility. It can also help with doctor visits, medications and other medical services. Maryland also offers home and community-based programs for people who would rather receive support at home.
Who qualifies
Eligibility is based on two main things:
- Medical need. A person must need the level of care a nursing facility provides. This is confirmed through a medical review.
- Financial eligibility. Income and assets must fall within the program’s limits. Some assets, such as a primary home in certain situations and personal belongings, may not be counted.
Special rules help protect a spouse who continues to live at home, so married couples should ask for guidance before assuming they do not qualify.
The five-year look-back period
When you apply, Maryland reviews financial records from the five years before the application date. This is called the look-back period. Gifts or transfers of money or property for less than fair value during that time can affect eligibility. Keeping good records makes the review go more smoothly.
Start gathering paperwork early. It is the single most helpful step for a smooth application.
What is a spend down?
If income or assets are above the limits, a person may still become eligible by reducing countable resources through allowable expenses. This is often called a spend down. Rules about what counts are specific, so a caseworker or an elder law attorney can help you plan.
How to apply in Baltimore
- Online through the state’s myMDTHINK benefits portal
- By mail or in person using the Long Term Care/Waiver Medical Assistance application
- With help from the facility. Many nursing facilities guide families through the application.
For Baltimore City and Baltimore County residents, long-term care applications are processed by the state’s Bureau of Long Term Care.
Documents to gather
- Proof of identity, age and Maryland residency
- Social Security, Medicare and any other insurance cards
- Income records, such as Social Security and pension statements
- Bank and investment statements
- Records of property, life insurance and any recent large transfers
Medicare and Medicaid together
Many people start with a short-term rehab stay covered by Medicare and later need ongoing care. Our guide, Does Medicare cover nursing home and rehab care?, explains Medicare’s role. For a look at all the options, see how to pay for long-term care. Local help is listed in our guide to Baltimore senior and caregiver resources.
Frequently asked questions
Does Maryland Medicaid cover nursing home care?
Yes. Maryland’s Long Term Care Medical Assistance program helps cover nursing home care for residents who meet its medical and financial requirements.
Who qualifies for Medicaid nursing home care in Maryland?
Applicants generally need to be Maryland residents who need a nursing facility level of care and who meet income and asset limits. The rules have some flexibility, especially for married couples, so it is worth asking for guidance.
What is the Medicaid look-back period in Maryland?
Maryland reviews financial transactions from the five years before the application date. Gifts or transfers made for less than fair value during that time can affect eligibility.
What is a Medicaid spend down?
A spend down is the process of reducing countable income or assets to meet Medicaid’s limits, for example by paying for care or other allowable expenses. A caseworker or elder law attorney can explain what is allowed.
How do I apply for long-term care Medicaid in Baltimore?
You can apply online through the state’s myMDTHINK portal, by mail or in person. For Baltimore City and Baltimore County residents, long-term care applications are handled by the state’s Bureau of Long Term Care. Many nursing facilities help families with the application.
This article is general information, not medical, legal or financial advice. Coverage rules can change, so confirm details with Medicare, your plan or your care team.
