How to Qualify for Medicaid for Nursing Homes and Other Long-term Care in Maryland

Medical Assistance (Medicaid) is the government health insurance program that helps pay for long-term nursing home care.

Financial Eligibility for Maryland Medicaid

Medicaid is means tested: the government looks at both the nursing home resident’s, and, if applicable, the nursing home resident’s spouse’s assets when determining financial eligibility for benefits.


In Maryland, the nursing home resident’s income test is “so long as income does not exceed the cost of care.” So, for instance, say that the nursing home resident receives Social Security, pension income and/or other retirement income of $3,000/month, and lives in a nursing home which costs $11,000/month. He meets the income test. All of his net monthly income goes to the nursing home, and Medicaid covers the rest.

There is no income test for the nursing home resident’s spouse: regardless of how much retirement pay or other income the community spouse receives, Medicaid never takes any of the community spouse’s income to help pay for the nursing home resident’s care.

In fact, Medicaid allows a lower income community spouse to keep some of the nursing home resident spouse’s monthly retirement income, up to a maximum of $3,022/month (in 2018).


With regards to assets, in determining Medicaid eligibility, Maryland Medicaid does not count (or counts but exempts) the following:

Nursing home resident: $2,500.

Community spouse:

  • the residence, of any value;
  • household furnishings;
  • a motor vehicle; and
  • in addition to all of that (in addition to the house, household furnishings and one car), a “community spouse resource allowance,” equal to one-half of the couple’s other property, up to $123,600 (in 2018).

Medicaid Planning

Most understand these rules on financial eligibility for Medicaid to mean: that’s what Medicaid allows you to keep, and the rest must go the nursing home. But that is not what the law says. Rather, the law is that you must “spend down” the over-scale. And you can spend it on nursing home care, if that’s what you want to do. Or you can spend it in other legally permissible ways that are not penalized, so you can keep more of your money, qualify for Medicaid faster, and get that government health insurance coverage for nursing home care.

Medicaid planning may include:

  • for a single nursing home resident, establishing and funding a supplemental needs trust (also known as a special needs trust);
  • for the nursing home resident’s spouse, the purchase of a Medicaid-compliant annuity; and
  • for the nursing home resident’s child(ren), gifting strategies.

For More Information or Help with Maryland Medicaid Planning

The person who knows about Medicaid law and how to help you with Medicaid planning is an elder law and disability law attorney.

The Law Office of Henry Nash practices Maryland Medicaid law. If you have any questions or concerns about paying for long-term nursing home care, and want to discuss with an experienced elder law and disability law attorney, please feel free to contact us.