Maryland Medicaid eligibility for home care: two tests, one decision
Usually the question comes up at the kitchen table. Mom needs help bathing and getting to the bathroom at night, and the family wonders whether Maryland Medicaid will pay for it.
The answer depends on two tests. MDH describes waiver eligibility in three parts: medical (a level-of-care tool), technical (permanent Maryland residence, choosing community care over an institution, and a plan of service that supports health and welfare) and financial (an income and asset review).
Below: the financial half first, then the medical half. Maryland Medicaid makes every decision.
Financial eligibility: Maryland Medicaid income limits for 2026
Full Medicaid comes first for CFC and CPAS
Community First Choice and CPAS don’t set their own income limit. The person must already have full Medicaid. MDH’s shorthand: you have full Medicaid if you have a red and white card.
Under COMAR 10.09.84.04, a CFC participant must qualify for Medicaid in an eligibility group under COMAR 10.09.24. Ask the eligibility worker which group applies.
300% of SSI for the waiver and PACE
The Community Options Waiver caps monthly income at 300% of the SSI benefit. PACE uses the same 300% cap for one person.
The 2026 SSI federal benefit rate is $994 a month for an individual ($1,491 for a couple). Calculated from SSA’s 2026 rate, 300% is about $2,982 a month (3 × $994). MDH publishes the rule as a percentage, so confirm the dollar figure.
Maryland Medicaid asset limit for home care
Countable assets have to be low. Here’s what the sources say for 2026:
- CO Waiver: no more than $2,000 or $2,500, depending on eligibility category.
- Increased Community Services: no more than $2,500, counting only the applicant’s own assets.
- PACE: no more than $2,000.
- Medically needy standard: COMAR 10.09.24.08 sets $2,500 for one person and $3,000 for a couple (aged, blind and disabled).
Don’t confuse these with the SSI resource limit of $2,000 for an individual and $3,000 for a couple. That’s an SSI rule, not the Maryland Medicaid limit.
The 60-month look-back on transfers
Giving money or property away can matter. For transfers on or after February 6, 2006, Maryland looks at the 60-month period before the date a person is both institutionalized and has applied for Medicaid.
The penalty bars payment for nursing facility services, equivalent institutional care and 1915(c) waiver services. A Maryland Medicaid manual release says the penalty applies only to people who are institutionalized or enrolled in a 1915(c) waiver, and that it doesn’t affect Medicaid eligibility itself. During the penalty, Medicaid simply doesn’t pay for those services.
Bring records of any large gifts or property sales from the last five years.
Spouses, estate recovery and what stays protected
When a married person applies, a spouse at home has protections under federal spousal impoverishment standards. For 2026, the CMS standards are reported as a community spouse resource allowance of $32,532 minimum and $162,660 maximum, and a maximum monthly maintenance needs allowance of $4,066.50 from January 1, 2026. Some allowances adjust each July 1. Ask the eligibility worker how these apply to your household.
Estate recovery under COMAR 10.09.24.15 applies to people who were 55 or older when they got Medical Assistance benefits. Recovery waits until a surviving spouse has died, and it’s barred in cases of substantial hardship.
Medical eligibility for Maryland Medicaid home care
Nursing facility level of care: CFC and the CO Waiver
Both Community First Choice and the Community Options Waiver require a nursing facility level of care. That doesn’t mean the person must live in a nursing home. It means their needs are at the level a facility would handle, and they choose to be cared for at home instead.
The CO Waiver adds technical rules: age 18 or older, not enrolled in another waiver or PACE at the same time, community services costing no more than institutional care, and the ability to live safely at home with services.
Help with one daily activity: CPAS
CPAS is for people who need help with at least one activity of daily living, such as bathing, dressing or moving around. It doesn’t require a nursing facility level of care, only a lower “CPAS level of care,” per Anne Arundel County’s program page.
How the medical test is done
A trained nurse or social worker from the local health department completes the interRAI assessment, according to 2019 MDH training material. The result shows whether the person meets nursing facility level of care or the CPAS level.
Maryland Medicaid eligibility by program
| Program | Medical test | Age | Income | Countable assets | How to start |
|---|---|---|---|---|---|
| Community First Choice | Nursing facility level of care | No limit | Full Medicaid required | Part of the full Medicaid test | MAP or 410-767-1739 |
| CPAS | Help with at least 1 ADL | No limit | Full Medicaid required | Part of the full Medicaid test | MAP or 410-767-1739 |
| CO Waiver | Nursing facility level of care | 18+ | Up to 300% of SSI (about $2,982/mo, calc.) | $2,000 or $2,500 by category | Registry through MAP |
| Increased Community Services | Nursing facility level of care, 6+ months in a facility | 18+ | Above 300% of SSI | Up to $2,500 | Referral from Medicaid’s Eligibility Determination Division |
| PACE | Nursing facility level of care | 55+ | Up to 300% of SSI | Up to $2,000 | Through a PACE provider |
| Medical Day Care Waiver | Nursing facility level of care plus a medical order | 16+ | Full Medicaid required | Part of the full Medicaid test | Local health department or MAP |
Baltimore families near Bayview may know Hopkins ElderPlus, the PACE program based at Johns Hopkins Bayview. Confirm its current service area directly.
If income is too high for Maryland Medicaid home care
Increased Community Services. If the person has lived in a nursing facility at least six months while Medicaid-eligible, Increased Community Services serves people whose income is above the CO Waiver cap.
In-Home Aide Services. DHS In-Home Aide Services helps adults 18 and older with personal care and chores. Clients may pay part of the hourly cost based on income and family size, and funding is limited.
Maryland Senior Care. For people 65 and older at risk of nursing home placement, Senior Care offers case management and gap-filling funds. Its own income and asset limits apply.
Insurance and private pay. Medicare doesn’t pay for long-term care, but private long-term care insurance may. Many families pay privately for personal care, homemaker services or respite care for a family caregiver.
Get an eligibility screening in Baltimore City or Baltimore County
Maryland Access Point screens for programs and explains options. In the city, call MAP of Baltimore City at 410-396-CARE (2273), Monday to Friday, 8:30 a.m. to 4:30 p.m. In the county, call the Baltimore County Department of Aging at 410-887-2594 in Towson. Statewide, dial 1-844-627-5465.
Next, our guide on how to apply for Medicaid home care walks through each step, and the Medicaid home care hub compares programs.
We serve families who use Maryland Medicaid personal assistance programs across our Baltimore service area. To talk through your situation with a Canton home care office, call 410-421-1041 or send us a message.
This page is general information, not legal or benefits advice. Rules change, so confirm your situation with Maryland Medicaid or Maryland Access Point.