Delaware Medicaid Eligibility: Income Limits, Asset Rules & How to Apply

Delaware Medicaid, administered by the Delaware Health and Social Services (DHSS), is a health Delaware Medicaid is administered by the Delaware Division of Medicaid and Medical Assistance (DMMA), a division of the Delaware Department of Health and Social Services (DHSS).

It provides health coverage to low-income Delawareans including children, pregnant women, parents, seniors, and people with disabilities, funded jointly by federal and state dollars.

Delaware is a small state with a distinctive Medicaid profile. As the second-smallest state by land area, Delaware operates with a relatively compact DHSS administrative structure — but one that covers a surprisingly diverse population: densely urban Wilmington in New Castle County, suburban communities in the middle, and a large retiree and seasonal population along the Sussex County coast. That geography creates meaningful variation in long-term care demand across the state.

What sets Delaware apart within this series: the state’s CHIP program — the Delaware Healthy Children Program (DHCP) — covers children and pregnant women up to 213% FPL ($2,787/month), matching Arkansas and higher than the 200% baseline used by Alabama, Colorado, and others.

Delaware’s primary HCBS waiver is delivered through the Diamond State Health Plan Plus (DSHP-Plus), a managed care model that integrates medical and long-term care services. And like Connecticut, California, and other expansion states, Delaware closed the ACA coverage gap in 2014, covering adults without dependents up to 138% FPL with no asset test.

This guide covers every major Delaware Medicaid program, 2026 income and asset limits, the 60-month look-back rule, and how to apply through Delaware ASSIST. For a quick eligibility check, use our Medicaid Eligibility Calculator before applying.

Delaware Medicaid Programs

Institutional / Nursing Home Medicaid

An entitlement program with no waiting list — everyone who qualifies is guaranteed coverage. It funds care in nursing facilities, hospitals, and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). Applicants must demonstrate a Nursing Facility Level of Care (NFLOC) based on documented functional limitations. Delaware’s small size means there are relatively few nursing facilities statewide — primarily concentrated in New Castle County and Kent County — which can affect placement options for Sussex County residents.

Diamond State Health Plan Plus (DSHP-Plus) — HCBS Waiver

Delaware’s primary home and community-based services program is the Diamond State Health Plan Plus (DSHP-Plus), a managed care model that integrates acute medical care with long-term services and supports. Unlike some states where HCBS waivers and standard Medicaid are administered separately, DSHP-Plus coordinates both through contracted managed care organizations. It covers in-home personal care, adult day services, delivered meals, and other community-based supports. DSHP-Plus is a non-entitlement program with limited slots — waiting lists apply, particularly for seniors in New Castle County. Apply early. While waiting for DSHP-Plus enrollment, many Delawareans also qualify for food assistance — see our Delaware SNAP benefits page.

Regular Medicaid (Aged, Blind, and Disabled)

Covers elderly, blind, or disabled Delawareans with lower income and assets, without requiring nursing-level medical need. No look-back period applies to this program. SSI recipients are typically categorically eligible, bypassing income and asset tests. For seniors on Social Security who also need food assistance, see our guide on whether seniors on Social Security can get food stamps.

Delaware Healthy Children Program (DHCP) — Children and Pregnant Women

The Delaware Healthy Children Program (DHCP) is Delaware’s CHIP program, covering children up to age 19 and pregnant women at income limits up to 213% FPL ($2,787/month for a household of one) — consistent with Arkansas and higher than the 200% base threshold used by Alabama, Colorado, and several other states. Pregnant women’s coverage extends 12 months postpartum. No asset test applies. Families who qualify here may also be eligible for WIC nutrition support — see Delaware WIC income guidelines or use our WIC Eligibility Calculator.

Medicaid for Adults (ACA Expansion)

Delaware adopted ACA Medicaid expansion in 2014, covering adults aged 19–64 without dependent children earning up to 138% FPL ($1,799/month for a single person). No asset test applies. Delaware’s large service industry, healthcare workforce, and tourism-adjacent economy along the Rehoboth Beach and Lewes coastal corridor relies meaningfully on this coverage. Starting January 2027, federal work requirements will apply to ACA expansion adults — a population that includes many of Delaware’s seasonal hospitality and retail workers.

General Eligibility Requirements

• Delaware Residency: You must currently reside in Delaware.
• Citizenship / Immigration Status: U.S. citizens, nationals, and qualifying immigrants — including permanent residents with 5+ years in the U.S., refugees, and asylees — are eligible. Undocumented immigrants are generally not eligible for full Medicaid, though emergency services may be covered.
• Income: Varies by program — see limits below.
• Assets: Limits apply for long-term care and aged/blind/disabled programs only.
• Medical / Functional Need: Nursing home Medicaid and DSHP-Plus require documented NFLOC.

2026 Income Limits for Delaware Medicaid

Delaware uses the standard 48-state FPL figures. Income limits below are expressed as monthly amounts.

Important Notes on Income

Nursing Home / DSHP-Plus applicants above the income limit: If monthly income exceeds $2,901, a Qualified Income Trust (QIT) redirects excess income to establish eligibility. Delaware Medicaid must be named as the QIT beneficiary at the recipient’s death. Delaware’s Personal Needs Allowance for nursing home residents is $50/month — lower than Arkansas ($75), Colorado ($72), and Connecticut ($60), but above Alabama’s $30/month minimum. For HCBS participants living at home, Delaware allows a higher personal income retention reflecting real-world household costs.

Married couples, one spouse applying: Only the applicant’s income counts toward the $2,901 limit. The community spouse may retain income up to a Minimum Monthly Maintenance Needs Allowance (MMMNA) of $3,948/month, provided housing and utility costs exceed $793.13/month (effective July 1, 2025 through June 30, 2026).

Use our FPL Calculator to check where your household falls, or see our Delaware Medicaid income eligibility page for a full program-by-program breakdown.

2026 Federal Poverty Level Reference (48 States & D.C.)

Asset Rules for Delaware Medicaid

Asset tests apply only to long-term care (Nursing Home / DSHP-Plus) and Regular Medicaid for the aged, blind, and disabled. ACA expansion adults, DHCP children, and pregnant women face no asset test.

Long-Term Care Medicaid (Nursing Home and DSHP-Plus)

Countable asset limits:

• Single applicant: $2,000
• Married, both applying: $3,000 total
• Married, one applying: $2,000 for the applicant; up to $157,920 for the non-applicant spouse (Community Spouse Resource Allowance, or CSRA)

Home equity limit: $730,000. The primary home is exempt if the applicant or their spouse lives there or intends to return, provided equity stays under $730,000. Delaware’s real estate market — particularly in the Wilmington suburbs of New Castle County and the growing coastal communities of Rehoboth Beach, Lewes, and Bethany Beach — has seen significant appreciation. Sussex County beach properties and second homes are classified as countable assets unless the primary home exemption applies, making property planning an important consideration for coastal Delaware homeowners.

Non-countable (exempt) assets include:

• Primary home (subject to the $730,000 equity cap)
• One vehicle
• Household goods and personal effects
• Irrevocable Funeral Trusts (IFTs)
• Medicaid Compliant Annuities
• Life insurance with a face value of $1,500 or less

Delaware’s 60-Month Look-Back Rule

Delaware enforces a standard 60-month (5-year) look-back period for Nursing Home Medicaid and DSHP-Plus. All asset transfers within that window are reviewed. Gifts or transfers below fair market value — including transfers of Delaware beach property or Wilmington-area real estate to family members — can trigger a penalty period of Medicaid ineligibility proportional to the value transferred.

Delaware’s retiree population — particularly in Sussex County, where retirement communities have grown rapidly — frequently involves property gifting and estate planning that intersects with look-back rules. Seniors who have transferred beach properties, investment accounts, or family land within 5 years of applying should consult a Certified Medicaid Planner before submitting an application. There is no look-back period for Regular Medicaid.

Delaware’s Medicaid Estate Recovery Program

After a Delaware Medicaid long-term care beneficiary passes away, the state’s Estate Recovery Program seeks reimbursement from the estate. The primary home is the most common recovery target when no exempt spouse or qualifying dependent remains in residence. Sussex County’s coastal real estate values make estate recovery exposure potentially significant — planning tools such as certain irrevocable trusts can help reduce this exposure.

Regular Medicaid (Aged, Blind, and Disabled)

Asset limit is $2,000 for individuals and $3,000 for couples. No home equity cap and no look-back period apply to this program.

Medical and Functional Requirements

For Nursing Home Medicaid and DSHP-Plus, applicants must demonstrate a Nursing Facility Level of Care (NFLOC) through a formal evaluation of:

• Activities of Daily Living (ADLs): bathing, dressing, eating, toileting, mobility
• Instrumental Activities of Daily Living (IADLs): cooking, shopping, managing finances, taking medications
• Cognitive or behavioral issues — including Alzheimer’s disease and dementia. A diagnosis alone does not satisfy NFLOC; documented functional limitations are required.

For Regular Medicaid covering the aged, blind, or disabled, applicants must document disability or blindness per Social Security Administration (SSA) criteria. NFLOC is not required for this program.

Delaware’s small geographic footprint means NFLOC assessments can generally be arranged without the travel burdens faced by applicants in larger rural states — though placement in a specific nursing facility or region may still require coordination, particularly for Sussex County residents who prefer to remain near family in southern Delaware.

What Federal Policy Changes Mean for Delaware Medicaid

The One Big Beautiful Bill Act, signed July 4, 2025, introduces Medicaid changes phasing in through 2028. Delaware’s expansion status means these changes affect a broader population here than in non-expansion states.

• Work Requirements (Starting January 2027): Federal work requirements will apply to ACA expansion adults aged 19–64. Delaware’s seasonal hospitality and retail workforce along the Sussex County coast — a major tourism corridor — may face documentation challenges during off-seasons. DMMA will need to build tracking and compliance infrastructure. Seniors, disabled individuals, pregnant women, and children are exempt.
• Reduced Retroactive Coverage (Starting January 2027): Coverage will only extend back 2 months from application, down from 90 days. Delawareans who delay applying after an illness or hospitalization will face more uncovered medical debt.
• More Frequent Eligibility Renewals (Starting December 2026): Renewals every 6 months instead of annually. Delaware’s relatively small DHSS administrative structure will need to manage a significant increase in renewal volume.
• New Out-of-Pocket Costs (Starting October 2028): Non-exempt beneficiaries may owe up to $35 per specialist visit. Primary care and preventive services remain free.
• Funding Cuts: Projected federal Medicaid cuts of approximately $1 trillion over 10 years may affect Delaware’s community health centers and hospital-based outpatient programs in Wilmington and Dover serving the state’s lower-income urban populations.

For how these changes affect SNAP benefits alongside Medicaid, see our article on Big Beautiful Bill SNAP changes.

Options If Your Income or Assets Exceed the Limit

Qualified Income Trusts (QITs): For Nursing Home Medicaid and DSHP-Plus, a QIT redirects excess monthly income to bring you under the $2,901 threshold. The trust is irrevocable and must name Delaware Medicaid as the beneficiary. Must be established by an attorney or Certified Medicaid Planner before application.

Irrevocable Funeral Trusts (IFTs): Pre-paid funeral and burial expenses placed in an IFT are exempt from asset limits. Confirm Delaware’s current IFT dollar cap with a Certified Medicaid Planner.

Asset Spend-Down: Converting countable assets into exempt ones — home improvements, vehicle purchase, paying off debt — can reduce countable assets below $2,000. Must be structured carefully to avoid look-back violations.

Medicaid Compliant Annuities: In spousal situations, converting excess assets into a compliant annuity can reduce the applicant’s countable assets while generating protected income for the community spouse.

Certified Medicaid Planners: Delaware’s growing retiree population in Sussex County — with beach properties, investment portfolios, and active estate planning — makes professional Medicaid planning particularly valuable. A planner can help structure assets to protect both eligibility and family wealth in Delaware’s coastal property environment.

While addressing a Medicaid income or asset issue, check whether SNAP food assistance is available in parallel — see SNAP income limits for Delaware to see if benefits can help cover food costs alongside health coverage.

How to Apply for Delaware Medicaid

Delaware centralizes most benefit applications through its Delaware ASSIST portal, which handles Medicaid, SNAP, and other DHSS programs together.

Application Methods

• Online via Delaware ASSIST (Recommended): Apply at assist.dhss.delaware.gov. Before applying, use our Medicaid Eligibility Calculator to confirm which program applies. For a step-by-step walkthrough, see our Delaware Medicaid application guide.
• Phone: Call Delaware Medicaid Customer Relations at 1-800-372-2022 for application assistance.
• In-Person or Mail: Download a paper application from dhss.delaware.gov and submit to a local DHSS office. Delaware has offices in all three counties (New Castle, Kent, and Sussex) — given the state’s small size, in-person access is more practical here than in larger states.
• Long-Term Care Support: Contact the Division of Medicaid and Medical Assistance or a local Area Agency on Aging at 1-800-223-9074 for help with DSHP-Plus applications and NFLOC assessment coordination.

Documents You’ll Need

• Proof of Delaware residency
• Proof of income (pay stubs, Social Security award letters, tax returns)
• Proof of assets (bank statements, investment accounts, property records) — for long-term care applications
• Proof of citizenship or qualifying immigration status
• Medical records documenting functional limitations (for Nursing Home / DSHP-Plus applications)
• Disability documentation per SSA criteria (for Regular Medicaid aged/blind/disabled)

An interview may be required for long-term care and disability-based applications. Delaware ASSIST handles SNAP and Medicaid in the same portal — if applying for both, you can complete them together.

Processing Times

• Standard applications: Up to 45 days
• Disability-based applications: Up to 90 days
• Pregnant women: May qualify for presumptive eligibility for outpatient care while the full application processes

Starting January 2027, retroactive coverage drops to 2 months before application. Apply promptly after any health event that generates medical bills you want Delaware Medicaid to cover.

Delaware Medicaid and Other Benefit Programs

• SNAP (Food Stamps): Many Delaware Medicaid recipients also qualify for SNAP. Delaware ASSIST handles both applications in the same portal. See our Delaware SNAP page or Delaware SNAP application guide. If you already receive benefits, see how to check your SNAP balance in Delaware.
• WIC: Pregnant women and young children qualifying for Medicaid typically also qualify for WIC. See Delaware WIC income guidelines.
• EBT Discounts: Delaware EBT cardholders may access discounts at certain retailers. See EBT discounts available in Delaware.
• Medicare: Many Delaware seniors rely on both Medicare and Medicaid simultaneously. Understanding the difference between Medicare and Medicaid is essential — Medicare covers short-term skilled nursing care, while Delaware Medicaid (through DSHP-Plus or nursing home Medicaid) covers long-term care costs that Medicare does not.
• SNAP Work Requirements: ACA expansion adults who also receive SNAP should know both programs will have federal work requirements starting in 2027. Read our guide on SNAP work requirements for what to expect and which exemptions apply.

Common Questions About Delaware Medicaid

How do I apply for Medicaid in Delaware?

Apply online at assist.dhss.delaware.gov, by phone at 1-800-372-2022, or in person at a DHSS county office. Our Delaware Medicaid application guide has step-by-step instructions. For a national overview, see where to apply for Medicaid.

What are the 2026 income limits for Delaware Medicaid?

Seniors and disabled in nursing homes or DSHP-Plus: $2,901/month (single) or $5,802/month (couple). Regular Medicaid (aged/blind/disabled): $967/month (single) or $1,450/month (couple). ACA expansion adults: $1,799/month (138% FPL). DHCP children and pregnant women: $2,787/month (213% FPL). Full details at our Delaware Medicaid income eligibility page.

Are there asset limits for Delaware Medicaid?

Yes, for long-term care and aged/blind/disabled programs: $2,000 (single), $3,000 (couple, both applying), or $157,920 for a non-applicant spouse. Home equity limit is $730,000 — relevant for Sussex County coastal property owners. No asset test for DHCP children, pregnant women, or ACA expansion adults.

What is the look-back period for Delaware Medicaid?

A 60-month look-back applies to Nursing Home Medicaid and DSHP-Plus. Property transfers — including Sussex County beach properties and Wilmington-area real estate — within 5 years of application can trigger penalty periods. No look-back applies to Regular Medicaid.

What is DSHP-Plus and how does it differ from standard HCBS waivers?

DSHP-Plus (Diamond State Health Plan Plus) is Delaware’s integrated managed care model that combines standard medical Medicaid with long-term home and community-based services in a single plan. Rather than managing acute care and long-term care separately, DSHP-Plus coordinates both through contracted managed care organizations — an integrated model designed to reduce duplication and improve care coordination.

Is Medicaid free in Delaware?

Most Delaware Medicaid programs have no premiums and minimal cost-sharing today. Starting October 2028, non-exempt beneficiaries may owe up to $35 per specialist visit. See our guide on whether Medicaid is free.

Does Delaware Medicaid cover dental care?

Delaware Medicaid covers dental services for children under DHCP. Adult dental coverage is more limited — primarily emergency extractions. See our full guide on what dental services Medicaid covers.

Does Delaware Medicaid cover prescriptions?

Yes — all major Delaware Medicaid programs include prescription drug coverage. See our article on Medicaid prescription coverage for details.

This guide reflects 2026 federal and Delaware DHSS/DMMA guidelines. Rules change — verify current requirements with the Delaware Division of Medicaid and Medical Assistance at dhss.delaware.gov or by calling 1-800-372-2022 before making eligibility decisions.