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

Maryland Medicaid is administered by the Maryland Department of Health (MDH) and funded by federal and state dollars. It provides health coverage to low-income Marylanders including children, pregnant women, parents, seniors, and people with disabilities.

Maryland runs one of the more distinctive Medicaid systems in the Mid-Atlantic region. Like Maine, the state does not use a Qualified Income Trust (QIT) for long-term care applicants with income above $2,901/month — instead using a medically needy pathway with a specific income threshold of $350/month for a single person.

Maryland’s asset limit for long-term care is $2,500 — slightly above the $2,000 standard but below Maine’s $10,000 — and the same $2,500 limit applies to Regular Medicaid for the aged, blind, and disabled. The children’s CHIP program — Maryland Children’s Health Program (MCHP) — extends to 319% FPL ($4,147/month), matching D.C., Illinois, Iowa, and Hawaii at the highest threshold in this series. Pregnant women qualify at a lower but still generous 252% FPL ($3,294/month).

Maryland also participates in the Restaurant Meals Program in select areas — allowing eligible elderly, disabled, and homeless Medicaid recipients to use their EBT card at participating restaurants. And the state’s Personal Needs Allowance of $88/month for nursing home residents is among the more generous in this series, reflecting Maryland’s high cost of living near the DC metro corridor.

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

Maryland 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). Maryland’s nursing home industry is concentrated in the Baltimore metro area, suburban DC counties (Montgomery, Prince George’s), and the Eastern Shore — Western Maryland and rural areas have more limited nursing facility options.

Community Options Waiver — Home and Community Based Services

Maryland’s primary HCBS waiver for seniors and disabled individuals is the Community Options Waiver, covering in-home personal care, adult day services, delivered meals, home modifications, and other community-based supports.

The Community Options Waiver is a non-entitlement program with limited slots and waiting lists. Demand is particularly high in Montgomery County, Prince George’s County, and Baltimore City — Maryland’s most populous and most ethnically diverse jurisdictions.

Apply as early as possible. While waiting, many Marylanders also qualify for food assistance — see our Maryland SNAP benefits page.

Regular Medicaid (Aged, Blind, and Disabled)

Covers elderly, blind, or disabled Marylanders with lower income and assets, without requiring nursing-level medical need. No look-back period applies.

Maryland offers a medically needy spend-down pathway — if income exceeds $967/month, qualifying medical expenses can be deducted to reach the Medicaid eligibility standard. SSI recipients are categorically eligible.

For seniors on Social Security who also need food assistance, see our guide on whether seniors on Social Security can get food stamps.

Maryland Children’s Health Program (MCHP)

MCHP (Maryland Children’s Health Program) covers children up to age 19 at income limits up to 319% FPL ($4,147/month for a single-person household) — matching D.C., Illinois, Iowa, and Hawaii at the highest children’s Medicaid threshold in this series.

Pregnant women qualify at a separate threshold of 252% FPL ($3,294/month), with coverage extending 12 months postpartum. No asset test applies to either program. Families who qualify may also be eligible for WIC — see Maryland WIC income guidelines or use our WIC Eligibility Calculator.

ACA Medicaid Expansion (2014)

Maryland expanded Medicaid under the ACA in 2014, covering adults aged 19–64 without dependent children earning up to 138% FPL ($1,799/month for a single person) with no asset test.

Maryland’s large federal government contractor workforce, service industry workers in the DC suburbs, hospitality employees in Ocean City and the Eastern Shore, and gig economy workers across the Baltimore metro relied heavily on this coverage. Starting January 2027, federal work requirements will apply to expansion adults. Maryland has not historically implemented work requirements and may pursue legal or administrative resistance.

General Eligibility Requirements

• Maryland Residency: You must currently reside in Maryland.
• 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. Maryland’s large immigrant communities in Montgomery County, Prince George’s County, and Baltimore City include many qualifying for coverage. 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 the Community Options Waiver require documented NFLOC.

2026 Income Limits for Maryland Medicaid

Maryland uses the standard 48-state FPL figures. Children (319% FPL) and pregnant women (252% FPL) qualify at different thresholds. Income limits below are expressed as monthly amounts.

Important Notes on Income

No QIT in Maryland — Medically Needy Pathway Instead: Maryland does not use a QIT (Miller Trust) for nursing home or waiver applicants with income above $2,901/month. Instead, Maryland uses a medically needy pathway with an income eligibility standard of $350/month for a single person.

Under this approach, a nursing home resident’s cost of care is applied against income to reduce it to the $350 medically needy level. The difference goes toward the cost of care, and Maryland Medicaid covers the remainder. This is structurally different from — and in many cases simpler than — a QIT. Attorneys and planners must apply Maryland-specific medically needy strategies, not QIT templates from other states.

Maryland’s Personal Needs Allowance for nursing home residents is $88/month — one of the more generous in this series, reflecting the high cost of personal items in Maryland’s DC-adjacent metro market. It is substantially higher than most Southern and Midwestern states in this series.

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). In Montgomery County, Howard County, and the DC suburbs, essentially all community spouses will meet the housing cost threshold.

Use our FPL Calculator to check where your household falls, or see our Maryland Medicaid income eligibility page for the full breakdown.

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

Asset Rules for Maryland Medicaid

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

Long-Term Care Medicaid (Nursing Home and Community Options Waiver)

Countable asset limits:

• Single applicant: $2,500 — slightly above the $2,000 standard but far below Maine’s $10,000
• Married, both applying: $3,000 total
• Married, one applying: $2,500 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.

Maryland’s real estate market — particularly in Montgomery County, Howard County, Anne Arundel County, and parts of Baltimore County — has some of the highest home values in the country outside of California and the Northeast coast. Many Maryland homeowners in these counties can approach or exceed the $730,000 cap. Applicants in the DC suburbs and Inner Harbor neighborhoods of Baltimore should carefully verify their equity position before applying.

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

Maryland’s 60-Month Look-Back Rule

Maryland enforces a standard 60-month (5-year) look-back period for Nursing Home Medicaid and the Community Options Waiver. All asset transfers within that window are reviewed.

Gifts or transfers below fair market value — including transfers of Maryland real estate, investment accounts, or cash to family members — can trigger a penalty period of Medicaid ineligibility.

Maryland’s high home values create specific look-back planning pressure. A Montgomery County or Howard County home that has appreciated dramatically in the past decade may, if gifted to adult children within 5 years, create a penalty period measured in years — not months. Estate attorneys and Medicaid planners in Maryland routinely encounter this scenario.

There is no look-back period for Regular Medicaid.

Maryland’s Medicaid Estate Recovery Program

After a Maryland Medicaid long-term care beneficiary passes away, Maryland’s Estate Recovery Program seeks reimbursement from the estate. Given Maryland’s high home values — particularly in the DC suburbs — estate recovery claims can be substantial.

Maryland limits estate recovery to the probate estate, meaning assets held in a properly structured trust may avoid recovery. Consult a Maryland-licensed Certified Medicaid Planner to explore protective strategies.

Regular Medicaid (Aged, Blind, and Disabled)

Asset limit is $2,500 for individuals and $3,000 for couples. No home equity cap and no look-back period apply. Maryland’s medically needy spend-down pathway is available here when income exceeds the limit.

Medical and Functional Requirements

For Nursing Home Medicaid and the Community Options Waiver, 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.

Maryland’s geography — spanning the DC suburbs, rural Western Maryland, the Eastern Shore, and Southern Maryland — creates significant variation in NFLOC assessment accessibility and nursing facility placement options across the state.

What Federal Policy Changes Mean for Maryland Medicaid

The One Big Beautiful Bill Act, signed July 4, 2025, introduces Medicaid changes phasing in through 2028.

Work Requirements (Starting January 2027): Federal work requirements will apply to ACA expansion adults aged 19–64. Maryland has not historically implemented work requirements and may pursue legal or administrative resistance — but federal compliance will likely be required.

Maryland’s large federal government contractor workforce presents a specific documentation wrinkle: many contractors have intermittent contract periods and may have gaps in documented employment that could complicate work requirement compliance even for people who are clearly working. 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. Marylanders who delay applying after a health event will face more uncovered medical debt — particularly consequential given Maryland’s high hospital costs.

More Frequent Eligibility Renewals (Starting December 2026): Renewals every 6 months instead of annually. Maryland’s large and mobile suburban DC population — with frequent job changes and address changes — may see higher renewal lapse rates.

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 Maryland’s safety-net hospitals in Baltimore City and rural hospitals on the Eastern Shore and in Western Maryland, where Medicaid is the primary payer for many patients.

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

Medically Needy Pathway (No QIT Required): Maryland uses a medically needy pathway rather than a QIT. The income eligibility standard is $350/month for a single person. Medical expenses — including nursing home costs — are applied against income to reduce it to this threshold.

Once income is reduced to $350/month on paper, Maryland Medicaid covers the remaining costs. This must be properly documented and structured — work with a Maryland-licensed attorney or Certified Medicaid Planner who knows Maryland’s medically needy system, not a planner who applies QIT templates from other states.

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

Asset Spend-Down: Converting countable assets into exempt ones — home improvements (especially valuable in Maryland’s high-appreciation suburban markets), vehicle purchase, or paying off debt — can reduce countable assets below $2,500. Must be structured carefully to avoid look-back violations.

Trust Structures for Estate Recovery: Because Maryland limits estate recovery to the probate estate, assets held in a revocable living trust or properly structured irrevocable trust may avoid Medicaid recovery. Consult a Maryland-licensed attorney.

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: Maryland’s no-QIT medically needy system, high home values in Montgomery and Howard counties, probate-limited estate recovery, and the $350/month income standard all require Maryland-specific expertise. Do not assume planners from neighboring states know Maryland’s rules.

While addressing a Medicaid income or asset issue, check whether SNAP food assistance is available in parallel — see SNAP income limits for Maryland.

How to Apply for Maryland Medicaid

Maryland uses the Maryland Health Connection portal for Medicaid and marketplace plan applications, and local DSS offices for in-person applications.

Application Methods

Online via Maryland Health Connection (Recommended): Apply at marylandhealthconnection.gov. Before applying, use our Medicaid Eligibility Calculator to confirm which program applies. For step-by-step guidance, see our Maryland Medicaid application guide.

Phone: Call the Maryland Health Connection Consumer Support Center at 1-855-642-8572 for assistance.

In-Person or Mail: Download a paper application from health.maryland.gov and submit to a local Department of Social Services (DSS) office. Maryland has DSS offices in all 23 counties and Baltimore City — in-person access is generally good across the state.

Long-Term Care Support: Contact the Maryland Office of Aging or a local Area Agency on Aging at 1-800-243-3425 for help with Community Options Waiver applications and NFLOC assessment coordination.

Documents You’ll Need

• Proof of Maryland residency
• Proof of income (pay stubs, Social Security award letters, tax returns, federal contractor income documentation)
• Proof of assets (bank statements, investment accounts, property records) — for long-term care applications
• Medical expense documentation — for medically needy spend-down applications
• Proof of citizenship or qualifying immigration status
• Medical records documenting functional limitations (for Nursing Home / Community Options Waiver applications)
• Disability documentation per SSA criteria (for Regular Medicaid aged/blind/disabled)

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 significant medical bills.

Maryland Medicaid and Other Benefit Programs

SNAP (Food Stamps): Many Maryland Medicaid recipients also qualify for SNAP. See our Maryland SNAP page or Maryland SNAP application guide.

If you already receive benefits, see how to check your SNAP balance in Maryland.

Restaurant Meals Program: Maryland participates in the Restaurant Meals Program in select areas — eligible elderly, disabled, and homeless Medicaid recipients can use their EBT card at participating restaurants for hot meals. See our guide on restaurants that accept EBT for participating locations in Maryland.

WIC: Pregnant women and young children qualifying for Maryland Medicaid typically also qualify for WIC. See Maryland WIC income guidelines.

EBT Discounts: Maryland EBT cardholders may access discounts at certain retailers. See EBT discounts available in Maryland.

Medicare: Many Maryland seniors use both Medicare and Medicaid simultaneously. Understanding the difference between Medicare and Medicaid is essential — particularly for long-term care in Maryland’s DC suburb markets where both program coordination and estate recovery exposure can be complex.

SNAP Work Requirements: ACA expansion adults who also receive SNAP should know both programs will have federal work requirements starting in 2027. Federal contractor and gig workers should document employment carefully. Read our guide on SNAP work requirements.

Frequently Asked Questions About Maryland Medicaid

Does Maryland Medicaid require a QIT (Miller Trust)?

No — Maryland is one of only two states in this series (along with Maine) that does not require a Qualified Income Trust for nursing home or waiver applicants with income above $2,901/month.

Maryland uses a medically needy pathway with an income standard of $350/month for a single person. Medical expenses — including the cost of nursing home care — are applied against income to bring it to this threshold. This approach is fundamentally different from QIT states and requires a Maryland-specific planner.

What is the income limit for Medicaid in Maryland?

For seniors and disabled in nursing homes or Community Options Waiver: $2,901/month (single). Regular Medicaid (aged/blind/disabled): $967/month (single). ACA expansion adults: $1,799/month (138% FPL). MCHP children: $4,147/month (319% FPL). Pregnant women: $3,294/month (252% FPL).

See our Maryland Medicaid income eligibility page for the full breakdown.

What is MCHP in Maryland?

MCHP (Maryland Children’s Health Program) is Maryland’s Medicaid and CHIP program for children, covering children up to age 19 at income limits up to 319% FPL ($4,147/month for a single-person household) — one of the highest children’s Medicaid thresholds in the country, matching D.C. and Illinois.

Even families earning nearly $50,000/year may qualify for their children’s coverage through MCHP. There is no asset test.

What is Maryland’s medically needy income standard?

Maryland’s medically needy income standard is $350/month for a single person applying for long-term care Medicaid. This is the target income level after medical expenses are deducted from countable income.

For example: if a nursing home resident has $3,200/month in income, the nursing home cost is applied against that income to reduce it to $350/month, and Maryland Medicaid covers the nursing home’s Medicaid rate. This is different from a QIT, which redirects income through a trust — under Maryland’s system, the income flows directly toward care costs.

What are the asset limits for Maryland Medicaid?

For long-term care: $2,500 for a single applicant and $3,000 for couples both applying. For Regular Medicaid (aged/blind/disabled): $2,500 (single) and $3,000 (couple). No asset test for MCHP children, pregnant women, or ACA expansion adults.

Note that Maryland’s home equity cap of $730,000 is particularly significant given the state’s high-value suburban DC and Baltimore markets — verify your equity position carefully.

How do home values in Montgomery County affect Medicaid eligibility?

If your home equity exceeds $730,000, the home may no longer be fully exempt as an asset for long-term care Medicaid. In Montgomery County, Howard County, and parts of Anne Arundel County, many mid-range homes now have equity approaching or exceeding this threshold.

If your home value is near or above $730,000, consult a Certified Medicaid Planner before applying. Strategies such as a life estate or irrevocable trust may protect the home — but must be executed well before the 5-year look-back window to be effective.

Can I get Maryland Medicaid if I’m a federal government contractor?

Yes — if your income is at or below 138% FPL ($1,799/month for a single person), you likely qualify for ACA expansion Medicaid. Federal contractors with intermittent contract periods or gaps between contracts often qualify during those gaps.

Starting 2027, work requirements apply — but documented contract work clearly qualifies as work activity. The key challenge is documenting periods of active contracts versus gaps. Keep records of contract start/end dates and any gaps in employment.

Does Maryland Medicaid cover dental for adults?

Maryland Medicaid covers dental services for adults in some programs — including emergency care and limited preventive services. Coverage levels can change with state budget priorities. Verify current adult dental coverage with MDH or your Medicaid managed care plan.

See our full guide on what dental services Medicaid covers.

Does Maryland Medicaid cover prescriptions?

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

This guide reflects 2026 federal and Maryland Department of Health guidelines. Rules change — verify current requirements with MDH at health.maryland.gov or by calling Maryland Health Connection at 1-855-642-8572 before making eligibility decisions.