You will need to complete and sign a Medicaid application form. The application form will request complete and detailed information on your financial situation. You will have to show that this information is true and verifiable before a decision on your eligibility can be made.

Provided you are a U.S. citizen, a Maryland resident, a registered immigrant/naturalized and at least 65 years of age and disabled, eligibility for Medicaid is based on your income and resources (assets). Income includes: wages, Social Security benefits, annuity payments, retirement and pension. Resources include: bank accounts, stocks, savings bonds, property, life insurance, valuable collections, more than one (1) vehicle, boat, trailer, mutual funds and retirement accounts (IRA). The way income and resources are evaluated to determine the amount that you can retain and be eligible for Medicaid are set by law. Additionally, in order for Medicaid to pay for your nursing home care, there must be a determination that you need the health care services provided by a nursing home, (medical level of care).

When you apply for Medicaid as an institutionalized person, the State will look at your finances for a certain period of time prior to your application to see if you, your spouse, or anyone else has transferred any of your resources or income at less than fair market value.  The earliest date that can be looked at is called the “look back” period.  Any transfer during that time for less than fair market value may result in a period of ineligibility to qualify for Medical Assistance benefits.

This date will be from 60 months (5 years) prior to the month you apply for benefits and are institutionalized.

*  Note: If you are married, your resources are treated differently than they are if you do not have a spouse.

Your countable resources cannot exceed $2,500.  If you exceed this limit by $1 as of the first day of any given month (with the exception of income being received and immediately paid out to the nursing home), you will be ineligible for Medicaid benefits the entire month.  Be mindful that if monthly income is received and not applied and/or spent on the Applicant’s cost of care within the same month received, the income is treated as an asset against the Applicant.

Your home, providing it is your principle place of residence, a spouse or dependent relative lives in the home, or you express an intent to return to the home. If your home is not occupied by a spouse or certain relative, and you have a life estate deed with full powers to sell the property, the full fair market value of the home is treated as an asset.

• A vehicle
• Ordinary household goods and personal effects.
• Life insurance with a face value of less than $1,500 or more than one policy with the cumulative face values equaling $1,500 or less. (If the face value of one policy or the cumulative face values of more than one policy is in excess of $1,500 the full cash value of the policy or policies are treated as an asset.)
• Burial spaces for Applicant or immediate family members.
• Term or group life insurance, which typically does not have cash value.
• An irrevocable funeral service trust or final expense policy.

Resources over the $2,500 limit must be spent down/used for the applicant’s prior medical expenses, funeral services and various other ways, just so long as they are not given away or exchanged for something of a lesser value.

When you apply for Medical Assistance, as assessment will be made of the total value of you and your spouse’s combined countable resources as of the first day of the first month one of you enters a nursing home.

A Medicaid lien is a claim against your home property equal to the dollar amount of payments the Medicaid Program has made on your behalf.

If the State of Maryland Medicaid Program determines and verifies that there is no reasonable expectation that you will return home from the nursing facility, the State will place a lien on your excluded home property unless it is occupied by one of the following: spouse, your unmarried child under 21, a son or daughter who is blind or disabled, or a sibling who has an equity interest in the home and who has resided in the home for at least one year prior to you entering the nursing home. The lien is lifted if you return to the home residence. When you die or your home is sold, no recovery will be sought through the lien if you have a surviving spouse, a surviving child who is unmarried and under 21, or a child who is blind or disabled. Also, no recovery will be sought as long as your home is occupied by a sibling who has an equity interest in the home, and who was residing there at least one year before you went into the nursing facility; or a son or daughter who has lived in the home for a least two years before you went in to the nursing facility and provided care which kept you out of the nursing facility.

Medicaid will seek recovery of payments correctly made if you were 65 years old or older when you received Medicaid, but only after the death of your spouse and only if you have no surviving unmarried child under 21 years of age or a son or daughter who is blind or disabled.

The full value of an account is considered to belong to you, the applicant, unless the other owner(s) can document that some or all of the funds are his or hers by contribution.  Additionally, certain account titling requires joint consent and agreement in order to access the account. This may render an account unavailable for the purpose of the resource assessment.

Any income received in your name is counted towards your cost of care. Income in your spouse’s name is not counted and a community spouse may qualify for a portion of your income toward household expenses.  From your income, certain deductions are allowed:

• $84 personal needs allowance, which can be used for personal expenses such as toiletries,

clothing, etc. (this amount is effective July 2021)

• An amount for your spouse (Spousal Income Allowance, if they qualify).
• The cost of any health insurance premiums, including Medicare and prescription drug plans.
• If you lived alone, you intend to return to your home, and it is medically reasonable to expect that you will be able to return to your home within six months, a limited monthly maintenance needs allowance to maintain your home can be requested.

If your monthly income, after these deductions, is less than the monthly cost of care, you will meet the income eligibility criteria for Maryland Medicaid benefits in a nursing home. The income remaining after these deductions must be paid to the nursing home. Medical Assistance benefits subsidizes your monthly income to pay the balance of the nursing home expenses up to the maximum that the nursing home is entitled to charge under the Maryland Medicaid Program.

When one spouse goes into a nursing home, Medical Assistance allows the spouse who remains

at home to keep a certain level of income. If you enter a nursing home, your spouse living at home may keep the greater of:

• All income paid in your spouse’s name, no matter how large the sum, OR
• All income paid in the spouse’s name plus as much of your income as is necessary to bring your spouse’s income up to $2,349.00 a month. If your spouse’s housing costs are high, the $2,349.00 can be increased up to $3,216.00 (2021 – these amounts change yearly).
• Please be advised that this information is general in content and not specific to any one situation. The Maryland Medicaid Program is governed by laws that are amended frequently. These laws originate at the Federal and State levels, and are enforced by the Maryland Department of Health and Mental Hygiene according to their own policies. This information is offered as a broad overview of some of the regulations that promote frequent questions. The information/content in this pamphlet should in no way be construed as legal advice.