How Medicaid Can Help Pay for Long-Term Care in Maryland

Q: What is Maryland's actual Medicaid asset limit for long-term care?

$2,500 for a single applicant — slightly above the $2,000 federal standard most states use. This is commonly misreported as $2,000 in general guides that don't account for Maryland's specific rule.

Q: How long is the Community Options Waiver waitlist in Maryland?

As of February 2026, there were 20,616 people on the registry, with roughly 700 invited to apply each month — a wait that can realistically run several years. Two alternative programs, Community First Choice and CPAS, have no waitlist at all.

Q: What is Maryland's nursing home Personal Needs Allowance?

$106/month — among the highest in the country, giving nursing home residents more for personal spending than most other states allow.

Published August 28, 2026 How we keep this accurate

This page is Maryland-specific. Medicaid long-term care rules vary significantly by state. See our national Medicaid Waivers Explained guide if you're elsewhere.

Two numbers many guides get wrong

Maryland's actual asset limit is $2,500, not the $2,000 federal standard many guides apply to every state. It's a small difference, but it's real — Maryland set its own limit slightly above the national norm.

Maryland's home equity limit is $1,130,000 — the federal maximum — not the $730,000 federal minimum some general guides mistakenly apply. Given high real estate values in the DC suburbs and Baltimore metro, this distinction genuinely matters for many Maryland homeowners.

A real number: the Community Options Waiver waitlist

Maryland's primary HCBS waiver, the Community Options Waiver (formerly the Home and Community Based Options Waiver, itself created by merging two older programs), prioritizes people already in a nursing home for at least 30 days. Everyone else joins a formal waitlist called the Service Registry.

As of February 28, 2026, there were 20,616 people on that registry, with roughly 700 invited to apply each month. At that pace, a multi-year wait is realistic for many applicants — this isn't a program to wait on if you might need it soon.

Two alternatives with no waitlist

	Community First Choice (CFC)	CPAS
Waitlist?	No — a federal entitlement	No — regular state plan Medicaid
Nursing-level care required?	Not always	No
Can hire a spouse as caregiver?	Yes	Yes

Source: Maryland Department of Health (MDH); figures effective 2026.

If you're facing the Community Options Waiver waitlist, ask about CFC or CPAS first. Both let you self-direct your own care and hire a caregiver of your choosing — including your spouse or an adult child — without the multi-year wait.

What Maryland residents actually keep

Maryland's nursing home Personal Needs Allowance is $106/month — among the highest in the country, meaningfully more than the $40 allowed in Virginia or $30 in South Dakota.

If your income is over the limit

Maryland doesn't require a Qualified Income Trust (Miller Trust) — it uses a Medically Needy spend-down instead. You're never simply disqualified for having "too much" income; you spend down on medical expenses instead.

How to actually start

Apply through Maryland Health Connection or your local Department of Social Services — ask specifically about Community First Choice and CPAS as faster-access alternatives to the Community Options Waiver.

If you're already on the Community Options Waiver registry, don't wait passively — pursue CFC or CPAS in the meantime if your needs qualify.

Common Questions

What is Maryland's actual Medicaid asset limit for long-term care?

$2,500 for a single applicant — commonly misreported as $2,000 in generic guides.

How long is the Community Options Waiver waitlist in Maryland?

Over 20,600 people were on the registry as of February 2026, with only about 700 invited monthly — a realistic multi-year wait.

What is Maryland's nursing home Personal Needs Allowance?

$106/month — among the highest in the country.