Maryland Long-Term Care: Options To Cover Costs

For every year you survive beyond the age of 65, you become statistically more likely to need long-term care (LTC). Planning for long-term medical care protects your assets and preserves eligibility for health benefits.

For legal advice about long-term services and supports, talk to a local elder law attorney.

What Is Long-Term Care?

Long-term care (LTC) can range from in-home care providers to skilled nursing facilities, all of which are extremely costly.

Maryland residents can expect to pay hundreds of dollars per day for nursing home care. The costs of care can be even higher, depending on where they live and the level of care or medical assistance needed.

Planning for long-term care is a complicated undertaking. Each person’s situation has different factors in play, including information you can’t know in advance, such as when you’ll need it. But it’s less expensive and easier for your loved ones to plan ahead than to figure things out in a crisis.

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Maryland Medicaid Coverage Eligibility

Don’t plan to rely on Medicare for LTC, as it only covers acute needs and caps at 100 days. The state’s Medicaid program (Maryland Medical Assistance Program) offers financial assistance for long-term nursing home care. However, Medicaid is only available for those who can no longer care for themselves and who qualify based on low income and assets.

According to the Maryland Department of Health, Medicaid covers about 1.5 million people in Maryland. Beneficiaries include low-income older adults, children, and people with disabilities. The government insurance program provides for nursing home care and some non-medical support services to help seniors stay at home.

Individuals aged 65 or older must meet strict eligibility requirements to enroll. The asset and income limits to qualify for nursing home Medicaid include:

• Income cannot exceed the cost of nursing home care
• Assets capped at $2,500 for a single applicant (with some exclusions)
• Require a nursing home level of care

The Medicaid health services program does not count certain exempt assets, including your home, if your spouse or a dependent is still living in it. Other exemptions include a vehicle, personal belongings, and burial plots.

Covered Medical and Nursing Care

Maryland Medicaid can cover more than just nursing home care. Maryland also covers Home and Community Based Services, including hiring a caregiver to help them live in their home.

Other community care services include meal delivery, home modifications, and personal care assistance.

Spending Down Higher Incomes To Qualify for Medicaid

You may be eligible with a slightly higher income level, as Maryland allows you to “spend down” excess income to qualify. This is like a deductible before your full benefits kick in. You can spend your income on prescription drugs, dental care, doctor visits, and mental health care costs to get your income down to the qualifying level.

You can take other recommended steps before you need LTC, such as transferring your assets to heirs via a gift, a life estate, or an irrevocable trust.

When you apply, any transfers made within the last five years will count towards your resources. You’ll be responsible for covering all or part of your care costs until you’ve “spent down” to the resource eligibility limit.

LTC Insurance in the State of Maryland

Another option to consider in LTC planning is insurance. Depending on when you begin your planning, you may be able to secure an insurance policy that covers your future in-home or nursing home care costs at a fraction of the actual price, paying a monthly or annual premium.

The best time to sign up for coverage is well before you think you’ll need it, ideally in your early-to-mid-50s. You’ll need a doctor to determine whether you meet the medical eligibility requirements.

Combining LTC Insurance and Medicaid

Many estate planning attorneys recommend a combination of Medicaid planning and LTC insurance for their clients as the best protection for their long-term care needs.

Maryland, like most other states, has a five-year look-back period from the Nursing Home Medicaid or Medicaid Waiver application. It’s possible to secure a health insurance policy that covers up to five years of care.

Allow time for asset transfers without fear of needing LTC before the end of the look-back period. After that, you can continue the policy if enough funds remain, or you can see if you qualify for Medicaid.

Find an Experienced Elder Law and Estate Planning Attorney

Planning for your care as you age can be complex and emotionally difficult. The right attorney can help protect your hard-earned resources, health care security, and peace of mind.