Maryland offers access to the Chesapeake Bay, Potomac River and Atlantic Ocean, making it a great choice for seniors who want to be close to the water. But the state isn’t all sailing opportunities and crab dinners; there are many more practical reasons to choose a Maryland retirement. Almost 16% of the state’s 1.6 million residents are aged 65 and older, and the senior population has access to nationally ranked hospitals such as Johns Hopkins, which has a specialized geriatrics team. This is one reason why the state ranked ninth for health care in the 2022 Senior Living Report

For affordability, Maryland ranks 13th. Although the cost of living here is higher than average, the cost of health care is low. Additionally, Social Security benefits are exempt from state income tax and there’s a generous deduction for taxpayers aged 65 and older. Tax dollars go toward programs that help seniors, such as discounted public transportation, and the cost of assisted living in the state averages $4,900 per month

This guide offers insight into the costs of assisted living and other forms of senior care in Maryland. It also has information about resources available to help seniors, and the rules and regulations that govern assisted living in the state.

The Cost of Assisted Living in Maryland

The Genworth 2021 Cost of Care Survey shows that assisted living in Maryland costs an average of $4,900 per month. This is $400 higher than the national average of $4,500. When compared to its neighbors, Maryland’s costs are about midrange. Pennsylvania and West Virginia are more affordable, with costs of $4,100 and $4,160, respectively. In Virginia, seniors pay $350 more than those in Maryland, or $5,250. Prices in the District of Columbia average $5,948, while Delaware has the highest costs in the region at $5,995 per month.

$4900

Maryland

$4500

The United States

$4100

Pennsylvania

$5995

Delaware

$5250

Virginia

$4160

West Virginia

$5948

District of Columbia

The cost of assisted living varies among surveyed cities in Maryland, from a low of $4,630 in Hagerstown to a high of $5,248 in Cumberland. In Baltimore, prices are slightly lower than the statewide average at $4,750 per month. Seniors in Salisbury pay $80 more than the Maryland median, with prices there averaging $4,980. 

$4980

Salisbury

$4750

Baltimore

$4630

Hagerstown

$5248

Cumberland

In addition to assisted living, Maryland’s older residents can access a range of senior living options that may better suit their budget and circumstances. At $1,928 per month, adult day health care is an affordable choice for people who only need assistance during the day. Both home care and home health care cost $5,148 per month in Maryland, which is almost $250 more than the $4,900 average for assisted living. Nursing home care is the least affordable option. A semiprivate room costs $10,342 per month, while private rooms average $12,167. 

$4900

Assisted Living

$5148

Home Care

$5148

Home Health Care

$1928

Adult Day Health Care

$10342

Nursing Home Care (semiprivate)

$12167

Nursing Home Care (private room)

Does Medicaid Cover Assisted Living in Maryland?

Maryland Medicaid, also known as Medical Assistance (MA), doesn’t directly fund assisted living. Instead, the state offers waiver programs that help older adults who wish to remain living at home or in the community. 

Two of these waivers can be used to provide services in assisted living facilities: the Community Options (CO) Waiver and the Increased Community Services (ICS) Waiver. They’re available to people who meet certain functional and financial eligibility criteria and services that are provided include case management, nutritionist services and behavioral consultation. 

What Assisted Living Services Are Covered by Medicaid in Maryland? 

The CO and ICS waiver programs provide similar services and supports, but the ICS program is specifically designed to help people living in nursing homes transition back to the community. 

Covered services include personal care, assistive technology, supports planning and nutritionist services. Assisted living is listed as a separate benefit for both waiver programs and covers the care you receive in these residential facilities, such as meals, activity programs and case management. Although not specifically stated, Medicaid waiver programs typically don’t pay for room and board.

Assisted Living Waiver Programs in Maryland

Community Options Waiver

The Community Options Waiver is also known as the Home and Community-Based Options Waiver. It’s designed to help people who need a nursing home level of care remain living in the community. In addition to delaying or preventing an individual’s entry into a nursing home, this waiver is also available to people who currently reside in a nursing home and want to return to their home or an assisted living community. 

The waiver is available to people aged 18 and over who meet the level of care required for placement in a nursing home. Applicants must also meet the financial eligibility requirements for waiver programs in the state. 

The services offered through the program include assisted living, case management, dietitian and nutritionist services and behavioral consultations. Recipients are also eligible to receive Medicaid services, which can include personal care, nurse monitoring and transition services. Not all assisted living facilities participate in the program, and those that do must be willing to accept Medicaid payment rates. 

People currently living in a nursing home can apply by contacting Maryland Access Point at (844) 627-5465. The program isn’t currently accepting applications from people living in the community, but you can contact the above number to be put on the waiting list. 

Increased Community Services Program

The Increased Community Services Program is specifically designed to help people living in nursing homes move back into the community. This could mean returning to their home, or moving into the home of a relative or an assisted living facility. The program provides transitional services to support recipients as they move, as well as long-term care services to support them in the community.

To be eligible for the program, applicants must currently reside in a nursing home and have been living there for at least 3 months. In addition, they need to have been Medicaid eligible for at least 30 days of those three months. Applicants must also require a nursing home level of care and meet the financial eligibility criteria for Maryland Medicaid’s waiver programs. An individual’s application won’t be approved if the cost of their care in the community will exceed what Medicaid pays for the nursing home care they’re currently receiving. 

Services provided through the program include personal assistance, care planning, nurse monitoring and assistive technology. Assisted living is listed as a benefit of the program and includes the services generally provided in these facilities, such as meals and social programming. 

Seniors can apply for the program by contacting Maryland Access Point at (844) 627-5465. 

How To Know If You’re Eligible for Medicaid in Maryland

As Medicaid is designed to help low-income people access health care, your financial situation is the primary criteria for eligibility. You must meet income and asset limits that differ depending on your circumstances and the Medicaid program you’re applying for. 

To be eligible for Maryland’s waiver programs, applicants must have an income of less than $2,523 per month or $30,276 per year. Married couples who are both applying are allowed to earn $60,552 a year. The asset limit is $2,000 for individuals and $3,000 for married couples when both spouses are applying. 

If only one spouse is applying, the asset limit is $2,000 for the applicant. However, the non-applicant spouse can keep up to $137,400 in assets. To meet Medicaid’s spousal impoverishment provisions, Maryland also lets the applicant transfer some of their income to their spouse as a minimum monthly maintenance needs allowance. 

Medicaid doesn’t count all assets when calculating your eligibility. Personal belongings, an automobile and irrevocable burial trusts are exempt. A home is also exempt if your spouse still lives there. Maryland has alternative pathways to qualify for Medicaid for people who don’t meet the financial limits. This includes spending down assets and income. 

2022 Medicaid Income Limits for Seniors in Maryland

Income Limits* 

Asset Limits

Single Applicant

$30,276

$2,000

Two-Person Household

(Only One Person Applying)

$30,276

$2,000 applicant

$137,400 non-applicant

Two-Person Household
(Both People Applying)

$60,552 

$3,000

*Per month

There are other criteria that applicants must meet to be eligible for Medicaid. Those applying for the waivers must be:

  • A Maryland resident
  • A U.S. citizen or non-citizen who meets the immigration status requirements
  • In need of a nursing home level of care

How To Apply for Medicaid in Maryland

People in need of Medical Assistance long-term services and supports, such as waiver programs, can apply online through the myMDThink portal. You can also submit a paper application in person or by mail. People living in Baltimore City or Anne Arundel, Baltimore or Prince George’s counties can return applications to the Bureau of Long Term Care. Applications from other areas of the state can be returned to a local Department of Social Services office. Application forms are available for download on the Medicaid website.

Information You Will Need 

The Maryland Department of Health requires documentation to process your application. You may be asked to provide:

  • Proof of identity
  • Proof of citizenship or immigration status
  • Proof of residency
  • Income statements, including banks statements and federal tax returns
  • Proof of assets, including current statements of stocks, life insurance policies and trusts
  • Private health insurance cards, including Medicare
  • Social Security number
  • Power of attorney or legal guardianship documents 

How to Get Help Applying for Medicaid 

Maryland has resources available for people who need help applying for Medicaid. Counselors available through the State Health Insurance Program can provide face-to-face guidance at offices throughout the state. In addition, Maryland provides detailed information on its Medicaid website and through the Long Term Care guidebook.

Resource 

Contact 

Description 

The State Health Insurance Program has volunteer counselors in all 23 counties of Maryland and Baltimore City who can help people navigate their health insurance options. The service is designed to assist with Medicare, but counselors can also give advice about assistance for low-income benefit programs, such as Medicaid. 

Online

The Medicaid website in Maryland has detailed information about available programs, eligibility criteria and how to apply. Applicants can explore the programs that offer long-term services and supports and discover the ones they may be eligible for.

Online

The Home and Community-Based Long Term Care Services Guidebook has information about the waiver programs available in the state, including those aimed at older adults. It details the benefits available, eligibility criteria and who to contact for further information. 

Does Medicare Cover Assisted Living in Maryland?

The short answer is that no, Medicare does not cover the cost of assisted living in Maryland. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Maryland.

Other Financial Assistance Options for Assisted Living in Maryland

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

 

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Maryland

Older adults in Maryland can access a variety of resources aimed at helping them as they age. The state government provides financial assistance for assisted living and prescription medication. State and local governments also have programs to help people find local resources, access transport and companionship and help resolve issues in long-term care facilities. 

Resource 

Contact 

Service 

(844) 627-5465

Maryland Access Point, more commonly known as MAP, is Maryland’s Aging and Disability Resource Center. It has a no wrong door policy, meaning it’s the single point of contact for people looking for long-term care services and community support. Seniors can go into a MAP office or call the helpline to access local resources, options counseling and assistance applying for benefits. 

(410) 767-1100

The Assisted Living Subsidy Program is a non-Medicaid program that helps low- and moderate-income seniors fund assisted living care. Applicants must be at least 62 years old, in need of nursing home care and financially eligible for the program. Financial limits for this program are higher than Medicaid’s criteria. The amount available depends on the individual and the county they live in, and subsidies are paid directly to the facility. 

(800) 551-5995

Maryland’s Senior Prescription Drug Assistance Program provides funds to help seniors pay for prescription medications. It’s available to moderate-income Medicare recipients who are enrolled in a prescription drug plan. The program subsidizes the premiums of approved prescription drug programs and may also help cover out-of-pocket expenses. 

Contact local offices

Area Agencies on Aging are designated by county governments throughout Maryland and in Baltimore City. These agencies provide a wide range of services to older adults including transportation, protective services and senior centers. The exact support offered depends on the needs of the local community. 

(410) 767-1100

The Maryland Department of Aging finances and oversees programs that are designed to help older adults lead healthy lives and support people with long-term care needs. It provides access to durable medical equipment loans, transportation services, legal assistance and a range of other aging-related programs.

Contact local office

The Long-Term Care Ombudsman protects the rights of people living in nursing homes and assisted living facilities. Volunteers investigate and help resolve issues for individual residents and also advocate at local, state and national levels for changes that can improve the well-being of all long-term care residents.

COVID-19 Rules for Assisted Living in Maryland

The following information is based on research done on several government websites, including coronavirus.maryland.gov and cdc.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 4/22/22, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Maryland Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Maryland Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for Maryland Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in Maryland

In Maryland, assisted living facilities are licensed and overseen by the Office of Health Care Quality, a division of the Department of Health. This office ensures that facilities comply with the laws and regulations that govern long-term care facilities in the state.

MARYLAND LAWS AND REGULATIONS

Assisted Living Service Plan Requirements 

A service plan must be developed within 30 days of admission and should outline what services will be provided and by whom. The service plan must be reviewed and updated at least every 6 months or if there’s been a significant change in the resident’s needs or preferences.

Assisted Living Admission Requirements 

A resident can only be admitted if the assisted living facility can meet their needs. On admittance, the facility must complete the Resident Assessment Tool to determine their care needs and if the resident requires staff to stay awake overnight. This tool includes a complete functional assessment and is used to develop the individual's service plan. 

Assisted Living Scope of Care 

An assisted living facility is a residential program that provides housing, supervision, personalized assistance, health-related services or a combination of these services to meet residents' needs. Facilities can be licensed to provide low, medium or high levels of care. 

Assisted Living Medicaid Policy 

Medicaid in Maryland has waiver programs that can help seniors fund their care in an assisted living facility. Participating facilities must be properly licensed, choose to take part in these programs and be willing to accept Medicaid rates of payment. 

Assisted Living Facility Requirements 

Resident rooms must meet minimum size requirements and no more than two people can share one room. Each room must have adequate storage for residents’ personal belongings. Facilities must provide furnishings, including a bed, unless the resident brings their own. 

All toilets, showers and bathtubs must have assistive railings unless a waiver is granted by the department. There must be one toilet per four residents plus a minimum of one for each floor, as well as one bathtub or shower for every eight residents. 

Medication Management Regulations 

Residents who receive at least nine medications, including over-the-counter drugs, will have their regimen reviewed by a pharmacist every 6 months. 

All staff who administer medications must complete a medication administration course. Drugs must be kept in a secure location, and staff are required to document when medication has been provided.

If a resident is living in the same facility as their spouse or domestic partner, their spouse can administer medications for them. This must be reviewed quarterly to ensure it continues to be safe.

Staffing Requirements 

Facilities must have enough on-site staff to meet the scheduled and unscheduled needs of residents. Maryland doesn't require that staff must be awake overnight. Instead, the Resident Assessment Tool is used to determine if awake staff are needed. Alternatively, the facility can obtain a waiver to use electronic monitoring instead of awake staff.

Staff Training Requirements 

Assisted living managers must complete state training and pass the relevant examination, in addition to meeting educational requirements based on the facility's licensing level. 

Other staff must participate in an orientation program and ongoing training. Annual training should cover topics including infection control and food safety. 

If staff aren't certified nursing assistants or geriatric nursing assistants, they must demonstrate competence to the delegating nurse before performing personal care duties.

Background Checks for Assisted Living 

All staff must undergo a criminal history records check or criminal background check within 30 days before they begin their employment. Facilities can’t hire anyone with a history of behavior that's potentially harmful to residents. 

Requirements for Reporting Abuse 

Any abuse or suspected abuse must be reported within 24 hours to Adult Protective Services by calling (800) 917-7383. Alternatively, it can be reported to relevant agencies including the long-term care ombudsman, local law enforcement and the Office of Health Care Quality, which can be reached at (877) 402-8221.

Assisted Living Facilities in Maryland (95)