Maryland is home to 6 million residents, 15.4% of whom are senior citizens aged 65 and older. The state’s Department of Aging funds an array of programs and supportive services, which helps make Maryland an ideal location to age in place. Seniors who decide to hire in-home care to retain their independence pay an average of $4,481 per month, which is somewhat higher than the national median cost. However, the state government’s strict regulation and oversight of home care agencies lets residents rest easy knowing that these licensed providers have met high standards.

The following guide provides information about care costs in Maryland and alternatives to help pay for in-home assistance, as well as free and affordable resources to aid aging in place.

The Cost of In-Home Care in Maryland

In-Home Care Costs in Nearby States

Nonmedical home care services in Maryland cost $4,481 per month, on average, according to the Genworth Cost of Care Survey 2019. This is approximately $200 less than the average paid per month in neighboring Delaware, and roughly $200 more than the national median. Monthly rates in the adjacent states of Pennsylvania and Virginia are about $100 and $300 lower, respectively. Seniors in nearby West Virginia pay the lowest cost in the region, at an average of just $3,432 per month.

$4481

Maryland

$4290

United States Average

$4671

Delaware

$4385

Pennsylvania

$4195

Virginia

$3432

West Virginia

Cost of Other Types of Care in Maryland

The $4,481 monthly cost of home care in Maryland falls about mid-range between those of home health services, at $4,576, and residential assisted living, which averages $4,300 per month. Skilled care in a nursing home costs more than twice the monthly in-home care rate, at $9,673. Adult day care is the least expensive care option in the state, at an average of only $1,775 per month.

$4481

In-Home Care

$4576

Home Health Care

$1775

Adult Day Care

$4300

Assisted Living Facility

$9673

Nursing Home Care

The Cost of In-Home Care in Maryland’s Top Cities

Comparing Costs Across Maryland

Based on the average rates in cities surveyed in the Genworth study, the cost of in-home care across Maryland varies by just $429 per month. The highest monthly rate is found in the state’s largest metropolitan area, Baltimore, where the average is $4,624. Seniors in Hagerstown pay $4,195 per month, which is the lowest price statewide and about $100 less than the national average of $4,290. This is roughly the same price variance between California, Salisbury and Cumberland, where monthly costs average $4,481, $4,385 and $4,290, respectively.

$4624

Baltimore

$4195

Hagerstown

$4385

Salisbury

$4290

Cumberland

$4481

California

Financial Assistance for In-Home Care in Maryland

Community Personal Assistant Services

Seniors who need hands-on help with activities of daily living but want to retain their independence may qualify for the Community Personal Assistant Services program. Offered as an entitlement of Maryland Medicaid, CPAS provides in-home personal assistance along with support planning and nurse monitoring services. Caregivers must be approved providers certified in CPR and first aid, and monitored by an RN.

Who Is Eligible
Applicants must meet the physical and financial eligibility requirements to qualify for Medicaid coverage and live in their own home, or the home of a family member.

How to Apply
Interested individuals may call the Maryland Medicaid Long Term Care and Waiver Services office at 410-767-1739 to apply.

Community First Choice

The Community First Choice program is an option available through the state Medicaid plan to help seniors stay in their own homes, or transition back to a community setting from a nursing home. It allows participants to choose their caregivers, including certain relatives. Covered services include help with daily living activities, light housekeeping and meal preparation, as well as assistive technologies, home modifications and transition financial assistance.

Who Is Eligible?
To qualify, applicants must be aged 65 or older, or disabled, and need help with two or more activities of daily living. They must also meet the Medicaid program’s financial eligibility guidelines.

How to Apply
Seniors should enroll in Medicaid first, then contact their local Area Agency on Aging to apply for the CFC program.

Community Options Waiver

Maryland Medicaid offers the Community Options Waiver to eligible seniors who currently reside in a nursing home and wish to return to the community or their own home. The waiver covers a range of benefits, such as case management, transition assistance, environmental modifications, personal assistance with activities of daily living and respite care.

Who Is Eligible?
Interested individuals aged 65 and over must require a nursing facility level of care and meet Medicaid’s income and asset limits.

How to Apply
Seniors should contact their nursing home’s social worker or the Area Agency on Aging serving their area to apply.

Increased Community Services Waiver

The Increased Community Services Waiver is offered by Medicaid to provide financial assistance for seniors who wish to make the transition from a nursing facility back to their own home. The waiver pays for a wide array of services, such as home assessments and modifications to enhance safety and accessibility, nutritionist advice, home-delivered meals, in-home personal care and caregiver training. Case management and nurse monitoring are also provided.

Who Is Eligible?
To qualify for the ICS waiver, seniors must be assessed as needing a nursing facility level of care, have lived in a nursing home for at least three months and been enrolled in Medicaid for a minimum of 30 days. They also must have an income no greater than 300% of the current Supplemental Security lncome limit and meet the program’s asset limit.

How to Apply
Seniors may begin the application process by contacting Maryland Access Point at 844-627-5465.

Senior Care Services Program

The state-funded Senior Care Services Program provides care coordination, personal care, accessibility modifications, respite care and other in-home services to help at-risk seniors avoid placement in a nursing home.

Who Is Eligible?
Eligibility for the SCSP is determined at the county level, and applicants must be aged 65 or older and need help with no more than three activities of daily living. The program is aimed at seniors who exceed the Medicaid financial guidelines, but meet the SCSP’s income and asset limits.

How to Apply
To apply, seniors should contact their local Maryland Access Point office.

Program of All-Inclusive Care for the Elderly

Maryland currently offers one PACE program, Hopkins ElderPlus, that may help eligible seniors maintain their independence and avoid admission to a nursing facility. The program provides enrollees with comprehensive medical, social and supportive services in the community, so they can continue living at home.

Who Is Eligible?
To enroll in PACE, applicants must be aged 55 or older, live in the program’s greater-Baltimore service area and meet specific income and asset guidelines. They must also be assessed as needing the level of care offered in a nursing home, but be able to safely live at home.

How to Apply
Interested seniors may contact Hopkins ElderPlus outreach coordinators at 410-550-8093 or 410-550-7047 to check on availability in their zip code or apply.

More Ways to Pay for In-Home Care

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost In-Home Care Resources in Maryland

Maryland seniors who wish to maintain their independence and age in place in their own homes may access a number of free or low-cost resources. These may include nutritious home-delivered meals, home modification funding, legal advice and more.

ContactServices Provided
Home-Delivered Meals

Locate a provider in your area through Maryland Access Point or by calling the DOA at 410-767-1100Seniors aged 60 and older can have healthy meals delivered to their door at no cost.
Maryland Accessible Homes for Seniors

Contact the Maryland DOA at 410-767-1100The Department of Housing and Community Development and DOA partner to offer eligible homeowners 30-year, interest-free deferred loans to pay for accessibility and safety home modifications. Residents aged 55 and older are eligible, and no repayment is required until the home is sold.
My Groceries to Go!

Call the DOA at 877-664-2233 to learn how to apply in your areaMy Groceries to Go! Program provides low-income seniors aged 60 and over with helpful nutritional information and a box of staple foods every month.
Senior Legal Helpline

866-635-2948Maryland Legal Aid operates a helpline to provide residents aged 60 and over with no-cost legal advice, brief legal services and referrals to appropriate agencies or lawyers.
In-Home Aide Services

Contact your Social Services office to applyThis state program provides an array of in-home and supportive services to Maryland residents who need assistance to continue living independently. Services are provided at a reduced rate based on applicants’ income.
Family Caregiver Support Program

Contact the DOA at 410-767-1100 or 800-243-3425The FCSP offers helpful information and various supportive services to those caring for Maryland seniors. Caregivers may access counseling, support groups, training, respite care assistance and other limited supplemental services.
Transportation Services

Contact your county transportation program or the Area Agency on Aging serving your localeThere are a variety of transportation options available throughout Maryland to help seniors attend medical appointments, shop for essentials, run errands and engage in social activities.
Senior Prescription Drug Assistance Program

Download an application or call 800-551-5995 to learn moreThe Maryland SPDAP program provides low- to moderate-income seniors enrolled in a Medicare Part D prescription drug plan with premium and coverage gap subsidies.
Senior Call Check Program

Call 800-243-3425 to learn more and sign up, or register online

The Maryland DOA offers a free daily telephone check-in service to ensure the safety and well-being of seniors aged 65 and older who live alone.

In-Home Care Laws and Regulations in Maryland

Residential service agencies that provide nonmedical in-home care to seniors are licensed through the Maryland Department of Health and Mental Hygiene, Office of Health Care Quality. The OHCQ is also responsible for conducting scheduled and unannounced inspections of RSAs to ensure compliance with state regulations, and investigating complaints made against agencies. The following table offers an overview of the regulations under which Maryland RSAs operate.

Scope of CareRSAs may provide a number of nonmedical in-home services to clients, including assistance with daily living activities and personal care. Noncertified staff may also provide medication reminders, perform light housekeeping duties, prepare meals, shop for groceries and accompany clients on errands and appointments.
Care Plan RequirementsAn RN must assess the care needs of each client, and then help agency staff formulate a personalized care plan and assign appropriate personnel. This plan must detail a client’s needs and short- and long-term care goals, the specific services the agency will provide and their frequency.
Medication Management RequirementsNoncertified RSA staff members who provide nonmedical in-home care may assist clients with self-administration of prescribed medications. Only licensed or certified staff may administer medications.
Staff Screening RequirementsDirect care workers must pass a criminal background check, TB screening and skills assessment.
Staff Training RequirementsStaff providing in-home care must receive training in personal care, how to identify changes in clients’ physical condition, record keeping, infection control, CPR and abuse and neglect prevention.
Medicaid CoverageMaryland Medicaid pays some or all in-home care costs for eligible seniors through its Community Personal Assistant Services and Community First Choice entitlement programs. Medicaid also covers home care services through the Increased Community Services and Community Options waivers.
Reporting AbuseSuspected abuse, neglect or exploitation of a vulnerable Maryland senior may be reported anonymously by calling the state’s Adult Protective Services abuse hotline at 800-917-7383.

Frequently Asked Questions

Are There Programs to Cover Home Modifications in Maryland?

Interest-free, 30-year deferred loans are available through the Maryland Accessible Homes for Seniors program to help address necessary modifications. Various Medicaid programs and waivers that cover in-home care also pay for essential accessibility and safety upgrades.

How Much Does In-Home Care Cost in Maryland?

According to the Genworth Cost of Care Survey 2019, seniors in Maryland pay an average of $4,481 per month for in-home care. This is about $100 less than the monthly average for home health services, which include nursing care, and almost $200 above the national median.

Are There Transportation Assistance Programs in Maryland?

Maryland seniors can access various transportation assistance options depending on their location. To learn what’s available in their area, seniors should contact their local Area Agency on Aging or county transportation program.

What Are Activities of Daily Living ?

Activities of daily living are the actions related to self-care that an individual completes on a day-to-day basis. These routine activities include personal hygiene and grooming, bowel and bladder functions, dressing and undressing, eating and mobility.

What Types of Services Does a Home Care Aide Provide?

In Maryland, home care aides may provide various nonmedical services, including helping with personal care tasks, such as bathing or showering, dressing, grooming and eating. They may also offer medication reminders, prepare meals, perform light housekeeping chores and accompany seniors on errands and appointments.

Home Care Services in Maryland (324)