Assisted Living in Delaware
Delaware is one of the smallest states in terms of land mass and population size, with just over one million residents as of 2021 Census estimates, but it has a relatively high percentage of senior citizens. Almost one in five (19.4%) of Delaware’s residents are aged 65 and over.
In our 2022 Senior Living Report, the state is ranked 25th for its quality of life and 29th in overall affordability. However, the cost of assisted living in particular is quite high, at an average of $5,995 per month, which is 33% higher than the U.S. average. The state’s highest ranking hospitals are located in Newark, Dover and Lewes. Christiana Hospital in Newark received the highest rating in Delaware and performs well in many procedures and treatment of conditions that commonly affect the elderly, such as hip and knee replacements, stroke, diabetes and heart surgery.
This guide includes detailed cost comparisons for assisted living in Delaware and the wider region, Medicaid coverage and eligibility requirements as well as state regulations and useful resources related to assisted living.
The Cost of Assisted Living in Delaware
Delaware’s average monthly cost of $5,995 for assisted living is roughly $1,500 above the norm for the United States, according to the Genworth Financial 2021 Cost of Care Survey. Pennsylvania is the only nearby state with assisted living costs below the national average, at $4,100 per month, while Maryland is also relatively affordable at $4,900. New Jersey and Washington, D.C. are priced higher than Delaware by $500 and $983 per month, respectively.
The United States
Assisted living facilities in Dover have an average monthly cost that’s just $78 higher than the Delaware average. However, due to a lack of cost data from other cities throughout the state, comparisons from cities in nearby states are included here. In Maryland, assisted living costs are considerably lower than those in Delaware, with Salisbury and Baltimore priced at $4,980 and $4,750, respectively. To the north, in Pennsylvania, the average monthly cost is $5,685 per month. On the opposite side of Delaware Bay, Ocean City, New Jersey, is much more expensive, at $7,490 per month.
Ocean City, NJ
Assisted living in Delaware is the second-most expensive of the five main levels of care for the elderly, at $5,995 per month. Care for seniors at home, including in-home medical services, is priced lower by roughly 10%. Adult day health care, which is a part-time service provided in the community, is the most affordable at $1,661 per month. The most expensive level of care is provided in nursing homes, which cost more than twice as much as assisted living, at an average of $12,273 per month for a semiprivate room in Delaware.
Home Health Care
Adult Day Health Care
Nursing Home Care (semiprivate)
Does Medicaid Cover Assisted Living in Delaware?
Yes, but Medicaid in Delaware doesn’t cover the entire bill for assisted living. Medicaid coverage of assisted living is provided as part of the Diamond State Health Plan – Plus. Medicaid and the DSHP-Plus initiative help low-income seniors, people with disabilities and other vulnerable members of the community who need help to avoid being placed in a nursing home and, ultimately, to live in the least restrictive environment possible.
What Assisted Living Services Are Covered by Medicaid in Delaware
Most of the services provided to eligible residents in licensed assisted living facilities are covered by Medicaid and DSHP-Plus. The following is a non-exhaustive list of the most common types of covered services related to assisted living.
- Personal care
- Medical supplies and durable medical equipment
- Community transition (to/from nursing home, hospital, etc.)
- Speech/physical/occupational therapy
- Inpatient/outpatient hospital services
- Nutrition services
- Case management
Residents must find another source of funds to pay for room and board costs, which make up a substantial portion of the total cost for assisted living.
How to Know if You’re Eligible for Medicaid in Delaware
Eligibility for Delaware Medicaid, the DSHP-Plus initiative and related services is based on the individual’s financial and medical status. The Division of Medicaid and Medical Assistance (DMMA) then determines which specific services are available to each individual. Income limits are calculated at 250% of the current Federal Benefit Rate (FBR), which is $841 per month as of 2022. Asset limits refer to liquid resources such as bank accounts, life/property insurance, retirement accounts, stocks, bonds and unoccupied properties. If a spouse or other qualified family member lives in the home, its value isn’t counted as part of the applicant’s assets.
Annual Income Limits
Two-Person Household (Only One Person Applying)
$2,000 (non-institutionalized spouse is allowed up to $137,400)
Two-Person Household (Both People Applying)
Other assisted living facility eligibility requirements unrelated to the applicant’s financial situation include.
- Aged 65 and over or disabled
- Delaware resident and U.S. citizen or legally residing noncitizen
- Resident of a licensed assisted living facility
- Requires the level of care typically provided in nursing homes
- Able to live safely in an assisted living facility
People who currently receive or are eligible for Supplemental Security Income (SSI) are automatically eligible for Medicaid.
How to Apply for Medicaid in Delaware
Applications for Medicaid can be made online via the Delaware ASSIST website, along with self-screening tools to help determine eligibility. Printable application forms in multiple languages can also be found on the website. Residents can also begin the application process over the phone or in person by calling (302) 255-9500 for further directions and to be put in contact with a nearby office.
Information You Will Need
The online application tool linked above provides a full list of the required documentation for each program upon completion. Applicants should prepare to provide the following:
- Social Security number
- Government-issued identification
- Proof of income and verification of assets
- Proof of medical conditions, disabilities or other need for assistance
- Green card or other proof of alien status (for noncitizens only)
Applicants who wish to receive coverage for services provided in assisted living facilities must be assessed by certified nursing staff as to their need for such services, who will then provide the relevant proof to the department.
How to Get Help Applying for Medicaid
The following services are available to help Delaware residents identify their long-term care and health insurance needs, understand the options available and learn how to apply for the appropriate services. All programs are free and available statewide, and some may offer in-person counseling sessions.
Call (800) 223-9074 during regular weekday business hours
This free service provides counseling via telephone and in-person meetings for elderly residents and family members who need help understanding their long-term care options. Staff can assist in the application and enrollment stage for various programs and services, providing help collecting the required documents and filling out forms. In-person counseling sessions can be held in the applicant's home, hospital or long-term care facility.
Call (800) 336-9500 for assistance over the phone or to arrange an in-person counseling session
The DMAB helps Medicare recipients understand the various related programs and supplements as well as Medicaid and other types of health insurance. Help is provided via telephone or at in-person counseling sessions at selected locations throughout Delaware, which are listed on the website.
Call (302) 571-4900 or (866) 843-7212
Seniors and family members can contact the customer relations department for Delaware Medicaid and Medical Assistance with questions about the programs available and benefits provided as well as assistance with the application process.
Does Medicare Cover Assisted Living in Delaware?
The short answer is that no, Medicare does not cover the cost of assisted living in Delaware. 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 Delaware.
Other Financial Assistance Options for Assisted Living in Delaware
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.
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 Delaware
Seniors who need answers to assisted living questions and concerns, as well as more general aging-related issues such as health insurance options, should contact one or more of the following resources. All of these resources are free for elderly residents of Delaware and anyone acting on their behalf.
Call (800) 223-9074 to speak with staff or email DelawareADRC@delaware.gov
The Delaware ADRC offers seniors and people with disabilities a central point of contact to ask questions, find the appropriate services and programs in their area and get help applying for local and state assistance. ADRC staff are knowledgeable about assisted living facilities and possible sources of funding to help cover the cost, such as Medicaid and the DSHP-Plus initiative, as well as other long-term care options. Information and assistance is free for seniors, people with disabilities and anyone contacting the center on their behalf.
Call 211 or visit the website for live chat and searchable database of available services
United Way and the State of Delaware’s Office of Management and Budget have partnered to provide this free and confidential helpline that's available 24/7. The helpline and website connect people with local health and human services throughout Delaware, such as programs for seniors, housing and utility assistance, medical care and nutrition services. Residents can call 211 to speak to a resource specialist, use the live chat function on the website or search for help among over 2,500 programs and services.
Call 1-844-245-9580 and select option 0 for assistance or visit the website to download an application
The DPAP helps Delaware residents who have a low income but don't qualify for prescription assistance other than Medicare Part D. Eligible residents can receive up to $3,000 per year to help pay for Medicare Part D premiums and medically necessary prescription drugs. Applicants must be aged 65 or over and meet the income requirements listed on the website.
Call (800) 870-3284 for the Newark location or (302) 856-7946 for Georgetown
The Delaware Assistive Technology Initiative (DATI) is a free service provided in Newark and Georgetown that's available to all state residents. These resource centers allow seniors and people with disabilities to see and try the various assistive technology available, with staff on duty to answer questions for those who don't know exactly what they're looking for. Equipment can be taken home to try as part of the loan program, and staff can attempt to locate funding sources to help purchase the necessary items.
Call (302) 478-8680 and select option 3
Low-income seniors aged 60 and over may be eligible for free legal advice and representation from DVLS. Lawyers can help with civil issues such as access to government benefits, protection from abuse, scams and fraud, guardianships and wills. Eligible clients must pay for court costs such as filing and service fees, but these make up a relatively small percentage of overall legal costs. There is no fee for the attorneys themselves.
COVID-19 Rules for Assisted Living in Delaware
The following information is based on research done on several government websites, including coronavirus.delaware.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 3/22/2022, 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.
Are loved ones allowed to visit to provide emotional support?
Are relatives allowed to visit for end-of-life care?
Are residents required to quarantine after visiting with a loved one?
Are visitors required to wear PPE (including masks) in order to visit residents?
Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?
Are visitors checked for elevated temperatures?
Are visitors required to answer questions about health, travel, and potential virus contact?
Outings & Social Activities
Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?
Are residents who leave required to quarantine when they return?
Are senior living communities required to cancel all group outings?
Are residents allowed to eat meals together in a common area?
Are residents allowed to gather in common areas for group activites?
COVID-19 Safety Measures for Staff and Residents
Are staff members regularly required to do a temperature check?
Are staff members regularly tested for COVID-19?
Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?
Are residents regularly screened for COVID-19 symptoms?
Are residents regularly checked for elevated temperatures?
Are residents regularly tested for COVID-19?
Assisted Living Laws and Regulations in Delaware
Delaware’s Department of Health and Social Services and its Division of Health Care Quality set the rules that must be followed by assisted living facilities in the state. The full list of assisted living regulations can be viewed online and we’ve included an overview of important points below.
Assisted Living Service Plan Requirements
The concept of "shared responsibility" must be used when creating and updating service plans, which means the resident and staff are both responsible for making decisions. Residents must be assessed, with the details used to create a written service agreement on or before the day of admission to the facility. The service agreement must contain details on the physical, medical and social services required by the individual.
Assisted Living Admission Requirements
Potential residents must not be admitted if they have conditions that are expected to require testing and frequent medication adjustments in order to avoid an acute episode. Residents must not be bedridden for longer than two weeks, require a ventilator or have other unstable conditions.
Assisted Living Scope of Care
Residents must not require full-time skilled nursing services. Facilities providing dementia care must make appropriate provisions and have a policy detailing them.
Assisted Living Medicaid Policy
The DSHP-Plus initiative, which is part of the state Medicaid program for eligible seniors, can pay for some services provided in licensed facilities. Residents who are eligible for Medicaid must be allowed to keep a minimum of $131 per month for personal needs.
Assisted Living Facility Requirements
The facility itself, including outdoor areas accessible by residents, must comply with local, state and federal laws. Buildings must be clean and well-maintained and free of hazards and unnecessarily restrictive barriers. Pest control programs must be implemented. Resident rooms and common areas must be appropriately heated and/or cooled. Bedrooms must house no more than two residents.
Medication Management Regulations
Facility administrators must follow written, publicly available policies relating to how medication is obtained, refilled, stored and disposed of. Procedures for the administration, self-administration and assistance with self-administration of medication must also be noted in the policies. Residents who are permitted to self-administer medication must be provided with a secured container or cabinet for storage.
Staffing levels must be sufficient in number, training and certification to satisfy the requirements of residents at all times. Staff must have access to the service agreement for all residents under their direct care or supervision. All facilities must employ a director. Facilities with up to 24 beds must also employ a part-time administrator, and facilities with 25 or more beds must employ a full-time administrator.
Staff Training Requirements
Staff must have current and valid certification, licensing and/or proof of other requirements relevant to their position and duties, with documentation kept on file by the facility administration. New staff must go through on-site orientation and ongoing in-service education.
Background Checks for Assisted Living
All employees must submit to fingerprinting, state and federal criminal background checks as well as drug testing in accordance with Delaware law. Additionally, employees are checked against numerous registries that track abuse, complaints and licensing issues via the Background Check Center.
Requirements for Reporting Abuse
Reportable incidents must be recorded in facility files, which include any incident in which abuse, neglect, mistreatment or financial exploitation has or is suspected to have occurred. Staff must be informed of their duty to report such incidents as part of their annual in-service education and training. Residents, family members and others can contact the Complaint & Incident Reporting hotline at (877) 453-0012 or submit a complaint form online.