Seniors in Maryland can enjoy bustling cities such as Baltimore or settle into a sleepy seaside town on the Chesapeake Bay. Either way, they get access to a wide range of resources and services designed to help seniors enjoy a comfortable lifestyle. World-class hospitals abound in the state, including facilities with geriatric specializations, such as Johns Hopkins Hospital. In addition, health care costs in the state are lower than the national average. Almost 16% of the state’s 6 million residents are aged 65 and above, and approximately 230 nursing homes with 30,000 beds are available to provide services to this population. Nursing homes provide residents with long-term care that can include skilled nursing services, medical monitoring and treatments, as well as meals, personal care and activity programs. The average cost of nursing home care in Maryland is $10,190 for a semiprivate room and $10,646 for a private room.
This guide has detailed information about the cost of nursing home care in the state, financial assistance, other resources available and nursing home regulations to help seniors and their families make decisions about their future.
Seniors in Maryland pay an average of $10,190 per month for nursing home care, according to Genworth Financial’s Cost of Care 2020 Survey. This is $2,434 more than the national average of $7,756. Compared to neighboring states, Maryland’s costs are in the middle of the range. Virginia has significantly lower costs at $7,665 per month, while in Pennsylvania, prices are slightly lower than Maryland, at $10,038. Seniors in West Virginia pay $11,376 per month, $1,186 more than those in Maryland.
There is a wide range of prices for nursing home care across Maryland, and seniors in different cities can incur very different costs. California and Cumberland are the most affordable cities, with an average of $8,137 and $8,213 respectively. Seniors in Hagerstown pay $9,794, while in Salisbury the cost is $10,768. Bethesda has an average cost of $11,726, and Baltimore is the least affordable city at $11,984.
Baltimore
$11984
Bethesda
$11726
California
$8137
Cumberland
$8213
Hagerstown
$9794
Salisbury
$10768
Nursing home care is the most expensive senior care option available, reflecting the skilled nursing and medical care it provides residents. The most affordable option is adult day care, at a cost of $1,842 per month. Assisted living in the state comes in at $5,000 monthly. In-home care and home health care are both more affordable than assisted living, averaging $4,576 and $4,767 respectively. This type of care, which offers services in the home, may be an option for people who need nursing home level care but want to age in place.
In-Home Care
$4576
Home Health Care
$4767
Adult Day Care
$1842
Assisted Living Facility
$5000
Nursing Home Care
$10190
Medicaid currently covers the costs of nursing home care for four out of every eight nursing home residents in Maryland. The state has an expanded coverage system that includes low-income adults. Around 18% of the population — just over 1.5 million people — is covered by Medicaid in Maryland. The program can cover the costs of a semiprivate room, board and laundry services for enrolled seniors residing in nursing homes. In addition, it covers basic medical equipment and supplies, medications, on-site physicians, nursing support and social services.
Maryland has approximately 230 nursing homes, and all of them accept Medicaid. An estimated 30,000 beds are available for nursing home care in the state, and residents can expect 24/7 hospital-like levels of care. The Statewide Medicaid Nursing Home Care Program helps seniors cover some of the fees associated with nursing home care. Those who’d prefer to remain in their own homes or communities may be eligible for the Medicaid Long Term Services and Supports program.
Applicants must meet certain medical and financial requirements in order to be eligible for Medicaid.
Financial eligibility is determined by the Department of Social Services. People who receive Supplemental Security Income (SSI) are automatically financially eligible for Medicaid. For 2022, those who require institutional care cannot have incomes that exceed the cost of care, whether as a single applicant or as a married couple. Asset limits are $2,500 per person with an increased $3,000 limit per person for 6 months when couples apply.
2022 Basic Medicaid Income Limits for Seniors in Maryland
| Annual income limits | Asset limits | |
|---|---|---|
| Single Applicant | Cost of care must exceed income | $2,500 |
| Two-Person Household (Only One Person Applying) | Cost of care must exceed income | $2,500 for applicant and $137,400 for nonapplicant |
| Two-Person Household (Both People Applying) | Cost of care must exceed income | $6,000 initially, dropping to $5,000 after 6 months |
Additionally, the senior applying:
Hospitals will apply for medical eligibility on behalf of seniors who are in hospital care prior to admission to a nursing home facility. Those who are in another setting prior to admission require a physician to complete a Medical Eligibility Review Form DHMH 3871. This form must be mailed with supporting documents to the Delmarva Foundation for consideration.
Seniors in Maryland have several options when applying for Medicaid. They can apply online through the MDThink website, mail their completed application to their local Department of Social Services or apply in person at the Department of Social Services. Seniors can phone (877) 463-3464 for assistance in completing the online or downloaded forms. Applicants can ensure the process runs smoothly by having all the required documents available before starting the application process. The process normally takes three to four months but may be delayed by insufficient documentation.
Information You Will Need
The following free resources are dedicated to helping families and seniors navigate the complicated process that surrounds Medicaid applications.
| Resource | Contact | Service |
|---|---|---|
| Maryland Department of Aging | (800) 243-3425 | The Maryland Department of Aging is operated by the Maryland Department of Health. It provides information regarding long-term care in the state and the steps required to obtain financial assistance toward nursing home care. Seniors and their families can obtain information from the website or visit their local office to ask any questions they may have. |
| American Council on Aging | Online Only | The American Council on Aging runs the Medicaid Planning Assistance Website. The site contains step-by-step guides for seniors and their families looking to apply for Medicaid coverage. The website offers a screening test that enables families to find out if their loved one is eligible for Medicaid. In addition, the website contains information on Medicaid basics and income regulations by state. |
| Benefits.gov | (800) 456-8900 | Benefits.gov is a federal website that contains an overview of Medicaid coverage in Maryland. This information is a useful starting point for families that are new to the process and are looking for contact details and general information regarding Medicaid. |
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
What Isn’t Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Families considering nursing home care for their loved ones may be interested to know the extent to which Medicare will assist in covering costs. Trained advisers from the following organizations are able to assist families in finding information and guidance that could help in their particular situation.
| Program | Contact | Service |
|---|---|---|
| SHIP | (410) 767-2077 | The State Health Insurance Assistance Program is administered by the Maryland Department of Aging and operated by local offices throughout the state. Volunteers provide free and unbiased information to seniors and their loved ones regarding Medicare. The trained volunteers don't receive a commission or promote any particular private insurance companies while discussing alternatives to Medicare. Sessions can be conducted in person or by phone. The volunteers are able to guide seniors through the process of applying for coverage that best suits their unique situation. |
| Medicare.gov | (800) 633-4227 | Medicare.gov is a website operated by the federal government that provides information on all aspects of Medicare. It has a live chat function that ensures seniors and their families can ask questions and get the information they require 24/7. The website gives a general overview of Medicare as well as state-specific information such as phone numbers and links to useful websites. |
| Benefits Checkup | (800) 794-6559 | Benefits Checkup is a national resource operated by the National Council on Aging. Seniors or their family members can take a short online quiz that will link them to benefits that may be available to them. Some of these benefits include Medicare Savings Programs and state-specific waivers. In addition, families can call the helpline to have their questions regarding Medicare or any other benefits answered by trained volunteers. |
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| Name | 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 skilled nursing care. |
| 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 nursing care. 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 skilled nursing care. 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 skilled nursing care will not typically be eligible to sign up for a LTC insurance policy. |
The state of Maryland offers a range of resources to assist seniors living in the state. A few of these resources are aimed at seniors living in nursing home care, while others are designed to meet the needs of those still living in the community. Some of these resources aim to help seniors age in place in an assisted living community or in their own home.
| Resource | Contact | Service |
|---|---|---|
| In-Home Aides Services | Contact the local office of the Department of Social Services | The Department of Social Services offers an in-home aides services program that assists seniors with disabilities who want to remain in their own homes. The program provides trained aides who are able to assist in a range of tasks, including bathing, meal preparation, cleaning and personal care. In addition, the program provides self-care training and case management services. Funding for the program is limited and there is a waiting list for the services. Applicants are prioritized according to need. |
| Area Agencies on Aging | (844) 627-5465 | The Area Agencies on Aging are local offices situated throughout the state that provide information and resources for seniors. The services offered differ between locations but may include planning assistance, caregiver support, assistance in applying for benefits, community services, legal assistance and in-home services. Senior centers operated by the agencies offer meals, social activities and wellness programs. |
| Accessible Homes for Seniors | (301) 429-7409 | The Maryland Department of Housing and Community Development operates a program that provides improvements to the homes of seniors aged 55 and older to make the homes safer and more accessible. Improvements offered may include grab bar and safety rail installations, ramp installations and widening of door frames. Funding is provided through zero percent interest deferred loans or grants. Applicants must own the home that requires modifications. |
| Long-Term Care Ombudsman | Contact local ombudsman | The Long-Term Care Ombudsman Program protects the rights and promotes the well-being of seniors in long-term care facilities such as nursing homes and assisted living communities. The program educates residents on their rights and advocates for change on a statewide and national level. It independently investigates complaints from seniors and works to resolve conflicts and issues. |
| Senior Care Services | (844) 627-5465 | The Senior Care Services Program is run by local Maryland Access Point offices throughout the state. The program provides a range of assistance and support services to seniors aged 65 and older who are at risk of nursing home placement. The program enables seniors to age in place in their own homes or communities. A case manager asses the unique care requirements of each senior and coordinates the required services. Some of the services provided by the program include respite care, adult day care, home-delivered meals, chore services, personal care and emergency response systems. |
| Topic | Rule |
|---|---|
| Licensing Requirements | All nursing homes must be licensed by the state. These licenses last for two years, unless revoked. Facilities that have a dual function, such as providing skilled nursing and other care services, must be licensed for each level of health care provided. |
| Staffing Requirements | Nursing homes must employ a sufficient number of staff to provide at least three hours of bedside care per resident every day. This care can be provided by registered nurses, licensed practical nurses or support personnel. Facilities must employ RNs in the following ratios:2-99 residents: One full-time RN100-199 residents: Two full-time RNs200-299 residents: Three full-time RNs300-399 residents: Four full-time RNsAt least one registered nurse (RN) must be in the facility 24/7, and facilities must also employ a medical director and an administrator. |
| Staff Training Requirements | Unlicensed staff must undergo a geriatric nursing assistant training program prior to providing direct care. The curriculum must be approved by the Maryland Board of Nursing. All staff must also complete training on cognitive impairment and mental illness. The facility administrator must organize an ongoing educational program for staff. |
| Admission Restrictions | Nursing homes must not admit individuals who require care beyond the capabilities of the facility or people who are dangerous to themselves or others. |
| Care Planning Requirements | An interdisciplinary team must develop a care plan for residents within seven days of their admission. Plans must be revised after an individual’s annual assessment or quarterly assessment or after a significant change in their condition. |
| Dietary and Nutritional Services Requirements | Nursing homes must provide at least three meals daily that meet the nutritional needs of residents, in accordance with physician’s orders. Facilities with more than 50 beds must hire a full-time qualified dietetic service supervisor, while smaller facilities may allow the supervisor to share cooking responsibilities with the cook. Regular consultation from a licensed registered dietitian must be organized if a dietitian isn’t on staff. |
| Specialized Rehabilitative Services | Specialized rehabilitative services are defined as:Occupational therapyPhysical therapySpeech pathologyAudiology servicesNursing homes do not have to admit people who require these services, but if they do, the services must commence within 48 hours of admission. |
| Medication and Pharmaceutical Services | Medications that are administered to residents must be prescribed by the resident’s physician. They can be administered by licensed personnel or graduates of a state-approved medicine aide course. The facility may employ a licensed pharmacist or arrange a written contract with a pharmacy to provide pharmaceutical services. |
| Activities Requirements | Facilities must provide a program of structured and unstructured activities that are designed to meet the needs and interests of residents. Nursing homes must employ a qualified resident activities coordinator to organize this program. |
| Infection Control Requirements | Nursing homes must establish an effective infection and control program that is managed by an infection preventionist. The infection preventionist must have training in infection surveillance. |
| Medicaid Coverage | Medicaid pays for nursing home care in Maryland for those who meet both financial and medical eligibility criteria. |
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