Senior care in Maryland runs above the national line in nearly every setting. Assisted living costs about $7,083 a month, and a semi-private nursing-home room about $150,015 a year, both well above the national medians. Where you are in the state matters too, since the Washington, D.C., and Baltimore suburbs run higher than rural Maryland.
This guide lays out what every senior-care setting in Maryland costs side by side, what pushes the price up or down, and how families actually pay, from private funds to Medicaid for those who qualify.
In This Guide
- Key Takeaways
- What Each Setting Costs in Maryland
- What Drives the Price
- How Families Pay
- How to Plan and Budget
- Frequently Asked Questions
What Each Setting Costs in Maryland
The figures below come from the CareScout (Genworth) Cost of Care Survey, the 2024 release (published March 2025) that gives the most recent state-level data. These are medians from an industry survey, not government rates and not maximums, so the cost at any one provider can land higher or lower depending on location, room type, and how much care a person needs.
Read across the settings and Maryland's pattern is consistent: costs run above the national figures in nearly every setting. Assisted living, nursing-home care, and in-home care all sit above their national medians, and within the state the Washington, D.C., and Baltimore suburbs run higher than rural areas. That changes the math for families, because the gap between a semi-private nursing-home room and assisted living here is large, about $65,000 a year.
| Care setting | Maryland (year) | Maryland (month) | National (year) |
|---|---|---|---|
| Assisted living | about $84,990 | about $7,083 | about $70,800 |
| Nursing home, semi-private room | about $150,015 | about $12,501 | about $111,325 |
| Nursing home, private room | about $173,375 | about $14,448 | about $127,750 |
| Home health aide (44 hrs/wk) | about $80,080 | about $6,673 | n/a |
| Homemaker services (44 hrs/wk) | about $80,080 | about $6,673 | n/a |
| Adult day care | about $30,615 | n/a | n/a |
The in-home figures assume a steady schedule of about 44 hours a week. A home health aide, who can help with hands-on personal care like bathing and dressing, and a homemaker, who handles household tasks like cooking and cleaning but not personal care, each run about $80,080 a year at that pace. Round-the-clock home care costs far more, because the hours multiply quickly, which is why heavy daily needs often tip the math toward a facility even where the home is the preference. Adult day care, at about $30,615 a year, is the lowest-cost option on the list and can give a family caregiver a break during working hours.
What Drives the Price
The single biggest driver of cost is the level of care a person needs. A nursing home provides 24-hour licensed nursing care, with a staff of nurses and aides on every shift plus the building, equipment, and oversight that skilled care requires. Assisted living is built for people who need help with daily tasks but not constant skilled nursing, so it carries a lighter staffing load. That difference shows up starkly in Maryland, where a semi-private nursing-home room costs about $150,015 a year against about $84,990 for assisted living, a gap of roughly $65,000.
Location is the second big driver, and it cuts within the state as well as against the national line. Maryland's nursing-home and assisted-living costs run well above the national medians, and the Washington, D.C., and Baltimore suburbs run higher still than rural parts of the state. A family comparing a facility in Montgomery County with one on the Eastern Shore can see a meaningful difference in the monthly bill for similar care.
Within any single setting, the advertised rate is rarely the whole bill. A facility usually quotes a base rate for room and routine services, then adds charges as care needs grow: help with more activities of daily living, medication management, memory care, or a higher staffing tier. A resident who enters needing little help and later needs much more can see the monthly cost climb well past the opening figure. When you compare quotes, ask what the base rate includes and what triggers an add-on, because two facilities with similar headline prices can bill very differently once care needs rise.
How Families Pay
Almost no one pays for years of senior care out of a single source. Most families start with private funds and shift to other payers as the bills mount. Here's how the main options work in Maryland.
Private pay is savings, income, the proceeds of a home sale, and long-term care insurance if a person bought it. It's the most flexible option, since it covers any setting, but it's also the one that runs out, and at about $150,015 a year for a semi-private nursing-home room, it can run out faster than families expect. Long-term care insurance, where it exists, can offset a share of the cost, though policies vary widely in what they pay and for how long.
Maryland Medicaid, called Medical Assistance, pays for long-term care, including nursing-facility care and home- and community-based services, for people who meet both a level-of-care test and the financial rules. Coverage of nursing-facility care is an entitlement for those who qualify, which means there is no waiting list for it. Eligibility has two parts that run separately. On the medical side, an applicant must be certified as meeting the nursing-facility level of care; the same finding is also the gateway to community-based options. On the financial side, you apply through your local Department of Social Services, and for 2026 the long-term-care income limit is 300% of the SSI federal benefit rate, about $2,982 a month for an individual, alongside a low countable-asset limit. When one spouse needs care, spousal-impoverishment rules let the spouse who stays in the community keep a share of the couple's resources and income, so the couple isn't held to the single-person limits.
If a nursing home isn't the right fit, Maryland funds home and community-based care mainly through the Community Options Waiver, also called the Home and Community-Based Options Waiver, which serves people who meet a nursing-facility level of care in their own home or community. Two more rules shape long-term-care planning: Maryland applies a 60-month look-back to asset transfers for less than full value, which can create a penalty period, and after death it pursues estate recovery for the long-term-care costs of people who received that care at age 55 or older, with exemptions for a surviving spouse, a child under 21, or a blind or disabled child.
A note on Medicare, because the assumption is common: Medicare covers only short-term skilled rehab after a hospital stay, not the long-term custodial care, the ongoing help with daily living, that most families are budgeting for. That long-term care is what private pay and Medicaid cover.
How to Plan and Budget
Start by matching the setting to the actual need, not the other way around. Because the gap between settings in Maryland is wide, a candid assessment of how much help a person truly needs can save tens of thousands of dollars a year. Many people who need help with daily tasks but not skilled nursing are well served by assisted living or a few hours a day of in-home care, while adult day care can stretch a family caregiver's reach at a fraction of a facility's cost. Reserve a nursing home for the level of care that genuinely requires it.
Then build a realistic timeline. Estimate the monthly cost of the right setting, list the resources available to pay for it, and work out how long private funds will last before Medicaid would come into play. If Medicaid is likely to be part of the plan, the look-back and estate-recovery rules reward starting early and getting advice, because last-minute moves to qualify often trigger penalties. Two Brevy guides go deeper here: Medicaid Planning Strategies walks through how to position assets and income within the rules, and Medicaid Personal Needs Allowance, Explained covers the small monthly amount a resident keeps.
Finally, budget for the add-ons, not just the base rate. Care needs tend to rise over time, so the figure you start with is rarely the figure you finish with. A plan that assumes some increase is more likely to hold up than one built on today's lowest quote.
Frequently Asked Questions
It depends heavily on the setting. Per the 2024 CareScout (Genworth) Cost of Care Survey, assisted living runs about $84,990 a year (roughly $7,083 a month), a semi-private nursing-home room about $150,015 a year, a private room about $173,375, a home health aide or homemaker about $80,080 a year (at roughly 44 hours a week), and adult day care about $30,615 a year. These are statewide medians from an industry survey, not maximums, so an individual provider can cost more or less.
A semi-private nursing-home room in Maryland runs about $150,015 a year, and a private room about $173,375, both well above the national medians of about $111,325 and $127,750. Costs run higher in the Washington, D.C., and Baltimore suburbs than in rural parts of the state. Because few families can pay these figures out of pocket for long, Maryland Medicaid pays for nursing-facility care as an entitlement for those who qualify.
Yes, for those who qualify. Maryland Medicaid, called Medical Assistance, covers nursing-facility care as an entitlement for people who meet the nursing-facility level of care and the financial rules, and it funds home and community-based care through the Community Options Waiver. You apply through your local Department of Social Services; the 2026 long-term-care income limit is 300% of the SSI benefit rate, about $2,982 a month for an individual, alongside a low countable-asset limit, with spousal-impoverishment protections for a spouse who stays in the community.
Maryland's nursing-home and assisted-living costs run well above the national medians, and the Washington, D.C., and Baltimore suburbs run higher still than rural parts of the state. The single biggest driver within any setting is the level of care a person needs, since 24-hour skilled nursing carries a far heavier staffing load than assisted living, which is why a semi-private nursing-home room costs roughly $65,000 a year more than assisted living here.
Most start with private pay, savings, income, home-sale proceeds, and long-term care insurance if they have it, then turn to Maryland Medicaid once a person meets the level-of-care and financial rules. Because Maryland has a 60-month look-back on transferred assets and recovers from the estates of people who received long-term-care Medicaid at age 55 or older, with exemptions for a surviving spouse or a minor or disabled child, planning early and getting professional advice usually pays off.
Learn More
Find personalized help building a realistic senior-care budget for Maryland at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.