A semi-private nursing home room in Maryland runs about $155,125 a year. That is a hard number to cover out of pocket for long. So the real question is which funding source applies to you, and in what order. This guide lays out how to pay for senior care in Maryland in 2026.

Many families combine several sources. Private savings can buy time while you line up Maryland Medicaid, VA benefits, or insurance.

In This Guide

How to Pay for Senior Care in Maryland: Your Options

There are five main ways to pay. Each one covers something different, and many families use a mix.

Payer What It Does What It Doesn't Do
Out of pocket Bridges the gap while other help is arranged Drains savings fast at Maryland prices
Medicare Up to 100 days of skilled nursing facility care per benefit period, generally after a qualifying hospital stay Doesn't pay for long-term custodial care, whether at home, in assisted living, or in a nursing home
Medicaid (Medical Assistance) Covers long-term care for aged, blind, and disabled residents who qualify, in a nursing home or at home through a waiver Income and asset limits apply, with a spend-down route when income is too high
VA Aid and Attendance Raises the VA pension's maximum rate for eligible wartime veterans and surviving spouses Service, discharge, age-or-disability, income, net worth, and care-need tests apply
Long-term care insurance Pays toward long-term care at home or in a facility once a benefit trigger and waiting period are met Applicants in poor health or already receiving care may not qualify for a new policy

What Senior Care Costs in Maryland

Know what you're paying for before you work out how to pay. The figures below are Maryland statewide medians from the CareScout 2025 Cost of Care Survey, released in March 2026. Maryland's medians run above the national medians for assisted living and both nursing-home room types, while its in-home care median matches the national median. Beginning with the 2025 survey, CareScout merged its former separate homemaker and home health aide categories into a single non-medical caregiver category.

Care Type Annual Median Monthly Median
In-home care (non-medical caregiver) $80,080 $6,673
Adult day health care $30,313 $2,526
Assisted living community $86,070 $7,172
Nursing home, semi-private room $155,125 $12,927
Nursing home, private room $173,375 $14,448

These are statewide medians from an industry survey, not government figures, and CareScout collects rates by metropolitan area, so prices near you can differ. CareScout's annual in-home care figure assumes 44 hours of care a week over 52 weeks, and its monthly in-home figure is that annual rate divided by 12. A two-year nursing home stay at the statewide median already passes $300,000. That is why families combine the funding sources below. For a fuller breakdown, see our cost of senior care in Maryland guide.

Paying Out of Pocket

Private pay draws on income and savings, such as Social Security, pensions, retirement savings, and home equity.

A few private-pay tools Maryland families use:

  • Home equity. Sell the home, rent it out, or borrow against it. The federally insured reverse mortgage, a Home Equity Conversion Mortgage (HECM), requires the borrower to be 62 or older and to live in the home as a principal residence, among other requirements such as counseling from a HUD-approved agency before getting the loan. It is not free money: the money received plus interest and fees are added to the balance each month, so the balance grows. The borrower must keep paying property taxes and homeowners insurance, live in the home as a principal residence, and keep it in good repair, or the loan can fall into default and may lead to foreclosure. The loan must be paid off when the last surviving borrower or eligible non-borrowing spouse dies, sells the home, or no longer lives there as a principal residence. Before any move, check how the home counts for Medicaid: Maryland sets a $752,000 excess home-equity limit for long-term care coverage.
  • Life insurance. An accelerated death benefit pays part of the death benefit early, and whether it is available depends on the policy offering it. Some older policies don't, but many insurers now make the option available, so ask the insurance agent or company. Don't count on adding it once care is needed: a policyholder is usually eligible only if the option was added before the insured became terminally ill. Whatever is paid comes out of what beneficiaries later receive. A policy can also be sold in a life settlement, generally for less than its death benefit, usually only by women about age 74 and older and men about age 70 and older. Many, but not all, states regulate life settlement providers, so confirm with your state insurance regulator that a broker or provider is licensed. Either move can affect Medicaid eligibility, so check first.
  • Retirement and investment accounts. Ask the eligibility worker how these count toward Maryland's Medicaid asset limits before you spend them down.

The hard truth: paying out of pocket at Maryland prices drains savings fast. Treat private pay as a bridge. Our guides to paying for in-home care and paying for assisted living cover the options in more depth.

What Medicare Does and Doesn't Cover

This is where families get caught off guard. Medicare does not pay for long-term care, which medicare.gov describes as help with daily activities such as dressing, bathing, and using the bathroom. Part A covers skilled nursing facility care only on a short-term, post-acute basis, not long-term custodial care.

What Medicare does cover is limited and medical:

  • Skilled nursing facility care for up to 100 days per benefit period after a qualifying inpatient hospital stay of at least three consecutive days. You must also enter a Medicare-certified SNF within a short time (generally 30 days) of leaving the hospital, and need skilled services related to that hospital stay. Days 1 through 20 cost $0 a day after you pay the $1,736 Part A deductible, so they aren't free outright, though you'll normally have already paid it for the hospital stay in the same benefit period. Days 21 through 100 require a daily coinsurance of $217 in 2026. After day 100, nothing.
  • Home health care when the person is under the care of a doctor or allowed practitioner who sets up and regularly reviews a plan of care, needs part-time or intermittent skilled nursing, physical therapy, speech-language pathology, or continued occupational therapy (needing more than part-time or intermittent skilled care disqualifies), is certified homebound, has a face-to-face encounter with a provider related to the main reason for the care, and gets the care from a Medicare-certified home health agency.
  • Hospice care when the hospice doctor and the person's regular doctor (if they have one) certify a terminal illness with a life expectancy of 6 months or less, the person signs a statement choosing comfort care instead of other Medicare-covered treatment for the illness, and the care comes from a Medicare-approved hospice.

If you were told there was no qualifying three-day stay, do not stop there. Time spent under observation or in the emergency room before admission does not count toward the three days, even overnight, and that is the trap to watch for. Medicare names four ways around it:

  • A waiver. You may not need the three-day minimum if the doctor participates in an Accountable Care Organization approved for a Skilled Nursing Facility 3-Day Rule Waiver, and a Medicare Advantage plan may also waive it.
  • Re-entry. If you re-enter the same or another SNF within 30 days of leaving one, you do not need another three-day qualifying hospital stay. The same is true if skilled care stops in the SNF and starts again within 30 days.
  • An appeal, with its deadline attached. If the hospital changed your status from inpatient to outpatient getting observation services, you have a right to appeal if you meet certain criteria, and an approved appeal means Part A may cover the hospital and SNF services. While you are still in the hospital, or for an admission on or after February 14, 2025, that is the prospective fast-appeal track and it is open. For a stay that already happened between January 1, 2009 and February 13, 2025, the retrospective track's 365-day filing window ended January 2, 2026: a later request is denied unless you establish good cause for filing late, and a request that gives no reason for the delay will not be accepted. If that describes you, file immediately with the good-cause explanation attached.
  • Another payer. Ask whether you can get care in another setting, such as home health care, or whether another program, such as Medicaid or VA benefits, can cover your SNF care.

What Medicare does not pay for is long-term custodial care, whether it is given at home, in adult day health care, in assisted living, or in a nursing home. For ongoing care, families turn to Medicaid, long-term care insurance, private pay, or VA benefits.

How to Pay for Senior Care in Maryland Through Medicaid

Maryland Medicaid, known as Medical Assistance, is administered by the Maryland Department of Health and covers long-term care for aged, blind, and disabled residents who qualify. That includes nursing home care and, through the Community Options Waiver, services at home or in the community instead of an institution.

Maryland is a medically needy state, so an applicant whose income is above the medically needy level can still become eligible through spend-down.

Who Qualifies in 2026

The rules are detailed, but the core figures for 2026 are these.

  • Assets: under Maryland's medically needy (non-MAGI) standard, the one the state publishes for applicants who are 65 or older, blind, or disabled, or enrolled in a home-and-community-based waiver, countable assets are limited to $2,500 for a single applicant in 2026 and $3,000 for a couple. Maryland's separate categorically needy (non-MAGI) standard is $2,000 for an individual and $3,000 for a couple, so ask the eligibility worker which standard your application is being judged against. Separately, Maryland's Medicaid manual sets a $752,000 excess home-equity limit for long-term care coverage.
  • Income: an applicant whose income is above the medically needy income level, $350 a month for an individual and $392 for a couple, can still become eligible by spending the excess down on incurred medical bills. The Community Options Waiver, which pays for long-term care at home, uses a different test: monthly income may not exceed 300% of the SSI benefit, $2,982 a month in 2026, and an applicant denied for income that is too high may be eligible for the Increased Community Services Program.
  • Spousal protection: under Maryland's spousal-impoverishment rules, the spousal share protected for the at-home spouse (the Community Spouse Resource Allowance) has a minimum of $32,532 and a maximum of $162,660 effective January 1, 2026.

MDH's own limits page says you may still be eligible if your income or assets are above the published limits, and to call the Department of Human Services for help with your limit amount.

Maryland also sets its Personal Needs Allowance well above the $30 federal floor: a Medicaid-eligible nursing-facility resident keeps $106 a month ($212 for a couple), and the rest of their income, after the allowed deductions, goes toward the cost of care.

Maryland also applies the federal 60-month look-back. Maryland's regulation counts back 60 months from the date the person is both institutionalized and has applied, and assets given away or sold for less than fair market value in that window can trigger a penalty period during which Medicaid won't pay for nursing facility care, an equivalent institutional level of care, or waiver services, though the rest of the person's coverage continues. Some transfers are exempt, such as an asset transferred to the person's spouse or for the spouse's sole benefit. For the full picture, see our guides to Maryland Medicaid income limits, how to apply for Maryland Medicaid, and Maryland Medicaid estate recovery.

Not sure whether your parent qualifies for Maryland Medicaid? Chat with Brevy's care navigator at brevy.com.

VA Aid and Attendance for Veterans

If your loved one is a wartime veteran or a veteran's surviving spouse, VA Aid and Attendance may help. It is paid with the VA pension, not as a stand-alone benefit. A veteran must first qualify for the pension: qualifying active-duty service that includes at least one day during a wartime period, no dishonorable discharge, yearly income and net worth within VA's limits, and at least one of these: being 65 or older, having a permanent and total disability, being a nursing-home patient for long-term care because of a disability, or getting SSDI or SSI. The veteran must also meet at least one aid-and-attendance requirement: needing another person's help with daily activities like bathing, feeding, and dressing; having to stay in bed, or spend much of the day in bed, because of illness; being a nursing-home patient due to lost mental or physical abilities related to a disability; or severely limited eyesight. For someone who qualifies, the pension's maximum annual rate rises from the basic rate to a higher Aid and Attendance rate.

The VA sets these maximums as annual amounts. For the rate year that began December 1, 2025 (the 2026 benefit year, which runs through November 30, 2026), the maximum annual pension rates with Aid and Attendance are:

The pension is paid monthly: VA subtracts countable income from the maximum rate, divides by 12, and rounds down to the whole dollar.

Each rate is a ceiling, not a payment: VA pays the maximum rate minus income for VA purposes. For the same rate year the net worth limit is $163,699, counting income for VA purposes as well as assets but not the primary residence, the car, or basic home items. VA also looks back over the 36 months (three years) before it receives the pension claim. If an asset that would otherwise have pushed, or helped push, net worth over the limit was transferred for less than fair market value in that window, VA assesses a penalty period of up to five years. That look-back never reaches back before October 18, 2018. If it looks like a fit, check it early.

Long-Term Care Insurance

Did your family member buy a long-term care policy years ago? Dig it out now. Read the benefit triggers, the daily or monthly benefit, and the elimination (waiting) period before you need them. A policy pays only once its benefit trigger is met, most often needing help with two or more of six daily activities or having a cognitive impairment, and after the elimination period has passed; most policies then pay care costs up to a pre-set daily limit until the lifetime maximum is reached.

A policy may also qualify under a Long-Term Care Partnership, which links approved policies to extra Medicaid asset protection. It is a state option rather than a national entitlement: federal law provides that states may establish a partnership, and one exists only where the state has an approved Medicaid state plan amendment providing for the disregard, so confirm with the insurer and the state Medicaid agency that a specific policy qualifies before counting on it. In a partnership created under the 2005 federal expansion, every dollar a qualifying policy actually pays out is a dollar of assets disregarded both in Medicaid eligibility and in estate recovery. Maryland's estate-recovery rules likewise bar recovery to the extent of LTC partnership policy benefits a person received. A new policy may be out of reach: most individual policies require medical underwriting, so someone in poor health or already receiving long-term care services may not qualify, though limited coverage or coverage at a higher non-standard rate is sometimes available. The premium depends partly on age at purchase, and the insurer may raise it later. If a policy exists, factor its benefit period or lifetime maximum into the rest of the plan, since many policies limit how long or how much they will pay. Our guide to long-term care insurance explains how these policies work.

Other Ways to Pay for Senior Care in Maryland

A few smaller levers can stretch a budget. None replaces the main sources above. Get advice before acting on the ones with long-term consequences.

  • Extra services through the Community Options Waiver. Beyond full Medicaid services and Community First Choice, the waiver may add assisted living services, medical day care, case management, and Senior Center Plus. To qualify, a person must need a nursing-facility level of care, be 18 or older, live at home or in the community, and meet the waiver's other medical, technical, and financial rules. There is a waitlist: join the registry by calling Maryland Access Point at 844-627-5465 and apply when invited, though a nursing-facility resident whose care Medicaid has paid for at least 30 days may apply with no wait.
  • Annuities and trusts. Before moving assets into either, remember that a transfer for less than fair market value inside the 60-month look-back can trigger a penalty, while some transfers, such as to a trust established solely for a blind or permanently and totally disabled child, are exempt. Talk to an elder-law attorney first.
  • A written funding plan. Combining sources in the right order is the whole game. Our guide to building a senior care funding plan walks through how to sequence them.

Learn More

FinancialMaryland Senior Property Tax ReliefMaryland's Homeowners' Tax Credit caps property tax by income ($60,000 limit, $200,000 net worth). File by April 15 for the July bill; Oct. 1 is the deadline. FinancialMaryland Retirement Income TaxMaryland exempts Social Security. Its Pension Exclusion, up to $41,200 at 65 or if you or a spouse is totally disabled, is cut by Social Security received. FinancialMaryland Estate TaxMaryland taxes estates over $5M, capped at 16% of the excess, and charges a separate 10% inheritance tax on heirs outside the close-family list. FinancialHow to Pay for Senior CareHow to pay for senior care: what it costs nationally and how Medicaid, Medicare, VA benefits, and private pay each fit. Who qualifies, what's covered, in 2026. FinancialHow to Pay for Assisted LivingHow to pay for assisted living in 2026: what it costs and how private pay, Medicaid waivers, VA Aid and Attendance, and long-term care insurance each fit. FinancialHow to Pay for Nursing Home CareHow to pay for nursing home care in 2026: what it costs and how Medicaid, Medicare, VA benefits, long-term care insurance, and private pay each fit in. FinancialHow to Pay for In-Home CareHow to pay for in-home care in 2026: what it costs and how Medicare, Medicaid HCBS waivers, VA benefits, and long-term care insurance each help cover it. Care TypesCost of Senior Care in MarylandWhat senior care costs in Maryland in 2026: assisted living runs about $7,172 a month, a nursing home about $155,125 a year. See every setting and how to pay. MedicaidMaryland Medicaid Income LimitsMaryland Medicaid has two income limits: $1,835/mo for adults under 65, with no asset test, and a $350 medically needy level plus spend-down for seniors. MedicaidHow to Apply for Maryland MedicaidLearn how to apply for Maryland Medicaid online, by phone, by mail or in person. Covers which route fits, spend-down, documents, timelines, and appeals. MedicaidMaryland Medicaid Estate RecoveryMaryland Medicaid estate recovery reaches estates of people who got benefits at 55+. See who is protected, what's at risk, and how to handle an MDH claim.

Frequently Asked Questions

Does Medicare pay for assisted living or a nursing home in Maryland?

No. Medicare doesn't pay for long-term custodial care, whether it is given in assisted living, adult day health care, or a nursing home. It pays for limited skilled care: up to 100 days in a skilled nursing facility per benefit period after a qualifying hospital stay, plus hospice and some home health care for people who meet their own eligibility rules. A missed three-day qualifying stay is not automatically the end of the road: an ACO or Medicare Advantage waiver, re-entry to a SNF within 30 days, an appeal of an inpatient-to-observation status change (the fast-appeal track is open for admissions on or after February 14, 2025, while the retrospective track's filing window closed January 2, 2026 and a later request now needs good cause), or another payer such as Medicaid or VA benefits may each still open it. For ongoing care, families turn to Medicaid, long-term care insurance, private pay, or VA benefits.

How does Maryland Medicaid help pay for senior care?

Maryland Medical Assistance covers long-term care for aged, blind, and disabled residents who qualify. That includes nursing home care and, through the Community Options Waiver, care at home or in the community. In 2026, under Maryland's medically needy standard, a single applicant can have up to $2,500 in countable assets, and income above the medically needy income level can be spent down on incurred medical bills.

How much does senior care cost in Maryland?

Per CareScout's 2025 survey, released in March 2026, a semi-private nursing home room runs about $155,125 a year, a private room about $173,375, assisted living about $86,070, and in-home care from a non-medical caregiver about $80,080, based on 44 hours of care a week. These are statewide medians, and CareScout collects rates by metropolitan area, so local prices can differ.

Can VA benefits pay for senior care in Maryland?

Yes. A veteran who qualifies for the VA pension, which requires wartime service among other tests, and who meets at least one aid-and-attendance requirement, such as needing another person's help with daily activities, may qualify for VA Aid and Attendance, which is paid with the pension. It raises the pension's maximum annual rate above the basic rate, and VA publishes a separate Aid and Attendance rate for a surviving spouse. For the rate year that began December 1, 2025, the maximum annual rate is $29,093 for a single veteran, $34,488 with one dependent, and $18,697 for a surviving spouse, paid monthly. Each of those is a ceiling rather than a payment: VA pays the difference between the maximum and the claimant’s income for VA purposes, so a claimant with other income receives less.

Find personalized help paying for senior care in 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.

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