Maryland Medicaid Income Limits 2026: Eligibility & Assets

Maryland Medicaid income limits come in two versions, and which one applies to you depends on your age and the kind of care you need. Most people searching for the number find the wrong one first.

If you are under 65 and not on Medicare, Maryland measures you with Modified Adjusted Gross Income (MAGI): adults qualify up to $1,835 a month for a household of one, and no asset test applies at all.1,2 If you are applying as someone 65 or older, blind, or disabled, or you are applying for nursing-home or waiver care, a different test governs: a $350 medically needy income level, a spend-down, and a $2,500 medically needy asset limit.3 The section below routes you to your numbers; the rest of this guide covers the second track in depth.

Which Maryland Medicaid income limit applies to you

Maryland Medical Assistance runs two separate income tests, and they produce very different numbers for the same household.

• MAGI (Modified Adjusted Gross Income): the test for adults under 65, children, pregnant women, and parents or caretaker relatives. No asset test applies to any of these groups.2
• The aged, blind, and disabled (ABD) test: the test for people applying on the basis of being 65 or older, blind, or disabled, and for anyone applying for nursing-home or waiver care. This is the $350 medically needy income level, the spend-down, and the $2,500 medically needy asset limit that the rest of this guide covers.3

The $350 medically needy income level is an ABD number.3 It is not the limit for a 58-year-old who is uninsured and working part time, or for a 45-year-old raising a grandchild. Those readers are measured under MAGI, against the figures below. Age or disability takes a person out of MAGI only for the ABD determination itself: someone 65 or older who is evaluated for a MAGI group, such as a grandparent applying as a caretaker relative, is still judged under MAGI, with no asset test.2

Maryland's MAGI income limits

Maryland publishes its MAGI standards as monthly income limits by household size, under three coverage groups it calls Adults, Children, and Pregnant. These limits are effective February 1, 2026, and MDH says to use this chart if you apply through Maryland Health Connection.1

Maryland's chart lists no Pregnant limit for a household of one.1 Under the federal MAGI household rules, the child or children a pregnant woman is carrying are sometimes added to her household.4 For scale, the 2026 federal poverty guideline for one person is $15,960 a year on the schedule for the 48 contiguous states and the District of Columbia (Alaska and Hawaii have their own figures).5 The expansion adult group's effective ceiling is 138% of the poverty level, and Maryland's $1,835 adult figure lines up with 138% of that $15,960 guideline.6,1

As poverty-level percentages. MDH's Guide to Maryland Medical Assistance Coverage Groups (revised April 2025) puts adults 19 up to 65 not eligible for Medicare at 138% of the federal poverty level (FPL), pregnant women at 264%, and children under 19 at 322%.1 Check your income against Maryland's dollar chart, and apply even if you land a little over it: MDH says some income doesn't count, and the only way to know for sure is to apply.1

Household size in that table is a tax-household count, not a headcount of who sleeps in the house. For the MAGI groups, federal rules key household size and composition to income-tax filing relationships: generally the taxpayer, a spouse they live with, and the people they claim as tax dependents. It is not always the tax household: someone who won't file taxes and won't be claimed as a dependent, for example, is counted under non-filer rules instead. MAGI household rules don't apply to the ABD groups at all, which use a different financial method, so the same family can be counted differently depending on which test applies.4

Parents and caretaker relatives: the pathway for a relative raising a child

Parents and caretaker relatives are their own mandatory eligibility group, and it is the group a grandparent raising a grandchild would look to. MDH's coverage-groups guide sets Maryland's standard for it at 123% FPL; Maryland's dollar chart does not break this group out separately.1

Federal law does not set this group's limit as a poverty-level percentage. Each state sets its own standard between a federal floor and a ceiling, and the floor is the state's old cash-welfare (AFDC) income standard as it stood on May 1, 1988, converted to a MAGI equivalent.7 In states that never adopted the ACA expansion, that state-set standard, not a poverty-level percentage, decides whether a working parent qualifies. Maryland is not one of them: it adopted the expansion, and its caretaker standard is 123% FPL.1,7

For a parent or caretaker 19 up to 65 and not eligible for Medicare, this is the narrower door: MDH covers parents and primary caretakers with income from 123% to 138% FPL in the adult group instead.1 Whether a particular relative meets the caretaker-relative definition is a determination the Maryland Department of Health makes, so ask before assuming a household does or does not fit.

Children: Medicaid and MCHP, Maryland's CHIP

Children under 19 are covered up to 322% FPL through Medicaid and the Maryland Children's Health Program (MCHP), Maryland's CHIP; MDH ties the top tiers (212% to 322% FPL) to its family-contribution rules, COMAR 10.09.43.1 Federal law sets 133% FPL as the minimum standard for children (some states must use a higher floor for infants), and that is a floor, not a cap, so Maryland's 322% sits far above it.8

No asset test on the MAGI side

None of the MAGI groups face an asset or resource test. Federal law bars Maryland from applying one to them, which is the sharpest contrast with the ABD track described below: the $2,500 medically needy asset limit does not exist on the MAGI side.2 An uninsured 60-year-old with $1,500 in monthly income and $30,000 in savings is measured as an expansion adult on income, with those savings disregarded entirely.1,2 The same person at 66, with identical finances, applying on the ABD track, is measured against Maryland's non-MAGI asset limits ($2,500 on the medically needy pathway), which never applied to them before.3

Turning 65 changes which income test you take

The ACA expansion adult group is written for people under 65 who are not pregnant and who are not entitled to or enrolled in Medicare. The federal income limit for that group is 133% FPL, which the mandatory 5-point MAGI disregard makes an effective 138% FPL for an adult applicant, and as a MAGI group it applies no asset test.6,2,1

On the 65th birthday, that pathway closes. Unless another MAGI group fits, the same person is assessed on the ABD track instead: the $350 medically needy income level with a spend-down, and the $2,500 medically needy asset limit that MAGI never applied.6,3

Consider a 64-year-old in Maryland with $1,600 a month in income and $10,000 in savings. Today she is covered as an expansion adult: she is under the $1,835 limit, and her savings do not matter because no asset test applies to her group. At 65, both halves of that change. Her income is now measured against the $350 medically needy level, leaving $1,250 a month of excess income that her incurred medical bills would have to offset. Her $10,000 in savings is now countable against a $2,500 limit. Not a dollar of her income changed.1,3

Maryland's structure softens one half of this. Because Maryland is a medically needy state, income over the $350 level does not by itself lock her out: she can become eligible by deducting incurred medical expenses from the excess, which is what spend-down means.3 The asset test is the half that surprises people, because nothing in her MAGI years prepared her for it.

Age is not the only trigger. The adult group also excludes anyone entitled to or enrolled in Medicare, so a person under 65 who reaches Medicare through disability leaves the no-asset-test group the same way.6

The $2,500 asset limit: $500 above the SSI standard

Maryland Medicaid is administered by the Maryland Department of Health (MDH). For an aged, blind, or disabled applicant, including someone applying for long-term care, the countable-asset limit effective February 1, 2026 is $2,500 for an individual and $3,000 for a couple. That is the medically needy (non-MAGI) resource standard, Schedule MA-2. It is not Maryland's only one: Schedule MA-2A sets the categorically needy non-MAGI standard at $2,000 for an individual and $3,000 for a couple, so name the pathway whenever you quote a Maryland asset limit.3

That $2,500 figure is worth pausing on.3 The SSI program's countable-resource limit is $2,000 for an individual and $3,000 for a couple.9 Maryland's categorically needy standard matches those figures, while its medically needy standard gives a single applicant $500 more room. That is real money for someone counting every dollar.3

"Countable" is the word that does the work, and Maryland's own resource regulation decides it. For someone at home, or a nursing-home resident who intends to return home, it excludes the home, any automobile whatever its value, household goods needed to run the home, wedding and engagement rings, burial spaces, and limited burial funds.3 For a resident who does not intend to return home, the list is narrower: the home is excluded only if a spouse or certain dependent relatives live in it, and the automobile exclusion does not carry over.3 For long-term care, Maryland caps how much home equity an applicant can have, covered below. MDH tells applicants to call the Department of Human Services for help with their asset limit amount, so ask there how your own assets are counted.3

Maryland Medicaid income limits: how the spend-down test works

This is the ABD side of the split above, and it is where Maryland surprises people. The medically needy income level for 2026 is $350/month for one person and $392/month for a couple.3 That is far below even the $994 monthly SSI federal benefit rate for an individual, so an applicant with any regular retirement income is likely to be over it.9

Being over that number does not end your application. Maryland is a medically needy state, which means it offers a spend-down. The amount by which your income exceeds the $350 level is your excess income, and Maryland's regulations define spend-down as becoming eligible by deducting incurred medical expenses from that excess.3

The Department of Human Services can tell you which bills count, over what period, and how health-insurance premiums such as a Medicare Part B premium are treated, so keep every medical bill and premium statement.

You may also hear about a Qualified Income Trust (also called a Miller Trust). Under federal law, that trust is a route to eligibility only in a state that does not cover nursing-facility services through its medically needy pathway; where a state does, the trust provision does not apply.10 Maryland is a medically needy state with a spend-down, so ask the Department of Human Services or an elder-law attorney before anyone sets up a trust.3

Home-based care has an income test of its own. Maryland's published limits page lists these same medically needy figures for anyone "aged 65+, blind or disabled, or ... in a Home and Community-Based Service program," but for the Community Options Waiver, MDH states that monthly income may not exceed 300% of SSI benefits and that countable assets may not be more than $2,000 or $2,500, depending on eligibility category.3 At the 2026 SSI rate, that income cap is $2,982 a month.9 If Medicaid denies a waiver application because income is too high, MDH says the applicant may be eligible for the Increased Community Services Program.3

Long-term care: what a nursing-home resident keeps

When Maryland Medicaid pays for nursing-facility care, the resident's monthly income, less certain allowed deductions, goes toward the cost of care.3 What they hold back is the Personal Needs Allowance (PNA), money reserved for the resident's own small expenses like clothing, a haircut, or a phone. Maryland sets its PNA at $106/month for an individual and $212 for a couple, effective July 1, 2025.3 Federal law sets only a floor under 42 CFR 435.725(c)(1): $30 a month for an aged, blind, or disabled individual, and $60 for a couple when both are aged, blind, or disabled and each spouse's income counts as available to the other. Maryland's is higher.2

The PNA is not the only money held back. Federal rules require the agency to deduct, in order, the PNA, a maintenance allowance for a spouse or family at home, and incurred medical expenses that no third party pays, including Medicare and other health-insurance premiums, so not everything above the PNA goes to the facility.2 For the national picture on how the PNA is set and calculated, see our explainer on the Medicaid personal needs allowance.

Protecting the spouse who stays home

When one spouse needs long-term care and the other stays in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Maryland applies the federal framework for 2026:3,11

So a married couple is in a very different position from a single applicant. Unlike the flat $2,500 individual limit, the community spouse's protected share runs from $32,532 to $162,660 in countable assets under Maryland's schedule, and a fair hearing or court order can protect more. The spouse also keeps a monthly income allowance while the other spouse receives Medicaid-funded care.3,11

The five-year look-back

Maryland reviews asset transfers made in the 60 months before a long-term-care application.3,12 Giving away money or property for less than fair market value during that window, such as gifting a grandchild a down payment or signing a house over to a child for a dollar, can trigger a penalty period during which Medicaid won't pay for nursing-facility care or home and community-based waiver services, even though you're otherwise eligible. The rest of your Medical Assistance coverage continues.3,12

There are legitimate exceptions (transfers between spouses, transfers to a blind or disabled child, certain caregiver-child home transfers)12 and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets. For the broader toolkit, see our guide to Medicaid planning strategies.

After death: estate recovery

Maryland's regulation directs the Department to seek recovery of Medical Assistance correctly paid from the estate of anyone who was 55 or older when they received it, and it is not limited to long-term-care costs, though it excludes Medicaid payments of Medicare premiums, copayments, and deductibles.3 Family circumstances delay recovery rather than cancel it: the state waits until after the death of a surviving spouse, and for as long as an unmarried child under 21 or a blind or disabled son or daughter survives. The Department may not seek recovery at all where, in its judgment, substantial hardship exists.3,10 For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Maryland

Maryland Medicaid is run by the Maryland Department of Health.3 Where you start depends on which track you are on.

Community Options Waiver applicants must also need a nursing-facility level of care.13 Apply even if you think your income or assets are too high. MDH's own limits page says you may still be eligible if your income or assets are higher than the limits listed, and an applicant over the medically needy income level can become eligible through spend-down.3

Learn More

Find personalized help working through Maryland Medicaid eligibility and spend-down for your family 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.