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 disabled, 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 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 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 SSI-related aged, blind, and disabled (ABD) test: the test for people 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 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.

Maryland's MAGI income limits

Maryland publishes its MAGI standards as gross monthly income by household size, under three coverage groups it calls Adults, Children, and Pregnant. These limits are effective February 1, 2026.1

The Pregnant column shows no figure at a household of one because a pregnant applicant is counted as a household of at least two.1 The $1,835 adult limit is 138% of the 2026 federal poverty guideline for one person, $15,960 a year on the schedule used by the 48 contiguous states and the District of Columbia, which is the schedule Maryland runs on (Alaska and Hawaii use higher guidelines).4,1

Gross or net? The 5-point disregard explains the two sets of numbers. If you compare Maryland's chart against the federal eligibility-levels table on medicaid.gov, the percentages do not match, and neither source is wrong. The federal table lists Maryland's standards as net figures, after a mandatory income disregard worth 5 percentage points of the poverty level: children at 317% FPL, pregnant women at 259%, parents and caretaker relatives at 123%, and expansion adults at 133%. Maryland's own chart states the same standards as gross income, before that disregard is applied, which puts each one exactly 5 points higher: children at 322%, pregnant women at 264%, and adults at 138%.1 The dollar limits in the table above are gross, so compare them against income before the disregard.

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 plus their spouse and tax dependents, with exceptions. The ABD groups use different household rules, so the same family can be counted differently depending on which test applies.5

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. Maryland's standard for it is 123% FPL, a net figure carried on the federal table; Maryland's own dollar chart does not break this group out separately.1

Federal law sets only a floor for this group, and the floor is a low one. A state must cover parents and caretaker relatives at least up to its own cash-welfare (AFDC) income standard, frozen as it stood in the mid-1990s and converted to a MAGI equivalent, which is typically far below the poverty level.6 That frozen floor is what strands working parents at very low incomes in states that never adopted the ACA expansion. Maryland is not one of them: it adopted the expansion, and at 123% FPL its caretaker standard sits well above the federal minimum.7,6

For a parent or caretaker under 65, this group is also the narrower of the two doors: the expansion adult group reaches 133% FPL on the same net basis, above the caretaker group's 123%.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, and why Maryland has no separate CHIP application

Maryland covers children under 19 at 317% FPL net (322% gross), and it uses that one standard across every age band: infants under 1, ages 1 through 5, and ages 6 through 18 are all held to the same number. There is no separate CHIP program to apply to; Maryland runs a single combined Medicaid and CHIP standard for children.1 Federal law requires states to cover children only to 133% FPL, so Maryland's standard sits far above the mandatory floor.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 countable-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 qualifies as an expansion adult on income alone.1,2 The same person at 66, with identical finances, is measured against a $2,500 asset limit that 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. Maryland covers that group at 133% FPL, which the mandatory 5-point disregard lifts to an effective 138% FPL, and as a MAGI group it applies no asset test.9,2,1

On the 65th birthday, that pathway closes. The same person is assessed on the ABD track instead: the $350 medically needy income level with a spend-down, and the $2,500 countable-asset limit that MAGI never applied.9,3

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 a $1,250 monthly spend-down before any health-insurance premium deduction. 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 the state has no income cap for long-term care, she is not locked out of coverage at 65 the way she would be in an income-cap state; she qualifies by spending down instead.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.9

The $2,500 asset limit: a little more room than most states

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.3

That $2,500 figure is worth pausing on.3 The federal default, unchanged since the 1980s, is $2,000, and most states still use it. Maryland sits a little above that floor. It's not the dramatic break that states like Illinois made when they raised the limit into five figures, but the extra room is real money for an applicant counting every dollar.

"Countable" is the word that does the work. Maryland, like every state, exempts a long list of assets from the count: your home (subject to an equity cap, covered below), one vehicle, household goods and personal effects, and prepaid burial arrangements. So the $2,500 limit applies to things like bank accounts, a second car, and investments, not the roof over your head.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 Almost no one's income is that low. A single Social Security check alone usually clears it several times over.

Being over that number does not disqualify you. Maryland is a medically needy state, which means it offers a spend-down: the amount your income exceeds the $350 medically needy income level becomes your monthly spend-down.3 Once you've incurred that much in medical or care costs in a given period, Medicaid covers the rest. Before the spend-down is calculated, the excess can first be reduced by what you pay for health insurance, such as a Medicare Part B premium or a Medigap policy.

The mechanics are a subtraction in two steps. First, subtract any health-insurance premiums you pay from your monthly income. Then subtract the $350 medically needy income level.3 What remains is your monthly spend-down: the amount of medical bills you must incur in the period before Medical Assistance pays the rest. Eligible costs include prescriptions, doctor visits, and your share of care expenses.

Because the spend-down exists, Maryland does not require a Qualified Income Trust (also called a Miller Trust). In strict income-cap states, an applicant even a dollar over the limit is shut out unless they route the excess through a special trust. Maryland has no such cliff. If your income is high, you spend down; you're never simply "too rich" for long-term-care Medicaid.

One number to know for home-based care: the home and community-based services (HCBS) waivers use a higher special income limit of $2,982/month, set at 300% of the 2026 SSI Federal Benefit Rate of $994.3,10 An applicant under that ceiling can qualify for waiver services without running the full medically needy spend-down.

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

When Maryland Medicaid pays for nursing-facility care, the resident contributes nearly all of their monthly income toward the cost of care. 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, one of the highest in the country (many states keep it near the $30 to $60 range).3,11

The same asset limit applies to nursing-home applicants. And because Maryland uses spend-down rather than an income cap, even a resident with substantial monthly income can qualify; they simply contribute more of it toward care, after the PNA and certain other deductions like a community-spouse allowance and health-insurance premiums. 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

So a married couple is in a very different position from a single applicant. Unlike the flat $2,500 individual limit, the community spouse can hold up to $162,660 in countable assets, half the couple's total, and keep a monthly income allowance while the other spouse receives Medicaid-funded care.3

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 long-term-care services, even though you're otherwise eligible.

There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) 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

Like every state, Maryland runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the state may seek repayment from the estate, unless the recipient is survived by a spouse or a minor, blind, or disabled child. An undue-hardship waiver also exists for cases where recovery would force a survivor off the property or into hardship.3,13 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, with eligibility processed locally. You have a couple of ways to apply.

Long-term-care applicants also go through a level-of-care assessment to confirm they need nursing-facility-level services. Apply even if you think your income is too high. Between the spend-down rules and the higher $2,982/month waiver income limit, many people who assume they're disqualified are not.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.