You can apply for Maryland Medicaid online, by phone, by mail, or in person, and as a medically needy state Maryland gives people over the income limit a way to qualify through spend-down., Coverage is administered by the Maryland Department of Health (MDH): Maryland Health Connection takes applications for the income-based (MAGI) groups. People aged 65 or older, blind or disabled, including those seeking nursing-home or waiver care, apply through their local department of social services instead: online at marylandbenefits.gov, by mail, or in person.

In This Guide

How Maryland's Medicaid Spend-Down Works

Maryland is a medically needy state, so income over the Medicaid limit does not end the application: if your monthly income exceeds the medically needy income level of $350 for a single applicant or $392 for a couple (effective February 1, 2026), you can still qualify by deducting incurred medical expenses from the excess.

Here is how the mechanic works. Your spend-down amount is your excess income: how far your countable income runs above the $350 medically needy income level for an individual. Countable income is not the gross figure on your benefit statement, because the agency applies the allowed deductions first. You meet the excess with incurred medical expenses that are not subject to payment by an insurer or other third party. Once those expenses reach the spend-down amount you can become eligible, but Medicaid does not reimburse the bills you used to meet it; those remain yours to pay.

Which bills count, including how old a bill can be and still be used, is decided under the rules the agency applies, so bring every unpaid medical bill you have rather than deciding for yourself that an older one won't help, and ask the office where you applied how to submit them.

Home and Community-Based Services (HCBS) waiver applicants are measured against the waiver's own rules. For the Community Options Waiver, MDH says monthly income may not exceed 300% of SSI benefits, which is $2,982 a month in 2026, and countable assets may not exceed $2,000 or $2,500 depending on eligibility category. If Medicaid denies a Community Options Waiver application because income is too high, MDH says the person may be eligible for the Increased Community Services Program, which you cannot apply to directly: it takes a referral from Medicaid's Eligibility Determination Division. The program has its own prerequisites: MDH says the person must need nursing facility level of care, have lived in a nursing facility for at least six months, and have been eligible for Medicaid for at least 30 days in a row. Federal terms for the program limit enrollment to 100 participants at any one time, with a registry for people waiting. See our Maryland Medicaid HCBS waivers guide for the details.

Nursing-Home Applicants: Income Against the Cost of Care

For a person in a nursing home throughout a calendar month, Maryland's regulation sets a different test. If countable resources are above the medically needy resource level, eligibility does not exist. Within that level, Maryland compares the person's income, after the allowed deductions, with the projected cost of care:

  • Income at or below the cost of care: eligibility exists, and the income is applied to the cost of care. Maryland's coverage-group guide calls this group L98, where Medical Assistance covers the portion of the nursing-home cost the person's income cannot meet.
  • Income above the cost of care: eligibility may be established through spend-down, on the day incurred medical expenses equal or exceed the excess available income; if they never reach it during the period under consideration, eligibility does not exist. In this group (L99), Medical Assistance does not cover the nursing-home cost of care, but it does cover other medical services not used for the spend-down.

The guide gives the resource limit for both groups as $2,500.

How to Apply for Maryland Medicaid

Federal rules require Maryland to accept your application through several channels, including online, by phone, by mail, and in person. Where you file depends on who is applying: MDH's application chart sends income-based applicants to Maryland Health Connection, and aged, blind or disabled applicants to marylandbenefits.gov or a local department of social services. MDH also says there is no wrong way to apply, and someone will help you wherever you apply.

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Step 1

Choose the right route for your program

Maryland Health Connection is where MDH says to apply if you are using its income-based (MAGI) limits, which it publishes for adults, children and pregnant women. People aged 65 or older, blind or disabled, or in a home and community-based services program are measured against different limits, including the $350/month medically needy level, and MDH tells them to call the Department of Human Services for help with those limits. Their applications, including for nursing-home or waiver care, are handled through the local departments of social services or their designees. If you get Supplemental Security Income (SSI), MDH says you are eligible for Medicaid and do not need to apply; that statement is about Medicaid coverage itself, so ask before assuming it also covers a nursing-home or waiver application. Federal rules let the state use a separate application, or supplemental forms, for people applying on a basis other than the MAGI rules, so ask which form fits your case before you fill one in.

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Step 2

Gather your documents before you start

Federal rules have the agency accept your application together with any documentation required to establish eligibility, so collect your income, asset and insurance records first. Do not hold the application for missing papers, though: Maryland's long-term care application form says to send the copies you do have, apply as soon as possible, and the agency will give you more time for the rest. See the checklist below.

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Step 3

Submit through the right channel

For the income-based groups, apply online at marylandhealthconnection.gov. If the applicant uses neither a computer nor the phone, apply by mail or in person instead: the agency has to accept an application either way.

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Step 4

Aged, blind or disabled, or applying for long-term care? Use the social services route

MDH's chart lists three ways for these applicants: online at marylandbenefits.gov, which DHS also names for long-term care applications; by mailing a completed form to your local department of social services; or in person at one of DHS's 24 local departments of social services. The paper form for nursing-home and waiver coverage is the Long-Term Care/Waiver Medical Assistance Application (form DHS/FIA 9709), which DHS offers for download on its Medical Assistance page. MDH's chart does not list Maryland Health Connection's website, app or call center, or the local health department, for these applicants. For questions about long-term services and supports, including waiver programs and nursing-home care, MDH lists 410-767-1739, Monday through Friday, 8 a.m. to 5 p.m.

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Step 5

Let someone apply for you if needed

Federal rules require the agency to accept an application from the applicant, an adult in the applicant's household or family, an authorized representative, or, if the applicant is incapacitated, someone acting responsibly for them. Applications are signed under penalty of perjury, and the agency must accept electronic signatures, including ones recorded by phone.

What Happens After You Apply

Federal regulation (42 CFR 435.912) caps how long Maryland may take. The state has no more than 45 days from the application date to decide for most applicants, and no more than 90 days for applicants who apply for Medicaid on the basis of disability. These are maximum periods for the agency, not a promise of speed.

Which window applies turns on the basis you applied under, not on whether a disability determination happens to arise in your case. An applicant aged 65 or older applying on the basis of age, including for nursing-home or waiver coverage, falls under the 45-day window, so if you are still waiting at day 50, that is past the standard rather than normal.

Maryland may run past the window only in unusual circumstances, and the regulation gives examples rather than a closed list: the applicant or an examining physician delays or fails to take a required action, or an administrative or other emergency beyond the agency's control intervenes. If the agency does run late, it must record the reasons in your case record, and it may not use the time limit as a waiting period or as a reason to deny you. The first of those examples is the one you control, so answer every document request the week it arrives.

Long-term-care applications are also checked against a 60-month look-back on asset transfers. If you or your spouse gave away or sold assets for less than fair market value in the 60 months before you applied, a penalty period may be assessed. That penalty stops Medicaid from paying for nursing-facility care and waiver services for a set number of months; it does not end the rest of your Medicaid coverage, and some transfers, such as those to a spouse, are exempt. An elder law attorney familiar with Maryland's rules can help you evaluate whether any transfers are problematic before you submit.

Why Your Application Date Matters

Federal law requires retroactive coverage: once you are found eligible, Medicaid pays for covered services you received in or after the third month before the month you applied, as long as you would have been eligible then. That back-coverage can pay for covered care you already received, which is one reason to file promptly rather than wait. A federal demonstration can shorten a state's window, and the exact start date inside it is set by the state plan, so confirm with Maryland Medicaid how far back your coverage will reach. One change is coming: for applications made on or after January 1, 2027, federal law (Public Law 119-21, Section 71112) shortens this window to two months before the application month for most applicants, and one month for the Medicaid expansion adult group.

After Approval

Once approved, nursing-home residents contribute their income, less the deductions federal rules allow, toward the cost of care. Maryland allows a Personal Needs Allowance of $106/month, which the resident keeps for personal expenses. Married applicants should ask about the spousal impoverishment protections, which let the community spouse keep income and assets up to the limits Maryland publishes.

Documents to Gather Before You Apply

No official Maryland list is reproduced here: the office reviewing your application decides which documents it needs. The records below are practical preparation for an income and asset review, so you can answer its requests quickly:

Identity and citizenship:

  • Social Security card or benefit statement
  • U.S. birth certificate, passport, or Certificate of Naturalization
  • State-issued photo ID or driver's license
  • Already on Medicare? Bring your Medicare card

Income:

  • Social Security award letter or most recent SSA-1099
  • Pension and retirement income statements
  • Documentation of any rental income, annuity payments, or other monthly income sources

Financial accounts:

  • Recent statements for all checking and savings accounts
  • Statements for CDs, IRAs, brokerage accounts, and any trusts
  • Records of any gifts or below-market sales of assets: the transfer look-back covers the 60 months before you apply

Property and insurance:

  • Property deeds and current tax bills for real estate
  • Life insurance policies (face value and current cash surrender value)
  • Prepaid burial contracts and cemetery plot deeds
  • Vehicle title

Medical bills and insurance:

  • Unpaid medical bills (for spend-down applicants, these are central to the application)
  • Medicare Part B and Medigap premium invoices
  • Explanation of benefits from any private insurance

What to Do if You're Denied

Maryland Medicaid applicants have the right to appeal a denial through a fair hearing. Federal rules cap how long a state's request window may run: 42 CFR 431.221(d) lets a state allow no more than 90 days from the date the notice of action is mailed. That 90 days is a ceiling on the state, not a window you are guaranteed, and a state that sets a shorter one may enforce it. Maryland uses the full federal window: for most decisions you must ask for a fair hearing within 90 days of the date on your notice. Check the date printed on your own notice and file against that, not against the federal maximum.

Request the hearing through the Maryland Department of Health, not through the hearing office. MDH says its online Medicaid Request for Fair Hearing form is the best way, and a request can also be mailed or faxed to the Maryland Department of Health, Attention: Medicaid Appeals, 201 West Preston St., L9, Baltimore, MD 21201 (fax 410-333-5154). If you already have Maryland Medicaid and are appealing a decision to end or reduce it, coverage can continue while the appeal is pending, but only if you file within 10 calendar days of the notice date, the postmark, or the effective date of the action, whichever is later. Even then, the agency can still cut or end services before the decision if it is determined at the hearing that the only issue is one of federal or state law or policy and the agency promptly tells you so in writing. If the decision is later upheld, you may have to repay the cost of services you received in the meantime. If you get your care through a HealthChoice managed care plan, you must first go through the plan's own appeal process, filing within 60 days of the date on the plan's denial notice, before you can ask for a State fair hearing.

The hearing itself is conducted by the Maryland Office of Administrative Hearings in Hunt Valley (410-229-4100). You will get a hearing notice from that office.

For legal help with an appeal, contact Maryland Legal Aid and ask whether it can take your case.

Where to Get Help Applying for Maryland Medicaid

These Maryland offices and programs can help with an application.

Maryland Health Connection Where MDH says to apply if you are using the income-based (MAGI) limits. www.marylandhealthconnection.gov
Maryland Department of Health: Medicaid Publishes Maryland's Medicaid income and asset limits; for help with the limits for people aged 65 or older, blind or disabled, MDH says to call the Department of Human Services. For questions about long-term services and supports, including waivers and nursing-home care, call 410-767-1739, Monday through Friday, 8 a.m. to 5 p.m. health.maryland.gov/mmcp
Local Department of Social Services Where people aged 65 or older, blind or disabled, including nursing-home and waiver applicants, can apply in person or by mail; DHS runs 24 local departments. Online applications go through marylandbenefits.gov. dhs.maryland.gov/weathering-tough-times/medical-assistance
Maryland Legal Aid Civil legal services; ask whether it can help with your Medicaid application or denial. www.mdlab.org
Maryland Access Point (MAP) Maryland's single entry point for older adults and people with disabilities who need help with long-term care planning. Call 1-844-627-5465 or reach your local MAP office. aging.maryland.gov/programs-and-services/maryland-access-point
State Health Insurance Assistance Program (SHIP) Free, confidential one-on-one counseling on Medicare and its savings programs, with a SHIP office in every Maryland county; useful if you have, or are about to have, both Medicare and Medicaid. aging.maryland.gov/Pages/state-health-insurance-program.aspx

For spend-down strategy, look-back analysis, and spousal impoverishment protection, a Maryland-licensed elder law attorney can advise you on your options.

Frequently Asked Questions

What if my income is over Maryland's Medicaid limit?

You may still qualify. Maryland is a medically needy (spend-down) state: if your income exceeds the medically needy income level of $350/month for an individual ($392 for a couple, effective February 1, 2026), you can become eligible by deducting incurred medical expenses from the excess. For the Community Options Waiver the test is different, an income cap of 300% of SSI ($2,982 a month in 2026). If Medicaid denies a Community Options Waiver application because income is too high, MDH says the person may be eligible for the Increased Community Services Program, which takes a referral from Medicaid's Eligibility Determination Division and requires, among other rules, at least six months living in a nursing facility and 30 days in a row of Medicaid eligibility; enrollment is capped at 100 participants at a time. In a nursing home, the test is your income against the projected cost of care rather than the $350 level.

What is the asset limit for Maryland Medicaid?

For an individual applying for long-term-care Medicaid, Maryland's medically needy (non-MAGI) countable asset limit is $2,500. For a couple, it is $3,000. The state's separate categorically needy standard is $2,000 for an individual and $3,000 for a couple. Your home is handled separately: for long-term-care coverage, Maryland's excess home equity limit is $752,000, so home equity above that amount rules out Medicaid payment for long-term care. Some assets do not count at all. For an aged, blind or disabled person living at home, or a nursing-home resident who intends to return home, Maryland's regulation excludes any automobile regardless of its value, burial spaces for the person and their immediate family, and up to $1,500 per person set aside for burial. A narrower list applies to a nursing-home resident who does not intend to return home, so ask which list covers you before you count your assets.

How far back does Maryland look at asset transfers?

Maryland applies a 60-month (five-year) look-back period to uncompensated asset transfers. Gifts, below-market sales, or transfers made within the 60 months before your application date may trigger a penalty period during which Medicaid will not pay for nursing-facility or waiver services; the rest of your coverage is not taken away, and some transfers, such as those to a spouse, are exempt., An elder law attorney can help you assess whether past transfers create exposure before you file.

Can I apply for Maryland Medicaid online?

Yes. Maryland Health Connection at marylandhealthconnection.gov takes online applications for the income-based (MAGI) groups. If you are aged 65 or older, blind or disabled, including applying for nursing-home or waiver care, MDH's chart sends you to marylandbenefits.gov instead, or to your local department of social services by mail or in person.

How long does a Maryland Medicaid application take?

Maryland has no more than 45 days from the application date to decide for most applicants, and no more than 90 days for applicants who apply for Medicaid on the basis of disability. These are federal ceilings on the agency under 42 CFR 435.912, not a guarantee of when your answer arrives, and the one that applies to you depends on the basis you applied under rather than on whether a disability question comes up: a senior applying on the basis of age is covered by the 45-day ceiling. Contact the office where you applied for a status update if you have not heard within 45 days.

Does Maryland Medicaid cover bills from before I applied?

It can. Federal law requires retroactive coverage: once you are determined eligible, Medicaid pays for covered services received in or after the third month before your application month, if you would have been eligible then. Because a state's window can be shorter under a federal demonstration, confirm with Maryland Medicaid how far back yours reaches. For applications made on or after January 1, 2027, this window narrows to two months for most applicants and one month for the Medicaid expansion adult group.

Learn More

MedicaidHow to Apply for Medicaid by State: Steps, Documents, and Where to ApplyHow to apply for Medicaid: the ways you can apply, the documents to gather, how long a decision takes, and the application guide for your state. MedicaidMaryland Medicaid Eligibility and 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. MedicaidMaryland Medicaid: A Guide for Seniors and FamiliesMaryland Medicaid covers long-term care in 2026: the $2,500 medically needy asset limit, $106 PNA, spend-down, HCBS waivers, and how to apply through MDH. MedicaidHelp Paying Medicare Premiums in MarylandMaryland Medicare Savings Programs in 2026: QMB, SLMB, and QI income limits, Part B premium savings, automatic Part D Extra Help, and how to apply. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidHow Medicaid Estate Recovery WorksMedicaid estate recovery can claim a home after death, but not while a spouse or a child under 21, blind or disabled survives. See your state's rules.

Find personalized help applying for Maryland Medicaid 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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