Maryland Medicaid Long-Term Care

Last updated: August 21, 2026 Jurisdiction: Maryland

Maryland Medical Assistance has separate long-term-care pathways

Maryland’s Medicaid program is the Maryland Medical Assistance Program. The state’s coverage-group guide separately identifies SSI recipients in long-term care, ABD long-term care, ABD long-term care with spend-down, and HCBS-waiver/PACE participants. Those labels matter because a person’s care setting, financial pathway, and managed-care status can all affect how the case is handled (Maryland coverage-group guide).

For an aged, blind, or disabled person, the published guide expressly includes an “ABD Long Term Care With Spend-down” group. Maryland’s 2026 appendix also publishes medically needy non-MAGI income standards of $350 monthly for one person and $392 for two people. These figures are not a nursing-home private-pay bill; they are part of the financial framework used for medically needy eligibility and spend-down analysis (Maryland coverage-group guide; Maryland 2026 appendix schedules).

Institutional and community care use different operational steps

Maryland’s institutionalized-persons manual describes medical certification by the Utilization Control Agent, or UCA, for people age 21 or older who need long-term care. The nursing facility starts the DHMH 257 Long-Term Care Patient Activity Report, and the UCA approval supplies the medical/level-of-care certification; the manual also identifies the DHMH 3871B Medical Eligibility Review Form for level-of-care and service requests (Maryland institutionalized-persons manual).

For community care, the state’s 2026 HCBS report says the Office of Long Term Services and Supports operates the Community Options and Model Waivers, while the Developmental Disabilities Administration operates the Community Pathways, Community Supports, and Family Supports Waivers. The report also identifies the Brain Injury, Medical Day Care Services, and Autism Waivers among Maryland’s eight 1915(c) programs (Maryland End the Wait report).

Coverage does not eliminate the contribution calculation

Long-term-care Medicaid requires more than a program label. The institutional manual describes a post-eligibility calculation that deducts the personal-needs allowance first and then applies other permitted deductions. It also explains that an asset-transfer penalty can close the long-term-care coverage span while leaving the person’s basic Medicaid eligibility on the general MMIS screen unaffected (Maryland institutionalized-persons manual).

Maryland starting point: identify the care setting, complete the required UCA medical review for facility care, and ask the eligibility worker which long-term-care coverage group and spend-down calculation applies. The state’s published materials show that the financial and clinical tracks are related but distinct (Maryland coverage-group guide).

Keep the medical certification, application date, income records, asset records, and transfer documentation together. Those documents are relevant to coverage, patient liability, spouse protections, and the five-year transfer review. For the larger framework, see Medicaid (Baseline).

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Maryland Medical Assistance has separate long-term-care pathways

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