Maryland is home to around 6.1 million people, and almost 16% of its residents are aged 65 and over. Older adults looking for a retirement location may find it an attractive and affordable option. Assisted living costs in Maryland average $4,900 per month, which is lower than in the neighboring states of Delaware and Virginia. Tax laws in the Free State can also benefit seniors, as there’s no state income tax on Social Security benefits and a generous deduction for income from public pensions and employee retirement plans. Although the overall cost of living is higher than the national average, health care costs are low and residents have access to leading hospitals with geriatric specializations, such as Johns Hopkins.  

This guide includes details about the cost of assisted living in Maryland and nearby states, as well as the prices of other senior living options. It also outlines ways to pay for senior care, available financial assistance programs and resources that can help adults as they age.

How Much Does Assisted Living Cost in in Maryland?

According to the 2021 Genworth Cost of Care Survey, the average cost of assisted living in Maryland is $4,900 per month. This is $400 higher than the national average of $4,500. When compared to neighboring states, Maryland’s cost falls about midrange. Costs in Pennsylvania and West Virginia are substantially lower, with averages of $4,100 and $4,160, respectively. Virginia’s average is closest to Maryland’s, at $5,250 per month, while seniors in Delaware pay $5,995 per month. 

The Cost of Assisted Living in Maryland’s Top Cities

Hagerstown offers the most affordable assisted living in Maryland, with seniors there paying $4,630 per month. The state’s biggest city, Baltimore, also has low prices with an average of $4,750. Costs in Salisbury are higher than the state average at $4,980, while Cumberland is the least affordable city with an average of $5,248. Maryland cities in the Washington metropolitan area likely have similar costs to the nation’s capital, where the average rate for assisted living is $5,948 per month. 

The Cost of Assisted Living vs. Other Types of Care

Older adults in Maryland have a range of senior living options that suit varying needs and budgets. The least expensive option is adult day health care, which costs $1,928, and provides services during the day in a group setting. Care provided in the home averages $5,148 per month. The rate is identical for both basic homemaker services and home health care, which provides some medical assistance such as skilled nursing. Nursing home care is the least affordable option, with the cost of a semiprivate room averaging $10,342 per month.

Can You Use Medicaid to Pay for Assisted Living in Maryland?

Medicaid in Maryland is also called Medical Assistance, or MA. Although it doesn’t cover assisted living care directly, the state has a number of home and community based services waivers. Two of these can help eligible seniors pay for assisted living services. 

Waiver programs are designed to help seniors access assistance in their home or a community setting. This delays or negates the need for them to enter an institution such as a nursing home, which is a preferable option for seniors and also saves the state money. To achieve this, these waivers cover a range of services to support living in the community, including personal care, meals, nurse monitoring and supports planning. However, the waivers don’t cover the cost of room and board. 

Medicaid’s Coverage of Assisted Living in Maryland

In Maryland, Medicaid indirectly covers assisted living care through two programs: the Maryland Community Options Medicaid (CO) Waiver and the Increased Community Services (ICS) program. The two have very similar benefits, however the ICS program is designed to help people currently living in a nursing home transition back to the community. 

Both the CO waiver and ICS provide assistance to people living in their homes or in certain group settings, including participating assisted living facilities. Assisted living is listed as a benefit of both programs and in general covers various services provided by communities, such as personal care and social programs. 

Waiver Programs for Assisted Living in Maryland 

Maryland Community Options Medicaid Waiver

The Maryland Community Options Medicaid Waiver is more commonly known as the Community Options or CO Waiver. It’s designed to help older adults and people with disabilities remain living in their homes or the community. Applicants must be aged 65 and over, or be aged 18-64 and have a physical disability. They must also be financially eligible for Medicaid and require a nursing home level of care. 

Participants in the program receive a range of care services in the home or a group setting such as an assisted living community. These include case management, nutritionist services and transitional services. They also have access to regular Medicaid benefits including medical and personal care. Assisted living services are only available at facilities that participate in the program and are willing to accept Medicaid rates. 

There’s a waiting list for this program. Seniors currently living at home can contact Maryland Access Point at (844) 627-5465 to be added to the Service Registry. People currently living in a nursing home can contact their local Area Agency on Aging to apply for the program.

Increased Community Services

Increased Community Services, or ICS, is a program that helps people living in a nursing home move back to the community. Applicants must be currently living in a nursing home and have been living there for at least 3 months. They must have also been eligible for Medicaid for at least 30 days of those 3 months. 

In addition, applicants must meet specific income and asset limits and require a nursing home level of care. Services can be provided to participants in their home, the home of a relative or an assisted living residence. However, the services provided through the program must cost less than nursing home care. 

As the program helps people leave nursing homes, transitional services are a key benefit. In addition, participants receive personal care, long-term support, case management and other services designed to help them live in the community. Participants are also eligible for Medicaid services such as medical care, pharmacy and durable medical supplies. 

Interested seniors can apply by contacting Maryland Access Point at (844) 627-5465.

Eligibility for Medicaid in Maryland 

Medicaid is intended to help low-income people access health care, so finances are the primary eligibility criteria. Applicants must meet both income and asset limits. 

The income limit for residents applying for long-term care assistance through Maryland Medicaid is $2,523 per month. For married couples who are both applying for the waiver, the limit is $2,523 per spouse. If only one spouse is applying, they may be able to transfer part of their income to their partner as a minimum monthly maintenance needs allowance, according to Medicaid’s spousal impoverishment guidelines. 

The asset limit for single applicants is $2,000, while married couples can have up to $3,000 in assets. If only one spouse is applying, the applicant can have $2,000, while the non-applicant spouse can have up to $137,400 in assets. Medicaid doesn’t count all assets when determining eligibility. Personal belongings, an automobile and irrevocable burial trusts are among the exempt assets. A primary home is also exempt if the applicant intends to return to it, or if a non-applicant spouse still lives there.

2022 Medicaid Income Limits for Seniors in Maryland

	Income Limits*	Asset Limits
Single Applicant	$30,276	$2,000
Two-Person Household(Only One Person Applying)	$30,276	$2,000 for applicant$137,400 for non-applicant
Two-Person Household (Both People Applying)	$30,276 per spouse	$3,000

*per year

Medicaid applicants must also be:

• A Maryland resident
• A U.S. citizen or qualified non-citizen
• In need of a nursing home level of care

Applying for Medicaid in Maryland

Seniors can apply for long-term services and support online through the myMDThink portal. Paper applications can be downloaded from the Medicaid website and submitted in person or by mail. The Bureau of Long Term Care manages applications from those living in Anne Arundel, Baltimore and Prince George’s counties and Baltimore City. Those living in other areas of the state can return applications to their local Department of Social Services office. 

Before You Apply

Information must be verified in order to process applications. The Department of Health may request:

• Proof of identity and residenc
• Proof of citizenship or immigration status
• Proof of income such as banks statements and federal tax returns
• Proof of assets such as life insurance policies and trusts
• Health insurance cards, including Medicare
• Social Security number
• Power of attorney or legal guardianship documents

Where to Go to Get Help 

Maryland has a number of resources available to help people who are applying for Medicaid. Face-to-face guidance is offered by counselors from the State Health Insurance Program. In addition, Maryland has a detailed website and has produced a Guidebook to assist applicants and beneficiaries.

Resource	Contact	Description
State Health Insurance Program	Contact local office	The State Health Insurance Program is designed to provide answers to questions about Medicare, but counselors also give advice about low-income benefit programs, such as Medicaid. There are volunteer counselors throughout the state who are trained to help seniors understand their health insurance options.
Medicaid Website	Online	Applicants can find detailed information about programs, eligibility criteria and how to apply for waivers on the state’s Medicaid website. It also has information about the different programs that cover long-term care and seniors can see what programs they may be eligible for.
Home and Community-Based Long Term Care Services Guidebook	Online	The Home and Community-Based Long Term Care Services Guidebook provides detailed information about the waiver programs available in Maryland. Seniors can learn about the benefits and eligibility criteria of the various programs and where to obtain more information.

Can You Use Medicare to Pay for Assisted Living in Maryland?

Unfortunately, Medicare does not cover the cost of assisted living in Maryland. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

For more information about what Medicare visit medicare.gov.

Are There Other Financial Assistance Options for Assisted Living in Maryland?

	How to Apply	How It Works
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free and Low-Cost Resources for Seniors in Maryland

Seniors in Maryland have access to a range of resources that provide support and assistance as they age. The state has a number of departments that can provide information on available aging resources and services. Seniors can also access financial aid for assisted living and prescription drugs costs and assistance resolving issues in long-term care facilities. 

Resource	Contact	Service
Maryland Access Point	(844) 627-5465	Maryland’s Aging and Disability Resource Center is known as Maryland Access Point, or MAP. It’s a single point of contact for people who need long-term care services and supports. There are MAP offices throughout the state and a helpline where seniors can access options counseling and assistance applying for benefits. Offices also provide referrals to local resources and community support services.
Maryland Department of Aging	(410) 767-1100	Maryland’s Department of Aging oversees and funds programs that help seniors lead healthy lives. It also provides support to people with long-term care needs. Older adults can access durable medical equipment, transportation, legal assistance and other aging-related programs through the department.
Area Agencies on Aging	Contact local office	There are Area Agencies on Aging in each of Maryland’s counties and Baltimore City, which may be run by local governments or nonprofit organizations. AAAs offer a variety of services, although the exact support provided depends on local community needs. These commonly include senior centers, transportation, meals and protective services.
Senior Prescription Drug Assistance Program	(800) 551-5995	The Senior Prescription Drug Assistance Program, or SPDAP, helps seniors pay for prescription medication. Moderate-income Medicare recipients who are enrolled in a prescription drug plan can access the program. Those enrolled in approved plans can receive a subsidy for their premium, and the program may also help pay for out-of-pocket expenses.
Assisted Living Subsidy Program	(410) 767-1100	The Assisted Living Subsidy Program helps low- and moderate-income seniors pay for care in an assisted living community. It’s a non-Medicaid program available to people aged 62 or older who require a nursing home level of care and meet the financial eligibility limits, which are higher than Medicaid eligibility criteria. Subsidies are paid directly to the facility and the amount provides depends on an individual’s circumstances and the county where they reside.
Long-Term Care Ombudsman Program	Contact local office	The Long-Term Care Ombudsman has volunteers available to investigate and help resolve issues for residents of nursing homes and assisted living facilities. The Ombudsman program also advocates for residents at the local, state and federal levels and helps protect the rights of people living in long-term care facilities.

COVID-19 Rules for Assisted Living in Maryland

The following information is based on research done on several government websites, including coronavirus.maryland.gov and health.maryland.gov. Preparing-for-and-Responding-to-COVID-19-in-LTC_final.pdf. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/8/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Yes
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Assisted Living Laws and Regulations in Maryland

Maryland has a comprehensive set of regulations in place that govern assisted living facilities in the state to ensure the health and safety of residents. Facilities are licensed and regulated by the Office of Health Care Quality, a division of the Maryland Department of Health.