Maryland Assisted Living & Home Care: Costs and Financial Assistance

Maryland Assisted Living & Home Care: Costs and Financial Assistance

Introduction:
This page is designed to aid Maryland residents in understanding the costs associated with elderly care throughout the state. The cost of assisted living, in-home care, and adult day care in different regions of the state is explored. Various payment options, as well as programs that offer financial or care assistance, whether it be residential or in the home, are also explored.

The compiled list of programs found on this page is comprehensive of what the state of Maryland has to offer for assistance with elderly care. However, additional programs are available at the national level and are not included here. When researching your options, it is important to consider all avenues of assistance. To assist in your search of finding elderly care that most appropriately fits your care needs and situation, make sure to use our Resource Locator Tool.

Assisted Living / Memory Care

In Maryland, according to Genworth’s 2019 Cost of Care Survey, in 2020, the average cost of assisted living per month is $4,300, with average monthly rates ranging from $3,750 to $6,263. This is a quite a range of cost, ranging from $45,000 to $75,156 annually. However, one can make cost saving efforts by relocating to an area of the state where the cost of assisted living is more reasonable. The most inexpensive assisted living can be found in the areas of Hagerstown, Baltimore, and Cumberland, where the average monthly rate is between $3,750 and $4,225. Salisbury has an average monthly cost approximately 20% higher than the statewide average at $5,250. However, the most expensive average cost of assisted living is found in California, where the monthly cost averages $6,263.

Alzheimer’s Care, also called Memory Care, costs an additional $937.50 – $1,565.75 / month, on average, due to the increased need for care and higher level of security.

Home Care

Per the Genworth Cost of Care Survey 2019, the average hourly rate for non-medical home care in Maryland in 2020 is $23.50. On the low end, home care can be as inexpensive as $22.00 / hour, and on the high end, as high as $24.25 / hour. The least expensive area for home care is in Hagerstown, where $22.00 / hour is the average cost. Salisbury and California also have average hourly costs ($22.50 to $23.00) under the statewide average. Baltimore has the most expensive average cost of care at $24.25 / hour.

Home health care, which offers some medical care provided by health care professionals, costs an average of $.50 more an hour statewide. However, depending on the geographic region within the state, this type of care can cost the same per hour as home health care or slightly more than the statewide average.

Adult Day Care

Adult day care runs Maryland residents $82 / day on average in 2020, according to Genworth’s 2019 Cost of Care Survey. The average daily rate for day care remains pretty consistent throughout the state, with a range from $68 – $85. The most affordable care can be found in California, where the average daily cost is $68. Cumberland, Baltimore, and Hagerstown are all comparable to the statewide average at a daily average of $81 – $82. The costliest day care is found around Salisbury, where the average rate is $85 / day.

 

Maryland Financial Assistance Programs

Medicaid Assistance Programs for the Elderly

Medicaid, also called Medical Assistance, or MA, in the state of Maryland, is a state and federal funded health care program. MA will cover the cost of nursing home care for low-income seniors and disabled individuals, as well as some in-home personal care.

The Community Personal Assistance Services program is part of the state MA plan and requires that individuals need a hands-on level of assistance with activities of daily living. Assistance with activities, such as bathing and grooming, nurse monitoring, and support planning, is available via this program, allowing seniors to remain living in their home or community. This program allows for self-direction, which means program participants can hire the caregiver of their choosing, including their adult child. For more information, click here.

The Community First Choice (CFC) program is an option under the state Medicaid plan. Via CFC, care services for the elderly are provided in their homes and adult foster care homes. Benefits include assistance with activities of daily living, such as mobility, toiletry, and dressing, and instrumental activities of daily living, like preparing meals and light housecleaning. Eligible applicants may choose the caregiver of their choice, including some family members. Other benefits include personal emergency response systems, home modifications, mental health services, and financial assistance to transition from a nursing home back into the community. To see eligibility requirements, click here.

In addition to the state plan, Medicaid also offers Home and Community Based Services (HCBS) Waivers. They cover long-term care for elderly, frail individuals in their homes and / or communities. This is intended to prevent and delay unnecessary nursing home placements, saving the state money, while also allowing the elderly to age in place. As of 2020, Maryland has four HCBS Waiver programs that are relevant to seniors.

1) The Community Options (CO) Waiver allows eligible applicants who need a nursing home level of care to receive benefits in their home or an assisted living community. This waiver, which was previously known as the Waiver for Older Adults, provides a variety of assistance, including personal care, meal delivery, home and vehicle modifications, and adult medical day care, among others. There may be a waitlist for services, which is county specific. To learn more about this wavier and the eligibility requirements, click here.

2) The Community Pathways Medicaid Waiver provides supports to individuals who have an intellectual or developmental disability that is chronic. Through this waiver, care services may be self-directed. This means the eligible applicant can hire the caregiver of their choosing, including select family members. Other benefits include home modifications, group home services, adult day health care, and respite care. Click here for more details.

3) The Medical Day Care Services Waiver provides daytime supervision and care supports for those who are at risk of nursing home placement. Personal care, nursing services, rehabilitation therapy, and social activities are all benefits. This program also allows fulltime caregivers a break from their caregiving duties. For more information about this waiver, click here.

4) The Increased Community Services (ICS) Waiver is for frail elders and physically disabled individuals who reside in a nursing home facility, but wish to live in their home or an assisted living facility. Via ICS, a variety of supports and benefits are available to promote living independently, such as home modifications, assistive technology, personal care assistance, and meal delivery. To see what other benefits are available and the program’s eligibility requirements, click here.

Eligibility

While long-term care eligibility requirements for regular Medicaid and Medicaid Waivers may vary a bit, senior residents of Maryland must meet functional criteria, as well as income and asset criteria. Generally speaking, as of 2020, the income limit for the state Medicaid program is $350 / month for a single applicant. For a Medicaid waiver, the income limit is much higher: One must not have a monthly income in excess of $2,349. This amount is equivalent to 300% of the Federal Benefit Rate (FBR). The asset limit also may vary between the state plan ($2,500) and Medicaid waivers ($2,000). However, certain assets, such as personal belongings, household furnishings, a vehicle, and an individual’s home, up to an equity value of $595,000, are generally considered exempt.

It’s important to note, the income and asset limits are different for married couples with a single applicant. For instance, non-applicant (community) spouses of nursing home or HCBS waiver applicants may be permitted up to $3,216 / month in income from their applicant spouses. In addition, community spouses can retain up to $128,640 in assets. Not only do these rules assist community spouses from becoming impoverished, they also effectively lower applicant spouses’ countable income and assets. That said, those who are over the income and / or asset(s) limits may still qualify for Medicaid. Medicaid eligibility can be complicated. For the best chance of acceptance into a Medicaid program, contact a professional Medicaid planner for assistance.

State (Non-Medicaid) Assistance Programs

Currently, the state of Maryland offers eight non-Medicaid assistance programs. All of these programs are intended to assist low-income, disabled and elderly individuals in living independently, preventing them from having to relocate to more costly nursing homes.

1) The Senior Care Services program provides a variety of supports, including adult day care, personal care, transportation assistance, chore services, medications, and respite care. For eligibility guidelines, click here.

2) The Assisted Living Subsidy program provides financial assistance to aid in covering the cost of assisted living. Services provided in assisted living might include meals, personal care assistance, and supervision. To learn more, click here.

3) The Congregate Housing Services Program (CHSP) provides financial assistance to help with the cost of living in a congregate or group home. In general, services provided in congregate homes include some personal assistance, homemaker services, meals, and monitoring of medications. For additional information, click here.

4) Through the In-Home Aide Services (IHAS) program, seniors and disabled individuals are provided a home health aide in order to continue to safely live at home. Assistance includes personal care, household tasks, transportation, and shopping. Learn more here.

5) The Senior Prescription Drug Assistance Program, also called the SPDAP Subsidy, provides financial assistance in covering the cost of Medicare Part D premiums and prescription medications. For eligibility information, click here.

6) The Accessible Homes for Seniors program offers a deferred payment loan of 30 years to assist seniors in making home modifications. This can enable them to remain living independently in their homes. Home improvements vary, but may include installation of ramps, railings, and grab bars. Learn more about eligibility requirements here.

7) Project Home, also called the Certified Adult Residential Environment (C.A.R.E.) program, allows elderly individuals to continue living in the community by living in an adult foster care home. Via this program, room and board is provided, as well as supervision, medication monitoring, and personal care assistance. For additional information, click here.

8) The Attendant Care Program (ACP) assists with the cost of personal care services to allow severely physically disabled adults up to the age of 64 to continue to live at home. Benefits may include personal care assistance, transportation, and household chores. To learn more, click here.