The state of Maryland is home to approximately 6 million residents, around 15% of whom are over the age of 65. As the large baby boomer generation continues to age, this figure is forecasted to grow; by 2023, experts expect 23% of the state population to be 60 or older, a rise of 26% since 2012.

As a relatively affordable state in the Mid-Atlantic region, especially in comparison to its costly neighbors in the Northeast, seniors in Maryland can expect to pay $4,300 per month for assisted living care. This is $250 higher than the national average of $4,051. For seniors who cannot afford this expense, other resources are available for those in need. This guide explores the cost of senior living care, possible financial support for low-income seniors and local programs that can offer assistance.

The Cost of Senior Living in Maryland

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Senior living in Maryland doesn’t subject older residents to one-size-fits-all facilities, instead it provides choices for seniors with varying health care needs, budgets and lifestyles. The levels of care provided, types of accommodations and amenities available significantly impact fees, as does each facility’s location. According to the 2021 Genworth Cost of Care Survey, Maryland is at the higher end of the senior living cost spectrum, with median fees generally above national averages.

Independent living is the most affordable care type, with fees of around $3,185 per month for amenities and accommodations. At $4,900, assisted living provides amenities, accommodations and three levels of care for seniors with varying needs. There isn’t a minimum staff-to-resident ratio, but there must be at least one registered nurse available and sufficient licensed nurses operating 24/7. Memory care is usually incorporated in an assisted living facility, with specially trained staff and 24-hour surveillance, which increases fees by around $1,660. Nursing homes offer near-hospital levels of care in residential environments, with fees averaging $10,342.

The Cost of Assisted Living in Maryland

Seniors in Maryland assisted living facilities typically pay $400 more than the national median of $4,500. However, when compared to its neighbors, such as Virginia, where fees average $5,250, Maryland’s costs are competitive. In Washington, D.C., the average price is $5,948 for assisted living, and in Delaware, it’s about $5,995 per month. Pennsylvania may be a choice for seniors on a lesser budget, as its usual charge is roughly $800 less per month than Maryland’s $4,900.

The Cost of Nursing Home Care in Maryland

Although the median fee for nursing home care in Maryland is $10,342 per month — a $2,434 increase on the national average — the state is more affordable than most of its neighbors. Only Virginia, where the median is $8,213, has lower fees. Pennsylvania is a little costlier, at $10,403, while Washington, D.C., and Delaware seniors pay significantly higher, at $11,467 and $12,273, respectively.

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

Medicaid can pay some or all costs for several senior living options. However, as it’s solely for people who need medical assistance, it won’t pay for seniors to reside in independent living facilities but will pay all costs for those in nursing homes. Seniors in assisted living and memory care facilities can receive some financial assistance through waiver programs. Although this option doesn’t meet all costs, it can pay for medical and some non-medical services. 

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial	Medicaid Waivers	No
Independent Living	None	N/A	N/A
Memory Care	Partial	Medicaid Waivers	No
Nursing Home Care	Full	Medicaid	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list. 

Medicaid’s Coverage of Assisted Living & Memory Care in Maryland

Seniors with needs that justify nursing home care but prefer assisted living or memory care can apply for one of two waiver programs to help with care costs. Both waivers can help seniors at most care levels.

Community Options Waiver

The Community Options waiver covers a wide range of supports short of nursing home care. These include:

• Assisted living and memory care
• Medical day care
• Family training
• Case management
• Senior center plus
• Dietician and nutritionist services
• Behavioral consultations
• Transportation to/from medical appointments, with an escort, if necessary

The waiver only covers medical and non-medical services, so seniors eligible for assisted living or memory care will need to fund their room and board costs by other means. To be eligible, the applicant must need help with daily tasks, such as personal care, in addition to having a monthly income no greater than 300% of SSI benefits, as of 2022. To apply, applicants can call (844) 627-5465 or visit the Maryland Access Point website to find the mailing address of their local Area Agency on Aging office.

Increased Community Services Waiver

The Increased Community Services waiver is for seniors currently living in nursing homes who are medically able to transition to assisted living or memory care. The waiver offers almost identical services to the Community Options waiver. To be eligible, the applicant must be a current nursing home resident who has lived in their facility for at least three months. The other criteria are the same as those needed for the Community Options waiver.

Successful applicants are eligible for an array of services, including:

• Assisted living
• Assistive technology
• Nurse monitoring
• Meal delivery
• Personal emergency response systems
• Adult medical day care
• Home modifications

The application process is the same for all waivers, with medical eligibility determined by the senior’s local health department and financials established by the Department of Social Services or the Department of Health and Mental Hygiene. To begin the application process or find out more, seniors should contact (844) 627-5465 or visit the Maryland Access Point website, where they will find the mailing address of the nearest office of their Area Agency on Aging that’s authorized to assist.

Medicaid’s Coverage of Nursing Home Care in Maryland

Medicaid meets the costs of around 20,000 seniors currently living in Maryland’s nursing homes. It covers expenses for 24-hour professional care in authorized facilities, which includes treatments by physicians, therapists and registered nurses and personal care from licensed nurses. It also covers all room and board costs and transportation for medical purposes. To be eligible, the applicant must fully satisfy the program’s age, citizenship, financial and health needs criteria.

Eligibility for Medicaid in Maryland

Although Medicaid and its waiver programs can cover costs for seniors in need of medical care, it applies different financial rules to both. The table provides information for seniors who need to enter nursing homes, while for those more suited to the waivers, the following applies.

• Income Limits (per month): $2,523 per applicant, which applies regardless if the senior is single, lives with their spouse or is applying with their spouse
• Asset Limits: $2,000 (single applicant and one applicant in a two-person household, and $137,400 for non-applicant spouse in a two-person household), $3,000 if both people in a two-person household apply

As of 2022, single applicants for waiver programs are allowed a maximum monthly income of $841, and couples, $1,261. SSI beneficiaries are automatically eligible for Medicaid in Maryland.

2022 Maryland Medicaid Income Limits

	Income Limits*	Asset Limits
Single Applicant	Can’t be greater than nursing home care costs	$2,500
Two-Person Household (Only on applicant)	Can’t be greater than nursing home care costs	$2,500 for applicant $137,400 for non-applicant
Two-Person Household (Both applicants)	Can’t be greater than nursing home care costs	$3,000 per spouse After 6 months, $2,500 per spouse

*Per year

**All the applicant’s annual income must pay for nursing home care, with the exception of a monthly spending allowance of $84 and Medicare premiums. If applicable, a monthly spending allowance for a non-applicant spouse isn’t counted, either.

Seniors applying for Medicaid in Maryland must also satisfy other eligibility requirements. These include:

• Being 65 years old or more
• Being a U.S. citizen or resident who meets immigration status requirements
• Providing their Social Security number
• Satisfying all medical eligibility criteria

Applying for Medicaid in Maryland

The speediest way to apply for Medicaid in Maryland is by completing an online application at MDThink. Alternatively, seniors can download an English or Spanish application form and post a completed copy to their nearest Department of Social Services office, which they can also visit in person to fill out an application.

Before You Apply

It’s important to have all the documentation before applying to avoid delays. These include:

• Birthdates of all applicants
• Social Security numbers, or document numbers if legal immigrants
• Proof of citizenship or immigration status
• Tax returns for previous years
• Employer and income information (if applicable)

How to Get Help

Medicaid can confuse some seniors, but there are organizations that provide assistance free of charge. All the agencies listed here can help seniors apply for Medicaid, even if their incomes and assets exceed limits. They can also support seniors by challenging rejected claims.

	Contact	What You Should Know
American Council on Aging	Online Only	The American Council on Aging is an online resource developed by many Medicaid experts across the country. In addition to providing current information about the program, the site also provides links to Medicaid planners in Maryland who can offer support in person or by phone.
Maryland Legal Aid	(866) 635-2948	Maryland Legal Aid provides free advice and support for low-income seniors on a wide range of matters involving civil law. Its long-term care assistance project helps seniors get the health care services they need, including those covered by Medicaid.
Medicaid Fraud Control Unit	(888) 743-0023	The unit educates seniors throughout the state on how to spot fraudulent activity related to their Medicaid benefits. It prosecutes all individuals or businesses that take advantage of seniors in long-term care facilities who receive Medicaid support.

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

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Medicare Support & Resources in Maryland

The following list contains several free resources for older adults with Medicare and those who want more information before choosing a plan. These resources can help seniors compare long-term care payment options, in addition to saving money on premiums and copays.

Resource	Contact	What You Should Know
State Health Insurance Assistance Program	(800) 633-4227	The State Health Insurance Program, commonly known as SHIP, is a free and confidential counseling service for Maryland seniors who want to know more and get the most from Medicare. Trained counselors inform clients about all aspects of Medicare, including supplementary programs, and provide unbiased advice on private health care insurance products. They can help seniors identify the pros and cons of Medigap and Medicare Advantage, in addition to making their money go further through the Medicare Savings Program.
Medicare.gov	(800) 633-4227	Medicare.gov is the federal government’s site for the program. It provides current information about eligibility, copays and deductibles, in addition to private plans, such as Medicare Advantage and Medigap. The site also provides links to care providers in Maryland and phone access to advisors knowledgeable about Medicare at a local level. Additionally, there’s a live chat function should seniors want information outside standard office hours.
Maryland Access Point	(844) 627-5465	Maryland Access Point is a one-stop resource for seniors who want to discover all the benefits available to them in the state. After answering a few questions regarding health care, the site lists qualifying services and provides basic information that includes links to providers in the visitor’s locality. The site also allows seniors to create a health care record and access resources that may be able to help pay for services.
Area Agencies on Aging	Multiple Contact Numbers	There’s an Area Agency on Aging serving every resident in each of Maryland’s 23 counties and Baltimore City. They administer many programs designed to help older residents age as comfortably as possible in their communities. Each agency has advisors who can help seniors plan for their long-term care by utilizing the benefits of an appropriate Medicare Savings Program. They can inform seniors about the pros and cons of each of the four programs in relation to the individual’s circumstances and discuss eligibility limits for the current year.

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

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Maryland. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
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 Senior Living Resources for Seniors in Maryland

Seniors in Maryland can access a wealth of free resources administered by organizations dedicated to their welfare. Those listed here can help seniors prepare their taxes, get help if their care provider is failing in their duties and find support networks for seniors facing cognitive declines. There’s also significant support for veterans and their families.

	Contact	What You Should Know
Maryland Long-Term Care Ombudsman Program	Multiple Contact Numbers	Anyone can contact the Maryland Long-Term Care Ombudsman Program if they have concerns about the quality of care in a senior living facility. Ombudsmen are trained volunteers who visit facilities to educate residents on their rights and investigate complaints. As each county administers the program locally, the complainant should call the appropriate number to register their concerns in confidence. In some cases, such as elder abuse, the ombudsman may involve law enforcement agencies.
AARP Foundation Tax-Aide Program	(888) 687-2277	The AARP Foundation Tax-Aide program is a free service that is offered to all Maryland seniors, with a focus on those with low incomes. Seniors who need assistance preparing their taxes have two options; they can use the online version, which includes free software and phone contact with an IRS-certified advisor or visit their nearest AARP-approved center, where an advisor can do the prep work for them.
Greater Maryland Chapter Alzheimer’s Association	(410) 561-9099	The Alzheimer’s Association is the nation’s primary support resource for seniors dealing with memory loss and their loved ones. The Greater Maryland chapter provides confidential one-on-one support and information and guidance through group therapy and online services. These include a 24/7 helpline with staff trained to support seniors and their families, webinar videos, for those unable to attend support sessions and early-stage engagement programs, and memory care cafes, where seniors can meet others in situations similar to their own.
Maryland Department of Veterans Affairs	(410) 260-3838	The department serves the needs of those who served their country, their spouses and dependents. Its veterans’ officers can assist veterans in obtaining local, state, and federal benefits as well as hunting and fishing licenses. Additionally, through the Maryland Veterans Trust, it can provide grants and loans to qualifying vets critically in need of financial assistance.
Retired and Senior Volunteer Program	(800) 942-2677	The Retired and Senior Volunteer Program, commonly known as RSVP, is an AmeriCorps program administered at a local level by multiple agencies and organizations throughout Maryland. It’s open to adults aged 55+ who want to use some of their time to help others in their communities. RSVP connects seniors with nonprofits that can use their current skills to benefit others and, if necessary, provide training. Work opportunities are varied, such as providing clerical assistance, delivering meals to homebound seniors and mentoring younger members of the community.
Maryland Durable Medical Equipment Re-Use	(240) 230-8000	Maryland Durable Medical Equipment Re-Use is a program managed by the Department of Aging. At no cost to the recipient, it provides gently used equipment donated to help seniors who would otherwise struggle to pay for desperately needed devices that can make their lives more comfortable. The program frequently distributes wheelchairs, canes, walkers, rollators and bedside commodes and power scooters. It also provides equipment to seniors at home, such as mechanical lifts and home hospital beds.

COVID-19 Rules and Restrictions for Maryland Senior Living Facilities

The following information is based on research done on several government websites, including dph.illinois.gov/covid19. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/7/2022, 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?	Not Available*
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

*NOTE: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

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)

Senior Living Laws and Regulations in Maryland

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

To keep Maryland seniors safe, the state imposes numerous rules and regulations on senior living programs. These policies are designed to provide the best possible care for senior living residents, from medication management to memory care support.

Admissions Requirements and Scope of Care

Senior living facilities are supportive care opportunities that help seniors with activities of daily living to promote an independent lifestyle for as long as possible. However, they don’t offer the same level of medical care as a nursing home. As such, admission is limited only to those who don’t require:

• Treatment of severe skin ulcers
• Ventilator support
• Significant nursing care
• Ongoing medical maintenance beyond prescription management
• Ongoing care for chronic conditions
• Care for communicable diseases
• Strict behavioral monitoring

The scope of care provided in a senior living facility depends on facility licensing. Level One programs have the least intensive care, while Level Three programs are the most in-depth. Only Level Two and Three facilities are eligible providers under the state Medicaid waiver program.

Service Plan Requirements

Service plans effectively map out the kind of care a resident needs in a senior living capacity, including the costs of required care. The service plan covers all aspects of living, including overall health, social needs, personal habits, behaviors and any risk factors. All senior living facilities must perform an evaluation of residents every six months, but this can be accelerated if there’s a distinct and sudden change in a patient’s condition or if nonroutine hospitalization takes place. Service plans can be adjusted to take into account variations in cognitive and behavioral needs as well as medical requirements.

Medication Management

It’s very common for those in senior living programs to require prescription medication to manage acute and chronic conditions. All licensed senior living facilities must provide support for self-administered medication, including help with reminders and opening packaging. Residents with nine or more regular medications, both prescription and OTC, must have their prescription regimens evaluated by a pharmacist every six months.

Only those caretakers who have completed a Board of Nursing program can administer medications.

Staffing Requirements

There are no minimum staffing ratios for senior living facilities in Maryland, but specific roles must be maintained as required by licensing. All senior living facilities must employ:

• A manager for daily operations and an alternate manager at times when the primary manager is not available
• A registered nurse to provide overnight nursing care
• Awake overnight staff, unless a physician or nurse has determined that this is unnecessary
• A medication technician who has completed the required Board of Nursing program
• Staff members who can provide direct and personal care to residents

Managers are required to complete 20 hours of training every two years. All staff members must receive onboarding and continuing education in subjects like food safety, first aid, emergency planning, resident rights, infection control and the resident assessment process.

Staff members working in a memory care capacity must take a state-approved training course on mental illness and cognitive impairment within the first 90 days of hiring. A delegating nurse must determine competence in these areas before a new memory care staff member can provide any personal care services.

Background Checks

senior living facilities are required to report criminal background checks for owners, applicants, managers, alternate managers and all other staff members to the state in order to receive or maintain a valid license.

Frequently Asked Questions

How much does assisted living cost in Maryland?

In Maryland, assisted living costs an average of $4,300 a month — about $250 more than the national average. However, pricing varies throughout the state, with the California and Lexington Park neighborhoods costing an average of $6,263 monthly while the Cumberland area averages just $3,750.

Are there financial assistance programs for assisted living in Maryland?

Yes, financial assistance programs are available for assisted living in Maryland. Numerous Medicaid waiver programs, including the Community First Choice program and Home and Community Based Services waivers. For those who served in the military, additional benefits may be available through the Department of Veterans Affairs.

What are Activities of Daily Living?

Activities of Daily Living, also called ADLs, are basic tasks required for normal life. This includes things like eating, dressing, bathing, using the bathroom and performing housework tasks. Assisted living facilities primarily provide residents with assistance with ADLs.

What is the difference between assisted living and a nursing home?

The primary difference between assisted living programs and nursing homes relates to the level of medical care available. Assisted living programs can offer limited first aid and medication management but don’t provide any sort of comprehensive treatment. Patients who require around-the-clock nursing care or more intensive medical interventions to treat serious conditions are best suited for a nursing home facility.

Who should consider assisted living?

Assisted living is best for seniors who are still able to maintain a semblance of independence but require some care to handle normal day-to-day tasks. Seniors who use a home health aide are usually good candidates for assisted living, as the services offered by licensed senior living facilities are on par with in-home care. Those with significant chronic health problems may be better suited for a nursing home versus an assisted living facility.

Learn More About Senior Living in Maryland

For more information about specific types of senior living in Maryland read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Maryland

Learn more about the cost of senior living in the top Maryland cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.