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According to the 2021 Genworth Cost of Care Survey, you can expect to pay $5,148 per month for home care in Maryland. Rates are the same whether you require in-home care, which is help with household chores such as cooking and cleaning or need home health care, which is assistance with personal care or medications. Home care rates vary depending on your location and the service level you need.
In some areas, such as Virginia, home health care costs are slightly less than in other states in the region. Maryland’s in-home care and home health care prices are on par with the national average. They’re somewhat higher than the neighboring states of Pennsylvania and Virginia but less expensive than Delaware and the nation’s capital. Pennsylvania’s monthly rates are $4,957 for both care types. Virginia’s monthly home care rates are the most affordable at $4,767 per month of in-home care and $4,954 per month for home health care. Washington, D.C. and Delaware have the highest monthly rates at $5,577 for both care types.
|Home Health Care
You might be interested in comparing other options to ensure that you’re getting the best value for your money and care for your needs. Typically, in-home care costs less than assisted living facilities, which charge $4,900 per month. Adult day care is the most affordable option at less than $2,000 per month. Nursing home care is the most expensive choice, with a median cost of $10,342 for a semiprivate room.
Medical Assistance, Maryland’s Medicaid program, covers home care agency services through the Medicaid State Plan. It also offers Home- and Community-Based Services (HCBS) waivers to targeted groups, including seniors and disabled adults. Medicaid includes personal care, durable medical equipment and physical therapy as part of its standard benefits.
Many seniors qualify for the state’s HCBS waivers, which allow residents to receive home care as an alternative to nursing home placement. Since the program requires medical eligibility criteria based on your functional needs, income limits may be higher than other Medicaid programs. The Department of Human Resources also offers a sliding-scale In-Home Aide Program to seniors who live at home, require an institutional care level and don’t have a caregiver.
|Community First Choice (CFC)
|The Community First Choice waiver provides one-on-one assistance to seniors and disabled adults who need help with daily activities and want to remain in their own homes. It covers personal care, medical monitoring, assistive technology, delivered meals and other Medicaid services, such as pharmacy and laboratory benefits. You must be eligible for Medicaid and require a nursing home care level.
|Community Personal Assistance Services
|Like the CFC waiver, Community Personal Assistance Services is available to Medicaid-eligible individuals who require a nursing home care level but can safely live in the community with support. It covers in-home personal care, medical monitoring and case management services, plus other Medicaid benefits.
|Home- and Community-Based Options Waiver (HCBS)
|If you require a nursing home care level and your monthly income cannot exceed 300% of the Federal Benefit Rate, you may qualify for Maryland’s HCBS Options Waiver. It provides case management, caregiver training and nutritional and behavioral counseling. You can also receive community center or assisted living facility care. The program may also cover certain CFC benefits, such as delivered meals, emergency response systems and home modifications. At this time, the program is open to nursing home residents only.
|Increased Community Services
|This program supports adults residing in a nursing home for at least 90 days, covered by Medicaid for at least 30 of those days. It covers a comprehensive array of supports, including emergency response systems, meals, assisted living, environmental modifications and more. It limits income to 300% of the SSI benefit rate and has other eligibility requirements.
Since Medicaid is a need-based program, it has strict financial requirements. To qualify for regular Medicaid, your annual income cannot exceed $4,200 if you’re applying individually or $4,704 if you’re applying with your spouse. An individual’s assets are typically limited to $2,000, and a couple’s asset limit is $3,000. Higher-income limits may apply to other Medicaid programs, including those that require a nursing home care level.
To qualify for Medicaid, you must also provide proof that you’re:
The easiest way to apply for Medicaid is online through MDThink. You can also visit your local Department of Social Services office to apply in person or drop off a paper application. If you’re applying for help with home care, fill out the Long-Term Care/Waiver Medical Assistance Application. You must also complete the Application for Assistance form if you’re aged 65 or older to apply for regular Medicaid. For individuals in Baltimore, Anne Arundel County or Prince George’s County, contact the Bureau of Long-Term Care for help with your application.
What Information You Will Need
When you apply for Medicaid, you will need to verify your eligibility with supporting documents. These include:
How to Get Help Applying for Medicaid
If you need help submitting your application or if you want to check your case’s status, the following agencies may be able to help, depending on the nature of your inquiry.
|Maryland Health Benefits Exchange
|If you want information about health insurance, including Medicaid and other subsidized programs, contact the Maryland Health Benefits Exchange Consolidated Customer Service Center at (855) 642-8572.
|Maryland Access Point (MAP)
|If you’re interested in applying for Medicaid waivers or if you’d like to compare long-term care options, contact Maryland Account Point. This statewide hotline will connect you to the MAP office in your county. The agency also offers long-term care needs assessments and case management services.
|Maryland Legal Aid
|Maryland Legal Aid provides free limited legal services to seniors and other at-risk residents. It can help with issues related to Medicaid, government benefits, long-term care, wills and trusts and other topics that are relevant to seniors.
Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.
Below is an overview of some of the services typically covered by Medicare for those who are eligible:
As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.
Read our guide to Medicare and Home Care Coverage for more information.
While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.
Seniors in the Old Line State can take advantage of various free resources thanks to local nonprofit groups and state and federal funding. Many programs are available starting at age 60, regardless of your income or other criteria.
|Accessible Homes for Seniors
|If functional limitations prevent you from aging in place, this program from the Department of Housing and Community Development may be able to help. It provides grants and delayed-repayment loans to pay for ramps, grab bars, doorway modifications and bathroom upgrades.
|Meals on Wheels of Central Maryland
|(410) 558- 0827
|This regional Meals on Wheels chapter delivers more than one million meals to 3,100 homebound seniors every year. The program provides two daily meals, including a hot lunch and a cold supper, with a sliding-scale fee schedule. Most clients pay just $2.50 to $8 per meal.
|Senior Call Check Program
|The Senior Call Check Program is a free service sponsored by the Department of Aging. It’s available to all state residents aged 65 or older, and it works with landline or cell phone service. Individuals receive a daily check-in call at a scheduled time. If the individual doesn’t answer after repeated attempts, it will notify nonemergency services or a family member.
|Senior Reduced Fare Program
|Seniors aged 65 and older qualify for reduced fares on Maryland’s public transit systems. Individuals unable to use regular buses can take advantage of accessible door-to-door transportation. These services are available to seniors in most counties, including Anne Arundel, Montgomery, Prince George’s and St. Mary’s.
|Maryland Energy Assistance Program
|Seniors struggling to pay their utility bills or facing disconnection can contact the Maryland Energy Assistance Program for help. Thanks to federal funding, households may be eligible for grants with up to $2,000 to assist with their gas or electric bills.
|Homeowners’ Property Tax Credit Program
|If your household income is $60,000 or less and you own no more than $200,000 in assets, you may qualify for the state’s senior property tax credit. This program limits the amount of property taxes to a percentage of your income.
In September 2021, Maryland’s governor announced a statewide COVID-19 vaccine mandate for home care workers. These requirements predate the Centers for Medicare & Medicaid Services (CMS) vaccination mandates required for home care agencies that accept Medicare or Medicaid. Statewide rules for COVID-19 testing and personal protective equipment remain in effect, and the latest regulations do not replace them. Home care agencies must maintain their own policies to prevent the spread of COVID-19.
This information is current as of April 2022 but may be subject to change. For the latest updates on what home care agencies are doing to protect you from COVID-19, contact Maryland Access Point or your Area Agency on Aging.
In Maryland, the Department of Health and Mental Hygiene distributes licenses to home care agencies. Agencies must provide a business plan and other documentation before the state can approve their application. It may require a certificate of need for applicants to start or expand a home health agency.
|What Types of Care Can Be Provided?
|Residential service agencies are authorized to help clients with daily living activities, including eating, bathing, grooming, mobility and personal care. State-licensed personnel, such as certified nursing assistants and medication aides, must perform certain services.
|Are Care Plans Required?
|Agencies must take reasonable measures to accommodate all referrals and develop a care plan for each client. A registered nurse (RN) must assess each client to determine their functional needs, assign personnel and provide staff training. They must base the care plan on the client’s physical and mental health and psychosocial well-being.
|Can Home Care Providers Assist with Medication Management?
|If a client requires help with medications or daily living activities, the agency must provide a certified caregiver. Medications must be administered by licensed or certified staff if the patient cannot self-administer prescriptions. The agency must administer medications according to state standards and maintain appropriate records.
|Are There Special Requirements for Screening Home Care Aides?
|Agencies must perform a criminal background check on all prospective employees, and they must maintain appropriate personnel records, including references, employment history and a negative tuberculosis test.
|Are Home Care Aides Required to Undergo Special Training?
|Certified nurse aides (CNA) and other qualified personnel typically deliver home care. The state requires at least 100 hours of training with 40 hours of supervised clinical work experience to become a CNA.
|Does Medicaid Cover Home Care in Maryland?
|Maryland’s Medicaid program covers home care through the Community Options Waiver. Medicaid coverage options depend on the applicant’s medical and financial needs.
|How Do I Report Abuse of Myself or a Loved One?
|You should report suspected abuse or neglect occurring in the community to the Department of Human Services by calling (800) 332-6347. There are Adult Protective Services offices in each county.
Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.