Delaware Medicaid Long-Term Care Eligibility for 2025

Delaware Long-Term Care in 2025:

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Delaware is an income cap state, meaning that applicants for Medicaid long-term care must not exceed specific income limits. The 2025 income limit for Nursing Home Medicaid and Long-Term Care Community Services (LTCCS) is $2,417.50/month. Excess income can be placed into a Qualified Income Trust (Miller Trust) to achieve eligibility. Delaware Medicaid requires both financial and medical eligibility to qualify for assistance. A nurse may assess the applicant to determine whether they require skilled or intermediate care.

When applying, the Delaware Division of Medicaid and Medical Assistance (DMMA) sends an application packet to the applicant or their family. Financial eligibility is determined by the information submitted, along with a review by a financial eligibility social worker.

Financial Criteria for 2025:
  • Countable Assets: Must be under $2,000 for individuals or $3,000 for married couples (when both spouses apply). Non-exempt resources include bank accounts, stocks, bonds, property, and retirement accounts.
  • Exempt Assets: Include a primary home (equity under $730,000), one car, personal effects, burial funds up to $1,500, irrevocable burial trusts up to $15,000, and life insurance with a face value under $1,500. A Miller Trust can be used for excess income.
Spousal Rules for 2025:

The community spouse may retain up to $157,920 in countable resources, with a minimum allowance of $31,584. If the community spouse’s monthly income is less than $2,555, they may receive income from the institutionalized spouse to meet this threshold. Additional allowances may apply for documented shelter expenses, with a maximum monthly income cap of $3,948.

Applications can be submitted online at Delaware ASSIST. For further information or assistance, contact the Delaware Division of Medicaid and Medical Assistance at:

Delaware Health and Social Services
Division of Medicaid & Medical Assistance
Phone: 1-800-372-2022
Website: https://dhss.delaware.gov/dhss/dmma/contact.html

The state enforces a 60-month look-back period to ensure no improper asset transfers occurred. Exempt transfers include the home being transferred to:

  • A spouse.
  • A child under 21, or who is blind or disabled.
  • A sibling with equity in the home who lived there for at least one year before institutionalization.
  • An adult child who provided care for two years, delaying institutionalization.

Services Available in Delaware in 2025:

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  • Nursing Facility Program
  • Long Term Care Community Services (HCBS) for elderly, disabled, and individuals with acquired brain injuries or HIV/AIDS
  • Developmental Disabilities Services Waiver
  • Program of All-Inclusive Care for the Elderly (PACE)

The majority of Medicaid beneficiaries in Delaware are enrolled in the Diamond State Health Plan Plus, a managed care program providing comprehensive services, including personal care, adult day care, meal delivery, and home modifications. PACE participants, however, are not eligible for managed care enrollment.

Delaware Long-Term Care Insurance Partnership:

This program allows individuals to protect assets equivalent to the benefits paid out by a long-term care insurance policy. For example, a policy with $155,000 in benefits allows for $155,000 in protected assets when applying for Medicaid. Each spouse must have their own policy to benefit.

How to Apply for Delaware Medicaid:

Applications can be submitted online at Delaware ASSIST. For further information or assistance, contact the Delaware Division of Medicaid and Medical Assistance at:

Delaware Health and Social Services
Division of Medicaid & Medical Assistance
Phone: 1-800-372-2022
Website: https://dhss.delaware.gov/dhss/dmma/contact.html