Medicaid Long-Term Care Guide in Delaware
Long-term care eligibility, benefits, and how to apply through the Delaware Division of Medicaid & Medical Assistance (DMMA), within Delaware Health and Social Services (DHSS).
What makes Delaware Medicaid different
In Delaware, the majority of Medicaid enrollees receive benefits via a managed care program called the Diamond State Health Plan (DSHP). Specific to long-term care, it is called Diamond State Health Plan Plus (DSHP Plus), broken into the Nursing Facility Program and Long-Term Care Community Services (LTCCS) Program. The state's previous HCBS Medicaid Waivers, including the Elderly & Disabled Waiver, were absorbed by the LTCCS Program. While Medicaid is jointly funded by the state and federal government, it is administered by the state under federally set parameters.
Administered by the Delaware Division of Medicaid & Medical Assistance (DMMA), within Delaware Health and Social Services (DHSS).
Program Types
Institutional / Nursing Home Medicaid
An entitlement; anyone who meets the eligibility requirements will receive assistance. Benefits are provided in Medicaid-certified nursing home facilities.
Level of care: Nursing Home
Home and Community Based Services (HCBS) / Long Term Care Community Services (LTCCS)
Delaware no longer offers HCBS Medicaid Waivers for its elderly population. Instead, long-term care services are provided via a managed care system (DSHP Plus LTCCS) at home, adult day care, rest residential care homes (adult foster care), and in assisted living. Unlike with HCBS Waivers, there are no enrollment caps or waiting lists.
Level of care: Nursing Home
Regular Medicaid / Aged Blind and Disabled
An entitlement; anyone who meets the eligibility requirements is guaranteed assistance. While Regular Medicaid is not Long-Term Care Medicaid, some long-term care services, such as personal care assistance or adult day care, may be available.
Level of care: Help with ADLs
2026 Delaware Medicaid Long-Term Care Eligibility for Seniors
Institutional / Nursing Home Medicaid*†
Home and Community Based Services / Long Term Care Community Services†‡
Regular Medicaid / Aged Blind and Disabled§
*All of a beneficiary's monthly income, with the exception of a Personal Needs Allowance of $75 / month, Medicare premiums, and potentially a Needs Allowance for a non-applicant spouse, must be paid to the nursing home. This is called a Patient Liability.
†Generally each spouse is considered as an individual, but in just a few cases, the income limit of a couple is used. For 2026, this is $3,727.50 / month.
‡Based on one's living setting, a program beneficiary may not be able to keep monthly income up to this level.
§In Delaware, persons who are determined eligible for SSI are automatically approved for Regular Medicaid. This includes long-term services and supports via Regular Medicaid, given one meets the functional criteria.
Explore Delaware Medicaid Programs
Compare programs, see caregiver pay rates, get step-by-step application guidance, and check your eligibility — all specific to Delaware.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Compare Medicaid Programs — Delaware
How the main LTC programs available in Delaware compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $15–18/hr | Hourly wage | No | Usually no | Often |
| Structured Family Caregiving (SFC) | Not in Delaware | Daily stipend | Yes | Usually no | Often |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
Delaware Medicaid programs
Diamond State Health Plan Plus
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in Delaware
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Consumer-directed care — hourly pay
Available in DelawareHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: DHSS · dhss.delaware.gov
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in Delaware
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in Delaware. The process typically takes 45–90 days from application to first paycheck.
Apply in Delaware: DHSS · dhss.delaware.gov
Medicaid Eligibility Screener — Delaware
Answer 7 quick questions — we'll check the financial and care requirements for Delaware and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
Key Rules at a Glance
- Nearly any income from any source is counted towards the income limit, including employment wages, alimony, pension payments, SSDI, SSI, IRA withdrawals, and stock dividends.
- Nationally, Holocaust restitution payments are not counted as income.
- In DE, the VA Aid & Attendance and Housebound Allowances, which are above and beyond the Basic VA Pension, do not count.
- Delaware uses a $2,485 / month income limit for Nursing Home and HCBS Medicaid (2026), which is lower than the $2,982 used by most states.
- When only one spouse applies for Nursing Home Medicaid or HCBS, only the applicant's income is counted.
- The non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) of $2,643.75 (eff. 7/1/25 – 6/30/26).
- A non-applicant spouse can increase their Spousal Income Allowance if housing/utility costs exceed the 'shelter standard' of $793.13 / month, but it cannot exceed $4,066.50 / month (Maximum MMNA).
- For Regular Medicaid, the income of both spouses is counted. There is no MMMNA for the non-applicant spouse.
Delaware's income limit of $2,485 / month is lower than the federal standard of $2,982 used by most states.
- Countable assets include cash, stocks, bonds, investments, annuities, cryptocurrency, bank accounts, and real estate in which one does not reside.
- In DE, the IRA / 401K of the applicant is counted. The IRA / 401K of a non-applicant spouse is exempt.
- Non-countable (exempt) assets include personal belongings, household furnishings, an automobile, up to $1,500 for burial, an irrevocable funeral trust up to $15,000, life insurance with a combined face value of $1,500, and generally one's primary home.
- All assets of a married couple are considered jointly owned regardless of which program one applies for.
- The Community Spouse Resource Allowance (CSRA) allows the non-applicant spouse to keep 50% of the couple's assets, up to $162,660.
- If the non-applicant's share falls under $32,532, they can keep 100% of assets up to $32,532.
- There is no CSRA for Regular Medicaid.
- The primary home is automatically exempt if the applicant's spouse, child under 21, or permanently blind or disabled child (of any age) lives in it.
- If this is not the case, there is a home equity interest limit of $730,000 (in 2026).
- Home equity is the value of the home minus any outstanding debt. Equity interest is the amount of equity owned by the applicant.
- If neither the applicant nor qualifying family live in the home, the applicant must have Intent to Return.
- There is no home equity interest limit for Regular Medicaid.
- The home is NOT exempt from Medicaid's Estate Recovery Program. After a beneficiary's death, Delaware's Medicaid agency attempts reimbursement of care costs through the deceased's estate.
- Delaware has a 60-month (5-year) Look-Back Period for Nursing Home Medicaid and HCBS Medicaid that immediately precedes the application date.
- During the look-back, Medicaid scrutinizes all past asset transfers. If assets were gifted or sold under fair market value, it is assumed this was done to meet Medicaid's asset limit.
- Violations result in a Penalty Period of Medicaid ineligibility.
- The Look-Back Rule does NOT apply to Regular Medicaid.
- The U.S. Federal Gift Tax Rule ($19,000 per recipient in 2026) does not extend to Medicaid eligibility — gifting under this rule still violates the Look-Back Period.
- MMMNA: $2,643.75 · CSRA: $162,660 · CSRA Min: $32,532
- When only one spouse applies for Nursing Home Medicaid or HCBS, only the applicant's income is counted.
- The non-applicant spouse may receive a Minimum Monthly Maintenance Needs Allowance (MMMNA) of $2,643.75 (eff. 7/1/25 – 6/30/26).
- The Spousal Income Allowance can increase if housing/utility costs exceed the 'shelter standard' of $793.13 / month, but cannot exceed $4,066.50 / month (Maximum MMNA).
- The Community Spouse Resource Allowance (CSRA) allows the non-applicant spouse to keep 50% of the couple's assets, up to $162,660.
- For Regular Medicaid, both spouses' income is counted and there is no MMMNA or CSRA.
- Qualified Income Trusts (QIT's) / Miller Trusts — Allow Nursing Home and HCBS Medicaid applicants over the income limit to become income-eligible by depositing excess income into an irrevocable trust. A trustee has legal control of trust funds, which can only be used for specific purposes such as medical expenses. Upon death, remaining funds must be paid to the state of Delaware.
- Asset Spend-Down — Spend excess assets on non-countable items such as home modifications (wheelchair ramps, roll-in showers, stair lifts), vehicle modifications, prepaying funeral/burial expenses, and paying off debt. Keep documentation as proof the Look-Back Rule was not violated.
- Medicaid Planning — Work with a Medicaid Planning Professional to become eligible and protect your home from Medicaid's Estate Recovery Program.
Delaware Medicaid Programs
Diamond State Health Plan Plus (DSHP-Plus)
This managed care program includes the Nursing Facility Program and Long Term Care Community Services (LTCCS) Program. Benefits via LTCCS may include adult day care, meal delivery, minor home modifications, respite care, personal emergency response systems, and more. Self-direction of personal care assistance is available, allowing one to hire friends and relatives, including a spouse or adult child, as caregivers.
Program of All-Inclusive Care for the Elderly (PACE)
Combines the benefits of Medicaid, including long-term care services, and Medicare into one program. Additional benefits such as dental and eye care may be available.
How to Apply
- Apply online at Delaware ASSIST
- Contact Delaware Health and Social Services (DHSS)
- Contact the Delaware Aging & Disability Resource Center for program information and application assistance
Prior to submitting an application, senior applicants should be positive all eligibility requirements are met. Having income and/or assets greater than the limits can result in a denial. Persons in these situations should seriously consider Medicaid Planning.
More Delaware Long-Term Care Resources
Take the Next Step for Delaware Medicaid
Find out if you qualify or see how Medicaid fits into your overall long-term care plan.
Sources & references
Verified May 2026- Centers for Medicare & Medicaid Services — Long-Term Services & Supports
- Administration for Community Living — State Medicaid Agencies
- Centers for Medicare & Medicaid Services — Medicaid Eligibility
- American Council on Aging — About Medicaid Planning Assistance
- Delaware Division of Medicaid & Medical Assistance (DMMA), within Delaware Health and Social Services (DHSS) — Delaware Medicaid — Official site