Waiver Description
Maryland Medicaid operates the Medical Day Care Services Medicaid Waiver, a Home and Community Based Services (HCBS) Waiver, for functionally disabled adults and seniors that require a nursing home level of care. Medical day care combines social activities and health-related support. Under this program, licensed daycare centers provide daytime supervision and care to help several thousand residents of Maryland.
This Medicaid waiver program may be referred to as simply Medical Day Care or by the acronyms MDCSW and MDC. This program is under the administration of Maryland’s Department of Health and Mental Hygiene (DHHM).
Individuals participating in other HCBS Waivers, such as the Community Options Medicaid Waiver and the Community Pathways Medicaid Waiver, also have access to medical day care through those waiver programs. Persons enrolled in the traditional Medicaid state plan who are at least 16 years of age, require a level of care consistent to that which is provided in a nursing home, and are not enrolled in PACE or a HCBS Medicaid wavier, are eligible to receive medical day care via MDSCW.
What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers and Waiver Funded Services, allow qualifying program participants to receive services outside of nursing homes. Medicaid’s standard benefit is to pay for nursing home residential care. However, when available, Medicaid Waivers help to provide more options for individuals. The cost of care outside of a nursing home needs to be less than the cost of care in a nursing home.
Eligibility Guidelines
The Medical Day Care Waiver serves adults ages 16 and over; there is no age maximum. To qualify, an individual must be a Maryland resident between the ages of 16 and 64 who is functionally disabled or over the age of 65. One must also be financially eligible for Medicaid.
Disability Requirements: Applicants must be under the care of a physician, be frail elderly, disabled or chronically ill, and must require hands-on assistance with at least one activity of daily living. One must be at-risk of placement in a nursing home if care cannot be delivered to the home. In other words, applicants must have a demonstrated need for an institutional level of care to enroll in MPAC.
Financial Requirements: In 2022, an individual’s monthly income cannot exceed $350. The limit for couples is $392. Maryland also allows individuals to qualify if their income is above $350 per month by deducting all of their unreimbursed medical expenses. This is called the Medically Needy pathway to enrollment.
*Applicants who receive Supplemental Security Income (SSI) automatically qualify.
In terms of assets, excluding the equity value of the home (limited to $636,000 in 2022), home furnishings, a vehicle, a burial plot, and other personal items, Maryland allows individuals to retain countable assets valued up to $2,500. Couples can retain $3,000 of their assets.
Persons uncertain about their financial eligibility should contact a planning professional before filling out an application for Medicaid.
Benefits and Services
The Medical Day Care Services Waiver Program offers a variety of services, from nursing and nutrition work to rehabilitation therapy and other health services that require medical supervision, in adult day care centers. Meals and activities are also provided, and transportation may be available to transport program beneficiaries to and from day care centers. Depending on the facility, these centers are open five to seven days each week, and services are provided between six and twelve hours per day.
While not specifically stated as a benefit, the program also relieves a primary caregiver by offering daytime respite from caregiving responsibilities. Personal care and supervision are, of course, provided during the time in which the individual is present at the Medical Day Care center.
How to Apply / Learn More
This program has a limited number of spaces available to applicants who qualify. In 2020, Maryland increased the available slots to approximately 7,700. Space is limited.
Non-Medicaid Applicants
To apply to receive Medical Day Care Services via a Medicaid waiver, interested parties can begin the process by contacting their representative of AERS (Adult Evaluation and Review Services) operated by local health departments. Click here for more information about AERS in Maryland.
Current Medicaid Beneficiaries
If an individual is already enrolled in the Community Options Waiver, the Traumatic Brain Injury Waiver, or the Model Waiver, and wants to enroll in Medical Day Care Services, the state directs inquiries to the individual’s case manager.
If an individual is enrolled under the Community Pathways Waiver, officials recommend contacting the individual’s service coordinator.
Some limited additional information about Medical Day Care Services is available here.
