Waiver Description
Maryland’s Medical Day Care Services Medicaid Waiver, a Home and Community Based Services (HCBS) Waiver, is available for functionally disabled adults and seniors who require a nursing home level of care and meet certain eligibility requirements. 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.
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 an HCBS Medicaid wavier, are eligible to receive medical day care through the Medical Day Care Services Waiver.
This program is under the administration of Maryland’s Department of Health.
What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers, allow qualifying program participants to receive services outside of a nursing home. Medicaid’s standard benefit is to pay for nursing home care. However, those who wish to live at home, in assisted living or in adult foster care, sometimes Medicaid will pay for nursing-home-level care in those locations if it can be obtained at a lower cost than in a nursing home.
Eligibility Guidelines
General Requirements
The Medical Day Care Waiver serves Maryland residents age 16 and over. However, if between the ages of 16 and 64, one must be functionally disabled. All applicants must be at risk of placement in a nursing home if care cannot be delivered to the home.
Financial Requirements
One must also be financially eligible for Medicaid.
Income Limits
In 2023, 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.
Asset Limits
In terms of assets, Maryland allows individuals to retain countable assets valued up to $2,500. Couples can retain $3,000 of their assets. However, certain assets are not counted toward the limits, including one’s home (limited to an equity value of $688,000 in 2023), home furnishings, a vehicle, a burial plot, and other personal items,
*Applicants who receive Supplemental Security Income (SSI) automatically qualify.
Over the Financial Limits?
Applicants with finances over these limits should consider working with a Medicaid planning professional. Persons in these situations still may be eligible for Medicaid, but just require financial expertise to help them allocate their income and resources appropriately.
Learn more about Medicaid planning here.
Benefits and Services
The Medical Day Care Services Waiver program offers a variety of services in adult day care centers. Some services that may be available include:
- Nursing
- Nutrition
- Rehabilitation therapy
- Other health services that require medical supervision
- Meals
- Activities
- Transportation
- Personal care
- Supervision
Depending on the facility, these centers are open five to seven days a week, and services are provided between six and 12 hours per day.
While not specifically stated as a benefit, the program also relieves a primary caregiver by offering daytime respite from caregiving responsibilities.
How to Apply / Learn More
Interested parties who are not yet enrolled in a Medicaid waiver can begin the process by contacting their local AERS (Adult Evaluation and Review Services) program. Click here for more information about AERS in Maryland.
Individuals who are already enrolled in an HCBS Medicaid Waiver should contact their waiver case manager or their service coordinator.
Some limited additional information about Medical Day Care Services is available here.
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.
