If you are researching long-term care for yourself, a spouse, or an aging parent, you are probably carrying several concerns at once. It takes hard work to build a home, savings, retirement accounts, personal property, or a business, and it only makes sense that you want to understand how care will affect your independence, family, and finances.
The answers below provide a Maryland-focused starting point. Costs and program rules change, and your eligibility depends on your health, income, assets, marital status, and the type of care you need.
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What is long-term care, and what does it actually include?
Long-term care includes ongoing assistance with health or personal-care needs, such as bathing, dressing, eating, toileting, medication reminders, mobility, supervision, and transportation. It can take place at home, in adult day care, assisted living, or a nursing home.
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Isn't long-term care just nursing home care?
No. Nursing home care is one form of long-term care, but long-term care also includes home aides, adult day services, assisted living, memory care, personal assistance, meals, and other support that helps you live safely with a chronic illness or disability.
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What are the main types of long-term care settings to choose from?
The primary choices are care at home, adult day care, assisted living, and nursing home care. The right setting depends on the level of supervision, personal assistance, medical care, safety, and family support you need, not simply your age or diagnosis.
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How much does long-term care cost in Maryland right now?
Based on the latest published 2026 Maryland cost medians, assisted living costs approximately $7,172 per month, while a nursing home costs approximately $12,927 per month for a semi-private room or $14,448 for a private room. Non-medical in-home care at about 44 hours per week averages roughly $6,673 per month, although actual prices vary by county, provider, hours, and care needs.
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What is the difference between private nursing home cost and the Medicaid rate?
The private-pay cost is the facility’s standard charge to a resident paying with personal funds, insurance, or another private source. The Medicaid rate is a state-approved reimbursement amount paid for an eligible resident in a participating facility, and it is usually different from, and often lower than, the private-pay rate.
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Why does long-term care cost so much?
Long-term care requires continuous staffing, supervision, meals, housing, insurance, regulatory compliance, equipment, transportation, and sometimes specialized dementia or medical services. A nursing home can require care around the clock, which explains why even one year of care can cost more than $150,000 in Maryland.
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Does Medicare pay for long-term care?
Medicare does not pay for ongoing custodial long-term care. It can cover certain medical services and short-term skilled nursing or home health services, but Medicaid, not Medicare, is the primary public payer for extended long-term care when a person meets Maryland’s financial and medical requirements.
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What exactly does Medicare cover for a skilled nursing stay?
Medicare Part A generally requires a qualifying three-day inpatient hospital stay, admission to a Medicare-certified skilled nursing facility within a short period, and a continuing need for daily skilled care. In 2026, Medicare covers days 1–20 after the applicable deductible, requires $217 per day for days 21–100, and pays nothing for covered skilled nursing days after day 100.
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Does Medicare cover assisted living?
Medicare does not pay for assisted living room, board, or routine personal assistance. It can still cover separate medical services (such as physician visits, prescriptions, or certain therapies) but those benefits do not cover the assisted living community’s monthly charge.
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Does Medicare cover care at home?
Medicare covers certain medically necessary home health services when you meet the eligibility requirements, such as receiving intermittent skilled nursing or therapy while considered homebound. It does not pay for ongoing in-home aides when your primary need is custodial help with bathing, dressing, meals, housekeeping, or supervision.
- Does health insurance or a Medicare Advantage plan cover long-term care?
Ordinary health insurance and Medicare Advantage plans generally cover medical treatment, not extended custodial care. A Medicare Advantage plan can have different rules for short-term skilled nursing or home health benefits, so check the plan documents, but do not assume it will pay for years of assisted living, nursing home, or personal-care services.
- Does Medicaid pay for long-term care in Maryland?
Yes. Maryland Medicaid, also called Medical Assistance, pays for qualifying nursing home care and certain home- and community-based services when you meet financial and functional eligibility requirements. Maryland’s Community First Choice program provides qualifying Medicaid participants with personal assistance and other services at home or in the community, while the Community Options Waiver supports eligible community-based care, including services connected with assisted living, subject to program rules and availability.
- How is long-term care at home different from care in a facility?
Home care allows you to remain in familiar surroundings, but it requires reliable caregivers, a safe home environment, transportation arrangements, and careful coordination of schedules and services. A facility provides housing, meals, staff, and structured supervision in one location, but it costs more and requires a move away from home.
- What is the difference between skilled care and custodial care?
Skilled care is nursing or therapy provided by, or under the supervision of, licensed professionals to treat, manage, or evaluate a medical condition. Custodial care is help with daily activities such as bathing, dressing, eating, toileting, mobility, and supervision; most long-term care is custodial, which is why Medicare does not cover it.
- When is the right time to move a parent into assisted living or a nursing home?
The right time is when remaining at home is no longer reasonably safe or sustainable, even with available support. Frequent falls, wandering, medication mistakes, unsafe driving, unpaid bills, malnutrition, repeated hospitalizations, or serious caregiver exhaustion are concrete signs that the family should evaluate a higher level of care.
- What should families look for when choosing a long-term care community?
Compare staffing levels, licensing and inspection reports, emergency procedures, care for dementia or medical conditions, available activities, transportation, medication management, and the process for increasing care. Also ask for a complete fee schedule, what happens if savings run low, whether the facility accepts Medicaid, and whether the community can meet future care needs without another move.
- What is long-term care insurance, and is it still worth buying?
Long-term care insurance pays benefits according to the policy’s covered services, daily or monthly limits, elimination period, benefit period, and eligibility triggers. It can be worthwhile when premiums are affordable and the policy provides meaningful coverage, but you must review exclusions, inflation protection, nonforfeiture provisions, and the possibility of future rate increases; Maryland maintains consumer information and approved-rate resources through the Maryland Insurance Administration.
- Can I stay in my own home and still get care paid for?
Yes, but the payment source matters. You can use personal funds, long-term care insurance, or qualifying Medicaid programs such as Community First Choice; the Community Options Waiver can also support eligible home- and community-based services, although waiver enrollment and service availability are limited.
- What happens to a family's savings when a loved one needs years of care?
Without insurance or public benefits, the family generally pays privately from income, savings, investments, retirement funds, or other available resources. Once a person qualifies for Medicaid, the program can pay covered care, but the resident usually contributes most available monthly income toward the cost, and Maryland Medicaid estate recovery rules can apply after death.
- When should I contact an attorney about long-term care planning?
Contact an attorney before a crisis, ideally when you first receive a chronic diagnosis, begin considering assisted living, anticipate nursing home care, or see your family’s savings being consumed by care costs. You should also seek advice before transferring assets, giving away money, selling a home, or applying for Medicaid because an incorrect transaction can create penalties, delays, or loss of options.
Plan for Long-Term Care Before the Crisis
Long-term care planning is about more than choosing a facility. It means comparing home care, assisted living, and nursing home options; understanding Medicare and Medicaid; reviewing insurance; estimating costs; and protecting your ability to receive appropriate care.
For more Maryland-specific information, review Amenta Law Firm’s guides on Maryland Medicaid programs for in-home, assisted living, and nursing home care and assisted living costs in Maryland. You can also visit the Maryland Medicaid Long Term Services and Supports page and Medicare’s official long-term care guidance.
Each question in this article can, and should, receive its own deeper discussion. If you or your family is facing a potential long-term care need, START YOUR LONG-TERM CARE PLAN NOW and contact Amenta Law Firm to discuss your Maryland options.
This article provides general information, not legal advice. Medicaid eligibility, insurance coverage, costs, and program rules are fact-specific and can change.