Delaware Nursing Home Medicaid 2026: Limits, Spouse Rules and How to Apply

Delaware Nursing Home Medicaid pays for a nursing home once Medicare’s short rehabilitation benefit runs out — but only after the family clears an income test, an asset test and a level-of-care assessment. This Delaware nursing home medicaid guide gives the 2026 figures, what the spouse at home is allowed to keep, how the five-year look-back works, and where in Delaware the application actually goes.

Every dollar figure below comes from the state Medicaid agency, CMS or the statute cited, and each resets on its own calendar. Where Delaware has not published a current figure we say so instead of guessing.

Delaware Nursing Home Medicaid: Recent Law Updates

Delaware Nursing Home Medicaid at a Glance (2026)

Delaware Nursing Home Medicaid Income and Asset Limits

Two tests, both applied to the person entering the facility. The income test looks at gross monthly income from every source — Social Security, pensions, IRA withdrawals, annuities, rent. The asset test counts what can be turned into cash: bank accounts, investments, retirement accounts in most states, and any property other than the home.

Delaware is an income-cap state. If the applicant’s gross monthly income is over the Delaware nursing home medicaid limit by even a dollar, the application is denied unless a qualified income trust (a Miller trust) is set up first and funded every month.

Delaware counts liquid resources such as bank accounts, stocks and bonds, but it does not count everything a family owns. An applicant may designate a set-aside for burial, and money already paid to a funeral home for burial space items — the casket, the vault, the burial plot, and the opening and closing of the grave — is not treated as a resource.

One car may be excluded when it meets the state’s provisions for its use. Personal belongings and household goods are not the target of the review; the home is treated under separate residence and equity rules.

Delaware is an income-cap state, so a medically-needy spend-down is not the route here. If gross monthly income exceeds the Nursing Facility Program limit, the applicant must establish a Qualified Income Trust, which Delaware and most families call a Miller Trust. The trust must be irrevocable.

Income is deposited into it and paid out toward the cost of care, and whatever remains at death reimburses Delaware’s Medicaid program for care it paid for. The state advises setting the trust up with a lawyer, ideally before the Medicaid application is filed.

What the Spouse at Home Keeps Under Delaware Nursing Home Medicaid

Federal spousal impoverishment rules stop Delaware nursing home medicaid from bankrupting the husband or wife who stays home. The at-home spouse keeps a protected share of the couple’s assets — between $32,532 and $162,660 in 2026 — and is guaranteed a monthly income floor of at least $2,705, rising to $4,066.50 when housing costs are high. The house is fully exempt while the spouse lives in it.

Delaware follows the federal spousal impoverishment protections adopted in 1989, and its published policy does not add unusual state-only twists. The state adds together everything the couple owns — his, hers and jointly held — to reach a case total, then protects a share for the spouse who remains at home.

Income received by the at-home spouse is not counted when deciding whether the applicant qualifies, but it is counted when DMMA calculates how much of the applicant’s own income may be diverted to the spouse as a monthly maintenance needs allowance.

The asset snapshot is taken on the first day of the continuous stay, not the application date. Families who spend down before asking for a resource assessment often spend money the spouse was entitled to keep.

The Look-Back Rule and Transfer Penalties

Delaware reviews every transfer made in the 60 months before the application. Money or property given away, or sold for less than it was worth, is added up and divided by the state’s penalty divisor — its average private-pay nursing home cost — to produce a period during which Delaware nursing home medicaid will not pay.

The divisor in Delaware is not published here yet — confirm with The application is taken by the Division of Medicaid and Medical Assistance, and the starting point published by the state is the DMMA Medicaid Central Intake Unit at 1-866-940-8963. Intake routes the case to two DMMA units in turn: the Pre-Admission Screening (PAS) unit for the medical decision, then a Financial Eligibility unit, where a financial eligibility social worker case manager is assigned to the family.

Applications may also be filed online through Delaware’s ASSIST portal, which lists Long Term Care among its programs. Nursing facility admissions staff commonly make the referral call..

60 months, federal standard. The IRS annual gift exclusion has no bearing here: a gift that is tax-free can still trigger a Medicaid penalty. Transfers to a spouse, to a disabled child, or of the home to a child who lived there and provided care for two years are the main exceptions.

How to Apply for Delaware Nursing Home Medicaid

Where: The application is taken by the Division of Medicaid and Medical Assistance, and the starting point published by the state is the DMMA Medicaid Central Intake Unit at 1-866-940-8963. Intake routes the case to two DMMA units in turn: the Pre-Admission Screening (PAS) unit for the medical decision, then a Financial Eligibility unit, where a financial eligibility social worker case manager is assigned to the family. Applications may also be filed online through Delaware’s ASSIST portal, which lists Long Term Care among its programs. Nursing facility admissions staff commonly make the referral call. — start the application.

Delaware decides medical need through Pre-Admission Screening, performed by the DMMA Pre-Admission Screening (PAS) unit. A registered nurse, working with a social worker case manager, visits the applicant in the hospital, at home or in the facility and evaluates whether the person requires a skilled or intermediate level of care as defined by Delaware Medicaid criteria.

Separately, federal Preadmission Screening and Resident Review (PASRR) applies: a Level I screen looks for mental illness or intellectual disability, and anyone flagged gets an in-depth Level II evaluation before nursing facility placement.

Bring five years of bank statements, deeds, vehicle titles, insurance policies, the Medicare and Social Security cards, and any trust or power of attorney documents. Missing paperwork is the most common reason a Delaware nursing home medicaid decision is delayed.

While the Application Is Pending

While the case is pending, the nursing home is not yet being paid by Medicaid, so the family or the resident’s own income generally covers the bill; many facilities admit and hold the balance until approval, then bill Medicaid back.

Delaware provides retroactive eligibility as federal rules require, covering Medicaid services already received during the months before application if the person would have qualified then, and DMMA issues a written Retroactive Medicaid Approval or Denial notice. UNVERIFIED for the typical decision time. Once approved, Medicaid also sends written notice explaining the Patient Pay calculation.

After approval, nearly all of the resident’s income goes to the facility each month as the patient share, minus a small personal needs allowance, health insurance premiums and the spouse’s allowance.

Denials, Appeals and What Comes After

Most Delaware refusals and delays are not about the illness at all. The frequent causes are missing or incomplete financial verification requested by the financial eligibility social worker, resources still above the allowed level, income above the cap with no Miller Trust in place, and transfers of money or property during the state’s look-back that trigger a penalty.

A PAS finding that the person does not meet skilled or intermediate level of care also stops the case. Any denial, delay, reduction or termination can be appealed by written request for a DHSS fair hearing.

One more thing families should know before they file: after the resident’s death, the state may seek repayment from the estate. That process — what it can reach and the exemptions — is covered in our guide to Delaware Medicaid estate recovery.

A Realistic Delaware Nursing Home Medicaid Timeline

Week one: the hospital or family calls the Medicaid office for the level-of-care assessment and starts gathering five years of statements. Weeks two to four: the assessment is done and the financial application is filed, usually with the facility’s admissions office helping. Weeks six to twelve: the caseworker verifies accounts and may ask for more documents; answer within the deadline on each request or the clock resets.

Approval, when it comes, is retroactive to the eligibility date, which is why filing early is the single most valuable thing a family can do.

Where to Get Help Free

Two free doors exist in every state: the Delaware SHIP counselor for the Medicare side and the state’s Aging and Disability Resource Center for the Medicaid side. Neither sells anything. For a Delaware nursing home medicaid question involving a house, a spouse at home or a recent gift, a local elder law attorney or legal aid office is the next call.

Official Sources

• Delaware calls this coverage the Long Term Care Medicaid Nursing Facility Program, run by the Division of Medicaid and Medical Assistance (DMMA) within Delaware Health and Social Services. It is one of several Long Term Care Medicaid Programs the state lists together, alongside Long Term Care Community Services, the Long Term Acute Care Program, the DDDS Lifespan Waiver and PACE. Delaware delivers most of this care through managed care under the Diamond State Health Plan Plus. Families and nursing home staff often shorten the name to “LTC Medicaid” or “the Nursing Facility Program.” — Delaware Medicaid: https://dhss.delaware.gov/dmma/ltcmedicaid/
• The application is taken by the Division of Medicaid and Medical Assistance, and the starting point published by the state is the DMMA Medicaid Central Intake Unit at 1-866-940-8963. Intake routes the case to two DMMA units in turn: the Pre-Admission Screening (PAS) unit for the medical decision, then a Financial Eligibility unit, where a financial eligibility social worker case manager is assigned to the family. Applications may also be filed online through Delaware’s ASSIST portal, which lists Long Term Care among its programs. Nursing facility admissions staff commonly make the referral call.: https://assist.dhss.delaware.gov/
• Medicaid.gov spousal impoverishment standards: medicaid.gov
• Medicare.gov Medicare Savings Programs: medicare.gov

This Delaware nursing home medicaid guide was checked against the state Medicaid agency, CMS and the statute cited above in September 2026. Figures reset on their own calendars (most on January 1); if a number here disagrees with a notice you received, the notice wins — and please tell us. This page is general information, not legal, financial or medical advice.

Related Guides

• Delaware Medicaid Home Care
• Delaware Filial Responsibility Law
• Delaware Medicare Savings Program
• Delaware Medicare Guide
• Browse All Medicare Guides