How to Apply for Delaware Medicaid for Long-Term Care

Your parent needs home care, the bills are piling up, and the state website has a dozen links that all seem to go in circles. The Delaware Medicaid application for long-term care services is a specific, sequential process — and missing a single step can delay approval by weeks.

Here is exactly how to move through it, from first contact to MCO enrollment.

Start with the Delaware ADRC, Not the Application

Before touching the formal application, call the Delaware Aging and Disability Resource Center (ADRC) at 1-800-223-9074. An options counselor will run a preliminary screening over the phone, assess immediate safety risks, and assign your parent a state case manager.

This step matters because the ADRC triggers the clinical assessment process — the Uniform Assessment Instrument (UAI) — which must happen before or alongside the financial application. Skipping it means your financial application sits without a matching medical eligibility determination.

Gather the Required Documents

Delaware's Division of Medicaid and Medical Assistance (DMMA) requires a specific documentation package. Incomplete submissions are the most common cause of processing delays.

You will need:

• 60 months of bank statements for every account your parent holds or has held
• Property deeds and mortgage statements
• Vehicle titles and registration
• Tax filings for the prior two years
• Health insurance premium verification (Medicare Part B, supplemental plans)
• The signed ERL1 form acknowledging Delaware's Estate Recovery and Lien policy
• If applicable, a notarized Qualified Income Trust (Miller Trust) document

If your parent's gross monthly income exceeds $2,982 (the 2026 cap), the Miller Trust must be established and the trust bank account opened before you submit the application. Without it, DMMA will issue an automatic denial.

Submit Through the ASSIST Portal or Paper Application

You have two paths:

Online: The Delaware ASSIST portal (assist.dhss.delaware.gov) handles applications for Medical Assistance, including long-term care. You can upload supporting documents directly.

Paper: Mail or deliver the Application for Medical Assistance to the DMMA Central Intake Unit at 1-866-940-8963, or to your county's DMMA Financial Eligibility office:

• New Castle County: Robscott Building, Newark (302-368-6610) or Thatcher Street, Wilmington (302-577-2174)
• Kent County: Milford State Service Center (302-424-7210)
• Sussex County: Georgetown State Service Center (302-856-5379)

DMMA has 45 days from receiving a complete packet to issue a determination.

What Happens After Approval

Once both financial and medical eligibility are confirmed, your parent enters the MCO selection window. Delaware runs all long-term care services through the Diamond State Health Plan Plus (DSHP-Plus), managed by three organizations: AmeriHealth Caritas, Delaware First Health (Wellcare), or Highmark Health Options.

You choose one. An MCO-assigned care coordinator then conducts a home visit, drafts a service plan, and authorizes specific hours for personal care, home-delivered meals, non-emergency medical transportation, and emergency response systems.

One critical advantage: unlike most states, Delaware's DSHP-Plus home care program is a legal entitlement. Once your parent qualifies, there is no waiting list.

Avoid the Most Common Application Mistakes

Three errors account for most Delaware Medicaid delays:

1. Submitting without the Miller Trust. If your parent is over the income cap, the application is dead on arrival without an executed QIT and corresponding bank account.
2. Incomplete look-back documentation. DMMA audits five years of financial history. Missing bank statements from a closed account or an undocumented gift to a grandchild will trigger a penalty period calculation.
3. Filing financial and medical applications out of sequence. The UAI clinical assessment and the DMMA financial application should move in parallel. If one finishes weeks before the other, care authorization stalls.

The Delaware Home Care Guide walks through each step with worksheets for the financial pre-screen, look-back audit, and Miller Trust setup — structured to prevent these exact mistakes before you submit.

See more Delaware guides →