Delaware Medicaid Income Limits for Long-Term Care in 2026

Your parent's Social Security check is $2,100 a month. Their pension adds another $900. That puts them at $3,000 — just $18 over Delaware's strict Medicaid income cap. Without a specific trust structure, that $18 disqualifies them from every state-funded home care and nursing facility benefit.

Delaware is an income cap state. Understanding the exact thresholds — and the workarounds the state actually permits — is the difference between approval and denial.

The 2026 Income and Asset Thresholds

Delaware sets its long-term care Medicaid income limit at 300% of the federal Supplemental Security Income (SSI) standard. For 2026, that strict cap is $2,982 per month in gross income.

This is not a sliding scale. If your parent's combined gross monthly income from Social Security, pensions, annuities, and any other source exceeds $2,982 by even one dollar, they are ineligible — unless they establish a Qualified Income Trust (Miller Trust).

The countable asset limit for a single applicant is $2,000. That includes bank accounts, stocks, bonds, and cash value life insurance. Assets that do not count: the primary residence (up to $752,000 in home equity), one vehicle, household furnishings, personal effects, and prepaid irrevocable burial contracts.

Spousal Impoverishment Protections

When one spouse needs long-term care and the other stays home, Delaware applies federal spousal protections to prevent financial devastation for the healthy partner.

Community Spouse Resource Allowance (CSRA): The at-home spouse keeps 50% of the couple's combined countable assets, up to a maximum of $162,660 in 2026. If combined assets are modest, a minimum floor of $32,532 is protected regardless.

Minimum Monthly Maintenance Needs Allowance (MMMNA): Delaware guarantees the community spouse a monthly income floor of $2,705 (effective July 1, 2026 through June 30, 2027), with a ceiling of $4,066.50. If the at-home spouse's independent monthly income falls below their calculated allowance, a portion of the applicant spouse's income is diverted to them.

These protections mean the state cannot leave a spouse destitute to qualify the other for care — but the calculations are specific and the figures change every year.

The Miller Trust Requirement

Delaware does not allow income spend-down. In states that do, an applicant can pay medical bills with excess income to effectively reduce their countable income below the threshold. Delaware offers no such option.

Instead, families must establish a Qualified Income Trust (QIT), commonly called a Miller Trust. The mechanics:

1. An elder-law attorney or the family drafts a notarized, irrevocable QIT agreement
2. A dedicated trust bank account is opened using the parent's Social Security Number
3. Each month, all income exceeding the cap is deposited into this trust account
4. The trust funds are used exclusively for the applicant's medical and care costs

Attorney fees for Miller Trust setup typically run $500 to $2,500. Monthly bank maintenance fees add $5 to $25. The trust must be established and the bank account open before submitting the Medicaid application — DMMA will deny any application where the income exceeds the cap without an executed QIT on file.

The 60-Month Lookback

Delaware audits all financial transactions from the 60 months before the application date. Gifts, property transfers below fair market value, and cash given to family members can trigger a penalty period during which the applicant must privately fund all care.

The penalty is calculated by dividing the uncompensated value of the transferred assets by the state's average daily cost of nursing home care. A $50,000 gift to a grandchild three years ago could mean months of disqualification.

What This Means for Home Care Planning

The income and asset limits apply equally whether your parent needs home care, assisted living, or nursing facility placement. All three run through the Diamond State Health Plan Plus (DSHP-Plus) managed care system. Meeting the financial thresholds unlocks the same benefits regardless of care setting.

The Delaware Home Care Guide includes a financial pre-screening calculator, a 60-month lookback audit worksheet, and step-by-step Miller Trust setup instructions — built specifically around Delaware's 2026 thresholds so you can assess eligibility before contacting an attorney or filing with DMMA.

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