Maryland Medicaid Countable Assets: What Counts and What's Exempt

The $2,500 Line That Decides Everything

To qualify for long-term care Medicaid in Maryland, a single applicant's countable resources must be at or below $2,500. For married couples where both spouses are applying, the combined limit is $3,000. When only one spouse applies, the community spouse (the one staying home) can keep up to $162,660 under the Community Spouse Resource Allowance.

That $2,500 number is what the caseworker at your local Department of Social Services is checking when they review your parent's financial records. But not everything your parent owns counts toward that limit. Knowing what's countable versus exempt is the difference between panicking over a seemingly impossible threshold and realizing your parent may already be closer to qualifying than you think.

What Maryland Counts as a Resource

Bank accounts. Every dollar in checking, savings, and money market accounts is countable. This includes accounts in your parent's name alone, jointly held accounts (the applicant's share is countable), and certificates of deposit.

Investments. Stocks, bonds, mutual funds, brokerage accounts, and cryptocurrency are all countable at their current market value.

Retirement accounts — and here's where Maryland differs. This is a critical trap that catches families who've read general Medicaid guides. Unlike some states that exempt IRAs and 401(k)s when they're in active payout status, Maryland counts the full cash surrender value of the applicant's IRAs as countable resources. A parent with $80,000 in an IRA and nothing in the bank is $77,500 over the limit. The spouse's IRAs are also counted for purposes of calculating the couple's combined resources during the CSRA determination.

Cash-value life insurance. If your parent's life insurance policies have a combined face value exceeding $1,500, the cash surrender value (not the face value) becomes a countable resource. A whole life policy purchased decades ago with a $50,000 face value could have $15,000–$25,000 in cash surrender value — that's countable.

Real estate other than the primary home. Rental property, vacant land, a vacation home — all countable at fair market value.

Vehicles beyond the first one. Maryland exempts one vehicle of any value (see below), but a second car, RV, boat, or other vehicle is counted at fair market value.

What Maryland Exempts

The primary residence. Automatically exempt if a spouse, a minor child (under 21), or a blind or disabled child of any age lives there. If no qualifying relative lives in the home, it's still exempt as long as the applicant expresses an "intent to return" — but only up to $752,000 in individual home equity. Home equity above that cap makes the applicant ineligible for long-term care Medicaid, even if they meet all other criteria.

One vehicle. One automobile of any value is excluded. It doesn't matter whether your parent drives a 15-year-old sedan or a $45,000 SUV — the first vehicle is fully exempt. If the family has two vehicles, the one with higher value should remain as the exempt vehicle, and the other must be counted or disposed of.

Household goods and personal effects. Furniture, clothing, appliances, jewelry worn daily, kitchen equipment — all exempt regardless of value. The caseworker isn't going to appraise your parent's living room furniture.

Irrevocable burial trusts and funeral plans. Pre-paid, irrevocable funeral contracts are excluded subject to applicable state-specific limits. Burial plots for the applicant and immediate family members are also exempt, as are separately designated burial funds up to state-specific limits.

Term life insurance. Policies with no cash surrender value (pure term life) don't count as resources regardless of face value. It's only policies with a savings component (whole life, universal life) that create countable value.

Life insurance with face value under $1,500. If the combined face value of all your parent's life insurance policies (including ones with cash value) is $1,500 or less, the cash surrender value is exempt.

The IRA Problem and What to Do About It

Maryland's treatment of IRAs as fully countable resources is the single biggest surprise for families who've done their research on other states. Here's how it plays out:

A 78-year-old parent has $40,000 in a traditional IRA, $1,200 in checking, and owns a home worth $280,000 where no spouse resides but the parent expresses intent to return. The home is exempt. The checking account is countable ($1,200). The IRA is fully countable ($40,000). Total countable: $41,200 — more than 16 times the $2,500 limit.

Options for dealing with excess IRA funds:

• Liquidate and spend down compliantly — withdraw the IRA funds (paying income tax on the distribution), then use the cash for compliant spend-down purposes: paying off the mortgage, prepaying funeral expenses, making home modifications, or paying medical debts
• Convert to a compliant annuity — for a community spouse, converting excess IRA funds into a Medicaid-compliant annuity transforms the countable principal into an income stream that is evaluated under the income rules

The key is sequencing. If your parent liquidates $40,000 from an IRA and the cash sits in a bank account for three months while you figure out what to do with it, it's still countable. The liquidation and spend-down should happen as part of a coordinated plan before the application is filed.

Joint Account Complications

When your parent has a joint bank account with a spouse, child, or sibling, Maryland's rules get nuanced. The caseworker will look at:

• Joint with a spouse: The entire balance is included in the couple's combined resources for CSRA calculation purposes
• Joint with a non-spouse: The applicant's share is presumed to be 100% of the account balance unless you can prove otherwise with documentation (contribution records, deposit histories)

If your name is on your parent's checking account for convenience — so you can help pay bills — that full balance may be attributed to your parent's countable resources. Documentation showing that your own deposits constitute your portion of the balance is essential to rebut the presumption.

Timing: The Snapshot Date Matters

For married couples, Maryland uses a "snapshot date" to calculate the Community Spouse Resource Allowance. This is typically the first day of a continuous 30-day period during which the applicant is in a hospital or nursing facility, or the date of waiver qualification. All countable resources as of that date are totaled, and the community spouse's protected share is calculated from that total.

This means the snapshot date determines how much the healthy spouse gets to keep. If your parent enters a facility on March 1 and that begins a continuous 30-day stay, March 1 becomes the snapshot date. Every bank balance, investment value, and IRA total as of that day is locked in for the CSRA calculation.

For a full breakdown of how to calculate your parent's countable resources and map out a compliant spend-down strategy, the Maryland Medicaid Long-Term Care & Asset Protection Guide includes worksheets that walk through each asset category with Maryland-specific rules.

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