Delaware-specific Medicaid spend-down rules
Delaware administers Medicaid through the Department of Health and Social Services (DHSS). The Division of Medicaid and Medical Assistance (DMMA) sets policy, while local Division of Social Services offices in Wilmington, Dover, Newark, New Castle, and Sussex County collect applications and verify resources.
The Nursing Facility Program pays for skilled and intermediate care in Delaware nursing homes that hold Medicaid contracts. LTSS home-based services run through Diamond State Health Plan Plus and Long Term Care Community Services, but asset tests still follow the same $2,000 resource standard for the applicant.
Delaware is an income cap state for long-term care. Families above the $2,485 monthly income standard (250% of the 2026 SSI amount) must assign excess funds to a Miller Trust, also called a Qualified Income Trust, with a Delaware trustee. Medical bill stacking does not replace that trust.
Community spouses may keep the greater of the CSRA calculation or certain income protections under spousal impoverishment rules. The state uses the federal maximum home equity cap of $713,000 in 2026 unless a spouse or dependent child still lives in the house.
Burial spaces, one vehicle, and up to $1,500 in a designated burial fund can be excluded if titled correctly. Prepaid funeral contracts follow separate DMMA policy guidance in DSSM 20000.
Look-back reviews cover asset transfers made within 60 months before application. Penalty length equals the uncompensated transfer amount divided by the average monthly nursing home cost published by Delaware DMMA.
Coastal applicants in Lewes and inland families in Milford follow the same resource test. LTSS slot availability varies by managed care region, but the $2,000 asset cap does not.
Call DMMA Medicaid Customer Relations at (800) 372-2022 or (302) 255-9500 to reach the DSS office closest to your home. Nursing facility intake also accepts referrals through the Central Intake Unit at (866) 940-8963.
Common mistake: Assuming Delaware exempts a second home because a sibling visits on weekends. Non-homestead real estate counts unless occupied by a spouse or dependent child under DMMA rules. Budget property taxes and sale costs before you rely on an appraisal.