When families begin planning for long-term care, misinformation can be just as stressful as the medical decisions themselves. In Maryland, myths about Medicaid Long-Term Care (MALTC) often lead people to delay planning, make costly mistakes, or assume they have no good options. Below are some of the most common misconceptions about MALTC—and the realities that every family should understand before a crisis hits.

1. You automatically lose your home if you go into a nursing home and/or apply for Medicaid Long-Term Care.

Misconception: Many Maryland families worry that applying for Medical Assistance Long-Term Care (also called Medicaid Long-Term Care, or MALTC) means that the nursing home and/or MALTC will take their home while they’re alive.

Reality: Your primary residence can be exempt from asset limits while you or your spouse lives there. Estate recovery (the state seeking reimbursement after death) has exemptions for surviving spouses, minor children, and disabled adult children. Working with an experienced elder law attorney can help you understand the different ways the home (or the proceeds from selling it) can be protected if you or a loved one applies for MALTC.

2. Medicare will cover long-term care like nursing homes or custodial care.

Misconception: People often think Medicare (or their supplemental health insurance) pays for extended long-term care if they need it.

Reality: Medicare does not cover ongoing custodial care (help with daily living). It only covers short post-hospital rehabilitation stays, typically up to ~100 days, and even then, benefits usually drop after day 20. Long-term care costs are generally not covered by Medicare, which is when MALTC can assist in providing coverage.

Even if you have a private long-term care insurance policy, coverage is often limited by time, daily maximums, or the type of care included. Policies may not cover the full cost of a nursing home, assisted living, or in-home custodial care for the duration you need. That’s where MALTC can step in; it provides coverage once Medicare benefits run out or private insurance limits are reached, helping ensure you can access care without depleting your savings.

3. Medicaid is only for the very poor; if you have savings or a home, you’re too rich to qualify.

Misconception: Many people think MALTC is only for those with no savings or income.

Reality: Qualification for MALTC is based on medical need and specific financial limits, not poverty alone. Even if you’ve worked hard and saved, you may still qualify as long as your assets and income meet the strict financial eligibility rules (for example, in Maryland, countable assets for MALTC are roughly $2,500 for individuals, with a Community Spouse Resource Allowance for married couples). Certain assets aren’t counted, and there are planning strategies to protect your wealth. MALTC ensures that people who need help with daily living can access care, regardless of whether they have modest savings or a home.

4. You have to spend everything down to $0 to qualify.

Misconception: Folks often think you must literally spend all your money on care before MALTC will help.

Reality: Spend-down may be one way to meet eligibility, but you don’t have to literally pay out everything first. Many assets are exempt (certain vehicles, home equity up to a point, personal belongings) and with proper planning (e.g., using an elder law attorney), you may protect much of your wealth legally. You don’t have to give up everything you’ve worked for and drain your life savings to qualify.

5. Gifting assets or transferring money is an easy way to qualify.

Misconception: People think giving gifts to family or moving money around will help them “get under the limit.”

Reality: MALTC in Maryland enforces a 5-year look-back period. If you’ve transferred assets for less than fair market value within the previous 60 months, you can trigger a penalty period where MALTC won’t pay for care. Certain transfers, however, are exempt, and there are rebuttable presumptions that can prevent a penalty. An experienced elder law attorney can guide you through these rules, protect your assets, and avoid unnecessary delays in benefits.

Navigating Maryland MALTC rules is complex, and mistakes can be costly – sometimes resulting in tens of thousands of dollars in penalties or putting your home and hard-earned assets at risk. Working with an experienced elder law attorney can make all the difference.  Rachel S. Vogel, Esq. of Semmes, Bowen & Semmes helps families understand their option, protect their wealth, and secure the long-term care benefits they or their loved ones need.  Don’t wait until a crisis forces rushed decisions.  Contact Rachel to put a thoughtful plan in place and gain peace of mind for the future.