Delaware Medicaid Eligibility: Income, Assets, and Look-Back

Delaware Medicaid eligibility comes down to three things: you live in Delaware, your income fits your coverage group, and, for some programs, your countable assets sit under a strict limit. Most non-disabled adults ages 19 through 64 qualify if their household income is at or below 138 percent of the federal poverty level, which works out to roughly $22,025 a year for a single person in 2026. Pregnant women, children, seniors, and people with disabilities qualify under separate rules with higher income thresholds or different tests entirely.

Income Limits by Coverage Group

The dollar figures below track the 2026 federal poverty guidelines and adjust every January.¹

Adults 19 through 64 with no disability qualify with income at or below 138 percent of the federal poverty level. That is roughly $22,025 for an individual and $45,540 for a family of four.
Pregnant women qualify at or below 212 percent of the federal poverty level, and a pregnant woman counts as at least two household members for the calculation.²
Children under 19 qualify at income levels well above the adult threshold. Infants under age one qualify through Medicaid at about 217 percent of the federal poverty level, with older children eligible at lower but still elevated thresholds. Families earning too much for children’s Medicaid may still qualify for Delaware’s CHIP program.

If you receive Supplemental Security Income based on age, blindness, or disability, you are enrolled in Delaware Medicaid automatically. Delaware is a “1634 state,” so the Social Security Administration notifies the state Medicaid agency when it approves your SSI claim, and coverage starts without a separate application.³⁴

How Delaware Counts Your Income

For most applicants — parents, children, pregnant women, and non-disabled adults — Delaware uses Modified Adjusted Gross Income.⁵ MAGI starts with your adjusted gross income from your tax return and adds back items like non-taxable Social Security benefits and tax-exempt interest. Child support you receive does not count.

Countable income includes wages, self-employment earnings, unemployment benefits, rental income, and Social Security payments. Tax deductions like student loan interest and IRA contributions reduce what counts. If your income moves with the seasons, Delaware looks at what you are currently earning rather than a fixed annual figure.

People who qualify based on age (65 or older), disability, or blindness are evaluated under a separate, non-MAGI framework. That framework also considers assets, which MAGI does not.

Residency and Citizenship

You need to live in Delaware and intend to stay. There is no waiting period. You can apply the day you arrive as long as you plan to remain here or moved for work.⁶ People without a fixed address still qualify as residents if they are physically present in Delaware with the intent to stay.⁷

Documents that prove residency include a Delaware driver’s license, state-issued ID, lease agreement, mortgage statement, utility bill, or government mail. If you are experiencing homelessness, a letter from a shelter or social service agency confirming your presence in Delaware works.

Non-citizens face additional rules. Lawfully present immigrants such as refugees and asylees can apply for full Medicaid without any waiting period. Green card holders and other qualified immigrants generally must complete a five-year waiting period before they can receive full benefits, though pregnant women and children may qualify sooner through Medicaid or CHIP. Undocumented immigrants cannot receive full Medicaid but may receive emergency medical assistance for life-threatening conditions under federal law.

Asset Limits for Seniors, Disability, and Long-Term Care

If you are applying based on age (65 or older), disability, or the need for long-term care, Delaware also looks at what you own. The countable resource limit is $2,000 for an individual and $3,000 for a married couple applying together.⁸ These figures have not changed in decades, and they catch more applicants than most people expect.

Countable assets include bank accounts, stocks, bonds, and real estate you do not live in. Several important assets do not count:

Your home, as long as your equity interest does not exceed $752,000 in 2026 and you or your spouse still live there, or you intend to return.
One vehicle used for transportation.
Personal belongings and household goods.
Prepaid burial arrangements and a small amount of life insurance.

MAGI applicants — the parents, children, pregnant women, and adults 19 through 64 covered above — are not subject to an asset test. Only the age, disability, and long-term care pathways look at resources.

Spousal Protections

When only one spouse needs long-term care Medicaid, the healthy spouse living at home does not have to spend down to nothing. The community spouse can keep up to $162,660 in countable assets in 2026.⁸ The community spouse also receives a monthly maintenance needs allowance, ranging from roughly $2,644 to $4,067 per month in 2026, to cover basic living expenses.

Miller Trusts When Income Exceeds the Cap

Delaware allows applicants whose income exceeds the long-term care cap, but whose assets meet the limit, to use a Miller Trust (a Qualified Income Trust). You deposit your monthly income into an irrevocable trust, and a trustee uses those funds to pay your patient responsibility to the care facility and other approved expenses. Income in the trust no longer counts toward the Medicaid income limit. When you pass away, anything left in the trust must be repaid to Delaware for the Medicaid benefits you received.

Creating a Miller Trust requires a written trust agreement, usually prepared by an attorney, and a dedicated bank account in the trust’s name. If the applicant is incapacitated and has no power of attorney authorizing trust creation, a court-appointed guardian may need to establish it.

Spending Down Excess Assets

If your assets exceed the limit but your income qualifies, you can spend down by converting countable assets into exempt ones. Common moves include paying off debt, making home modifications like wheelchair ramps, adapting a vehicle for accessibility, or prepaying funeral and burial costs. Keep receipts for every purchase. Medicaid reviews these transactions, and anything that looks like a gift rather than a fair-value purchase can trigger a penalty period.

The Five-Year Look-Back on Asset Transfers

When you apply for long-term care Medicaid, Delaware reviews the previous 60 months of financial transactions for both you and your spouse.⁹ If you gave away assets or sold them below market value during that window, Medicaid imposes a penalty period during which you are ineligible for long-term care benefits. The length depends on the value of the transfer.

Some transfers do not trigger a penalty. You can transfer your home without consequence to:

Your spouse
A child under 21, or a child who is blind or permanently disabled
A sibling who already has an ownership interest in the home and has lived there for at least one year before your admission to a facility
An adult child who lived in your home for at least two years before you entered a nursing home and provided care that allowed you to remain at home during that time

Transferring assets to family five or six years before you ever need care is legitimate planning. Doing it 18 months before you apply creates a penalty that can leave you without coverage when you need it most. Anyone considering significant gifts or transfers should consult an elder law attorney well before applying.

How to Apply

Delaware offers three ways to apply:

Online through Delaware ASSIST, the state’s benefits portal.¹⁰
By phone at 1-800-372-2022. For long-term care Medicaid specifically, call 1-866-940-8963.
In person at a local State Service Center, typically by appointment.

Bring or upload proof of identity, residency, and income. Common documents include pay stubs, tax returns, Social Security award letters, bank statements, and your lease or mortgage statement. Long-term care and disability-based applications also require asset documentation.

Delaware verifies applications through electronic data matching with the Social Security Administration, the IRS, and other agencies. If something does not match what you reported, expect a request for additional documentation. Standard applications must be processed within 45 days under federal rules. Disability-based applications can take up to 90 days.

Retroactive Coverage

Medicaid can cover medical expenses you incurred during the three months before you applied, as long as you would have been eligible during those months. If you had a hospital stay or another major expense in the weeks before filing, tell the Medicaid office. Retroactive coverage can keep bills out of collections or refund expenses you have already paid.

If Your Application Is Denied

The most common reasons Delaware denies an application are exceeding the income limit, holding too many countable assets on a long-term care or disability track, and incomplete paperwork. The denial notice explains why, and it is the starting point for either fixing the problem or filing an appeal.

A few situations trip people up:

Missing documents. If you do not respond to a verification request in time, Delaware denies the application. You can usually reapply immediately with the missing materials.
Income just over the line. Slightly above 138 percent of the federal poverty level may still open the door to subsidized Marketplace coverage, or you may be able to lower your countable income through allowable deductions.
Asset transfers inside the 60-month look-back for long-term care applicants.
Immigration status. Non-citizens who have not cleared the five-year waiting period, and are not in an exempt category, will be denied full coverage, though emergency Medicaid may still be available.

You have 90 days from the date the denial notice is mailed to request a fair hearing through the Division of Social Services.¹¹ You can file online, by mail, or in person, and you can bring documents, witnesses, and an attorney or representative to the hearing.¹²

Estate Recovery After Long-Term Care

One boundary worth knowing before you apply for long-term care Medicaid: after a recipient dies, Delaware is required to seek repayment from the estate for long-term care services Medicaid paid.¹³ For recipients who were 55 or older, the state may also recover costs for nursing facility services, home and community-based services, and related hospital and prescription drug expenses.⁹

Recovery is blocked while a surviving spouse is alive and lived in the home, and when the deceased is survived by a child under 21 or a child who is blind or disabled.¹⁴ A sibling who lived in the home for at least a year before the recipient entered a facility, and who has an equity interest in the property, is also protected from a lien on the home.¹³ Delaware must waive estate recovery when enforcing it would cause undue hardship, though the waiver lasts only as long as the hardship continues.

1
HealthCare.gov. Federal Poverty Level (FPL)
2
Delaware Department of Health and Social Services. 2025 Federal Poverty and Medicaid Assistance Levels
3
Delaware Administrative Code. Delaware Administrative Code – 17000 SSI Related Programs
4
Social Security Administration. State Medicaid Eligibility and Enrollment Policies and Rates of Medicaid Participation Among Disabled Supplemental Security Income Recipients
5
Delaware Administrative Code. Delaware Social Services Manual 16000
6
Legal Information Institute. Delaware Admin Code 16-14000-14110 – State Residency
7
Delaware Register of Regulations. Delaware Register of Regulations – State Residency
8
Medicaid.gov. January 2026 SSI and Spousal CIB
9
Office of the Law Revision Counsel. 42 USC 1396p – Liens, Adjustments and Recoveries, and Transfers of Assets
10
Delaware Health and Social Services. Delaware ASSIST
11
Delaware Department of Health and Social Services. Administrative Notice A-13-2025 – Fair Hearing Requests
12
Legal Information Institute. Delaware Admin Code 16-5000-5500 – Issuing Fair Hearing Decisions
13
Delaware Code. Delaware Code Title 25 Chapter 50 – Liens and Estate Recoveries
14
Medicaid.gov. Estate Recovery