Delaware Medicaid planning,
in plain English.

The numbers that matter in Delaware

• Penalty divisor (2026): $13,378/month — every $13,378 in gifted assets during the 5-year lookback = 1 month of Medicaid ineligibility.
• Nursing-home cost (2026, semi-private): ~$14,676/month = $176,112/year.
• CSRA ceiling: $162,660 (community-spouse resource allowance).
• MMMNA band: $2,643.75 to $4,066.50/month (minimum monthly maintenance needs allowance).
• Home equity limit: $752,000.
• Applicant asset cap: $2,000 (non-exempt).
• Applicant income cap: $2,901/month (state-federal common threshold, 2026).
• Managed long-term care: Yes — enrollment required after eligibility.
• Estate recovery posture: Minimum (only TEFRA-required).

Programs and acronyms in Delaware

If you're searching for help with long-term-care Medicaid in Delaware, these are the names and acronyms you'll encounter on state-agency forms, in elder-law conversations, and in nursing-facility paperwork.

• Delaware Medicaid — Diamond State Health Plan / DSHP-Plus. The state's Medicaid program brand.
• Delaware Division of Medicaid & Medical Assistance (DMMA) — administers Delaware Medicaid and processes long-term-care eligibility decisions.
• Diamond State Health Plan Plus (DSHP-Plus) — Statewide MLTSS program covering nursing-facility services and Long Term Care Community Services through capitated managed care.
• Long Term Care Community Services (LTCCS) — HCBS component of DSHP-Plus providing personal care, adult day, and assisted-living services as alternatives to nursing-facility placement.
• Delaware ASSIST — Delaware's online Medicaid application portal: assist.dhss.delaware.gov/
• DHSS — Delaware Health and Social Services (Parent agency over DMMA).
• DSAAPD — Division of Services for Aging and Adults with Physical Disabilities (LTSS intake).

The Delaware planning levers

Every Medicaid plan in Delaware pulls some combination of five levers: (1) community-spouse asset re-allocation inside the CSRA ceiling, (2) spend-down on exempt assets (home improvements, new car for the community spouse, pre-paid funeral), (3) irrevocable trust transfer outside the 5-year window, (4) caregiver-child exception or disabled-child exception on the home, and (5) personal-service contracts paying a family member for documented caregiving hours.

Which lever fits depends on the specific assets, the crisis timeline, and — critically — whether the applicant is already in a facility. If a family member is already admitted, the playbook narrows to levers (1), (2), and (5) only.

What planning looks like, by timeline

5+ years out: full menu available. Irrevocable-trust transfers, gifting, long-term-care insurance — all work if executed cleanly. Time is the most valuable asset in Medicaid planning.

1–5 years out: half-menu. Transfers still trigger the lookback but a known penalty period can be absorbed by private pay. Community-spouse re-allocation is still a big lever.

Already in a facility: crisis planning. Most gifting is off the table. Spend-down, community-spouse allowance, personal-service contracts, and exempt-asset purchases become primary. See the crisis playbook.