Caregiving in Maryland— the questions adult children actually ask.

Maryland is one of only two states (with New Jersey) that has BOTH a state estate tax AND a state inheritance tax. The Maryland estate tax has a $5M per-individual exemption, with rates up to 16% above the threshold. The Maryland inheritance tax is 10% on transfers to beneficiaries outside a defined class — exempt beneficiaries are spouses, children, parents, grandchildren, siblings, and a few related categories. Transfers to nieces, nephews, cousins, friends, or unmarried partners face the 10% inheritance tax.

The inheritance tax is paid out of the transfer to the beneficiary — Maryland imposes it on the recipient, though it's typically collected through the estate. Exempt beneficiaries (spouses, children, parents, grandchildren, siblings, sons-in-law/daughters-in-law, and some others) pay 0%. All other beneficiaries — nieces, nephews, cousins, unmarried partners, friends, charities other than IRS-qualified ones — pay 10% on the value transferred to them. If you're naming a beneficiary in your parent's Maryland estate plan, who you name has direct tax consequences.

For long-term-care Medical Assistance (Maryland Medicaid), the asset limit is $2,500 for a single applicant — Maryland uses a slightly higher individual asset limit than the SSI-baseline $2,000 used by most states. The community spouse can retain a community-spouse resource allowance (CSRA) up to approximately $157,920 in 2026. The home is generally exempt subject to the federal home-equity cap. One vehicle is excluded.

Community First Choice is a Maryland Medical Assistance state-plan option (authorized by §1915(k) of the federal Social Security Act) that pays for personal-attendant services for people with substantial ADL needs. Unlike a waiver, CFC is an entitlement for eligible Marylanders — meaning if your parent qualifies, they cannot be put on a waitlist. The program covers personal care, certain support services, and back-up systems. It's one of the more progressive elements of the Maryland LTC system. Talk to your parent's Medical Assistance case manager about CFC eligibility.

Yes, through Maryland's Community First Choice (CFC) program and the Community Options waiver. Once your parent is approved, the program can authorize payment to a paid caregiver — including an adult child; a spouse generally cannot be paid. Hourly rates are set by the state and vary; typical 2026 rates run roughly $13-$16/hour. The fiscal intermediary handles payroll and tax withholding. Talk to your parent's Medical Assistance case manager for enrollment details.

Maryland's Family and Medical Leave Insurance program (Time to Care) was enacted in 2022. Employer and employee contributions began July 1, 2025, and benefit payments begin July 1, 2026. The program provides up to 12 weeks of paid family and medical leave per year, including leave to care for a family member with a serious health condition (which includes parents). Wage replacement is on a sliding scale up to a weekly cap.

Call Maryland Adult Protective Services at 1-800-917-7383. The Maryland Department of Human Services operates the statewide intake line for reports of suspected abuse, neglect, or exploitation of vulnerable adults. Reports can be made anonymously. For immediate danger, call 911. Mandatory reporters under MD Family Law §14-302 include health care providers, social workers, police officers, and some educators, but anyone can and should report.

Maryland adopted a statutory short-form Power of Attorney under Md. Estates & Trusts Code Ann. §17-202, which Maryland banks and brokerages broadly accept. The statutory form simplifies many transactions; non-statutory POAs are also valid but face more institutional scrutiny. Out-of-state POAs are generally honored if valid where executed (Md. Estates & Trusts §17-105), but Maryland practitioners typically recommend executing a Maryland-form POA after relocation. Maryland banks have specific procedures and an out-of-state POA may produce delays.

The Maryland state median for a private one-bedroom in an Assisted Living Program is approximately $5,800-$6,800/month based on Genworth's 2024 Cost of Care Survey. Montgomery County and the close-in DC suburbs are the most expensive markets in Maryland — frequently $7,000-$9,500/month. Eastern Shore and Western Maryland communities run $4,500-$5,800. Memory care typically adds 25-35% on top. Maryland licenses assisted living in three levels (1, 2, 3) based on the population served and care intensity.

Maryland offers a small-estate procedure under Md. Estates & Trusts Code Ann. §5-601 et seq. when the value of the regular probate estate is $50,000 or less (or $100,000 if the surviving spouse is the sole heir). Above those thresholds, regular probate through the Orphans' Court is required, which is more formal and time-consuming. Maryland is one of a few states with separate Orphans' Courts (specialized probate courts), one in each county. Probate-avoidance planning — beneficiary designations, joint tenancy, revocable trusts — remains the higher-leverage move for most families.