1. A. To be eligible for the Maryland Medical Assistance Program, an applicant or recipient shall be a Maryland resident.
2. B. An individual is a Maryland resident if the individual resides in Maryland with the intent of remaining permanently or for an indefinite period, regardless of whether the individual maintains the residence permanently or at a fixed address.

3. C. Residency in a state begins on the day that an individual:

   1. (1) Enters the state with the intent to remain permanently or for an indefinite period; or
   2. (2) Decides to remain in the state permanently or for an indefinite period after entering for another purpose.

4. D. An individual is not a resident of a state if the individual:

   1. (1) Is temporarily residing in or visiting the state without the intent of remaining, except as specified under §I(2)(b)(ii) or §I(3) of this regulation;
   2. (2) Came into the state for a specific, time-limited purpose and does not intend to remain, except as specified under §I(2)(b)(ii) or §I(3) of this regulation; or
   3. (3) Entered the state voluntarily to obtain noninstitutional medical care, such as for acute hospital inpatient services.
5. E. Residency in a state established on any day in a calendar month shall constitute residency for the full month.

6. F. Retaining Residency.

   1. (1) Residency is retained until abandoned.
   2. (2) Temporary absence from a state, with the intent to return to the state when the purpose of the absence is accomplished, does not interrupt continuity of residency, unless another state's Medical Assistance program determines that the individual is a resident of the other state.

   3. (3) An individual who is routinely absent from a state for a protracted period of time retains residency in that state if the individual:

      1. (a) Declares the intent to remain a resident of the state;
      2. (b) Has an established residential address in the state; and
      3. (c) Is not certified for Medical Assistance or receiving public assistance in another state.

   4. (4) Residency in a state is not affected by an absence for:

      1. (a) Unanticipated medical care; or
      2. (b) Out-of-state medical treatment preauthorized by the state's Medical Assistance Program.
7. G. An individual is ineligible for a state's Medical Assistance Program for any month in which the individual is not a resident of the state.

8. H. State Supplementary Payment for a Recipient of Supplemental Security Income (SSI).

   1. (1) Notwithstanding any other provisions of this regulation, the state of residence for a recipient of a state supplementary SSI payment is the state making the supplementary payment.

   2. (2) An individual receiving a state supplementary payment from another state who moves to Maryland with the intent of remaining in Maryland is not eligible for Maryland Medical Assistance until:

      1. (a) The individual's change of state residence is verified; and
      2. (b) Changes, if any, in the individual's payment amount are made with the Social Security Administration.

9. I. Additional Residency Criteria for Noninstitutionalized Individuals.

   1. (1) Noninstitutionalized Child.

      1. (a) Except as otherwise specified in this regulation, a noninstitutionalized, unmarried individual younger than 21 years old is considered a resident of the state where the child lives:

         1. (i) With the child's parent or other caretaker relative; or
         2. (ii) In another living arrangement if the child is not living with the child's parent or other caretaker relative, and the child's parent or other caretaker relative is not responsible for the child's day-to-day care and supervision.
      2. (b) For a child receiving federal payments for foster care or adoption assistance under Title IV-E of the Social Security Act, the child's state of residence is the state where the child lives, even if it is not the state making the payments.
      3. (c) If a noninstitutionalized child's Medical Assistance eligibility is determined based on blindness or disability, the child's state of residence is the state where the child lives.

   2. (2) Noninstitutionalized Adult. A noninstitutionalized adult, including an individual younger than 21 years old who is married or otherwise emancipated from the individual's parents, is considered a resident of the state where the individual lives:

      1. (a) Voluntarily with the intent to remain permanently or for an indefinite period; or

      2. (b) At the time of Medical Assistance application, if the individual is:

         1. (i) Determined as incapable of indicating intent, in accordance with §K of this regulation; or
         2. (ii) Not receiving assistance from another state and entered the state with a job commitment or seeking employment, whether or not the individual is currently employed.
   3. (3) The exclusion of Medical Assistance eligibility under §D of this regulation for individuals who temporarily reside in the state without the intent of remaining shall be waived for members of an assistance unit that includes a migrant worker, in MAGI Exempt coverage groups.
   4. (4) Notwithstanding any other provision of this regulation, the state of residence for an individual placed by a state government in another state is the state that arranges or makes the placement for medical or other publicly funded services.

10. J. Additional Residency Criteria for Institutionalized Individuals.

    1. (1) For an institutionalized adult, including an individual younger than 21 years old who is married or otherwise emancipated from the individual's parents, the state of residence is the state where the individual is institutionalized, if the individual indicates the intent to remain in the long-term care facility indefinitely.
    2. (2) If an institutionalized adult became incapable of indicating intent when the individual was 21 years old or older, the individual's state of residence is the state where the individual is institutionalized.

    3. (3) An institutionalized child younger than 21 years old, or an institutionalized adult who became incapable of indicating intent when younger than 21 years old, is a resident of the state in which the:

       1. (a) Individual's parent or other legal guardian resided at the time of the individual's placement in the long-term care facility;
       2. (b) Individual's parent or other legal guardian currently resides, who applied for Medical Assistance on the individual's behalf; or
       3. (c) Individual is institutionalized if the individual was abandoned by the individual's parents and does not yet have a legal guardian.
    4. (4) Notwithstanding any other provision of this regulation, the state of residence for an individual institutionalized by a state government in an out-of-state facility is the state that arranges or makes the placement.
    5. (5) The Department may not deny Medical Assistance eligibility to an institutionalized individual who satisfies the residency requirements of this regulation, on the grounds that the individual did not establish Maryland residency before entering the long-term care facility.

11. K. An adult is considered incapable of indicating intent if the individual:

    1. (1) Has an Intelligence Quotient of 49 or less, or a mental age of 7 years old or younger, based on tests acceptable to the Department's Developmental Disabilities Administration;
    2. (2) Is judged legally incompetent; or
    3. (3) Is found incapable of indicating intent based on medical documentation obtained from a physician, psychologist, or other person licensed by the state in the field of intellectual disabilities.

Authority: Estates and Trusts Article, §14.5-1002; Health-General Article, §§2-104(b), 2-105(b), 15-103, 15-105, 15-121, and 15-401—15-407;
Annotated Code of Maryland; Annotated Code of Maryland

Effective date: May 1, 1983 (10:6 Md. R. 558)

Regulations .01, .02, and .06 amended as an emergency provision effective December 1, 1992 (19:25 Md. R. 2198); amended permanently effective June 1, 1993 (20:10 Md. R. 852)

Regulation .02B amended effective May 1, 1986 (13:8 Md. R. 898); August 8, 1988 (15:16 Md. R. 1914); May 1, 1989 (16:8 Md. R. 910); December 1, 1992 (19:23 Md. R. 2041); March 24, 1997 (24:6 Md. R. 485); June 2, 1997 (24:11 Md. R. 793)

Regulations .02B; .03C; .04; .07B, I, J, L; .08G, H; .09B; .10C, E, F; .11D, E; .12B; .14A; and .15D amended as an emergency provision effective May 1, 1983 (10:11 Md. R. 962); adopted permanently effective September 1, 1983 (10:17 Md. R. 1521)

Regulations .02B and .05A amended as an emergency provision effective October 3, 1997 (24:22 Md. R. 1550); amended permanently effective January 12, 1998 (25:1 Md. R. 16)

Regulation .02B amended effective November 24, 2005 (32:23 Md. R. 1826); December 31, 2007 (34:26 Md. R. 2262); October 14, 2013 (40:20 Md. R. 1652)

Regulation .03 amended as an emergency provision effective May 4, 1990 (17:11 Md. R. 1339); amended permanently effective August 13, 1990 (17:15 Md. R. 1858)

Regulation .03-1 adopted effective April 1, 2002 (29:6 Md. R. 567)

Regulation .03-1B amended effective June 9, 2003 (30:11 Md. R. 735)

Regulation .03-2 adopted effective April 1, 2002 (29:6 Md. R. 567)

Regulation .03-2F amended effective January 6, 2003 (29:26 Md. R. 2027)

Regulation .03-3 adopted effective June 7, 2004 (31:11 Md. R. 856)

Regulation .03-3 amended effective December 27, 2010 (37:26 Md. R. 1787)

Regulation .03-4 adopted effective June 7, 2004 (31:11 Md. R. 856)

Regulation .03-4A amended effective December 27, 2010 (37:26 Md. R. 1787)

Regulation .04 amended effective May 1, 1986 (13:8 Md. R. 898); May 1, 1989 (16:8 Md. R. 910); June 30, 2008 (35:13 Md. R. 1179); April 19, 2010 (37:8 Md. R. 615)

Regulation .04J amended as an emergency provision effective October 1, 2001 (28:24 Md. R. 2125); emergency status expired March 29, 2002

Regulations .04J, .07B, G—N, and .08B, G—L amended as an emergency provision effective March 1, 1984 (11:5 Md. R. 449); emergency status extended at 11:14 Md. R. 1247 (July 6, 1984)

Regulations .04J, .07B, G—N, and .08B, G—L amended effective October 15, 1984 (11:20 Md. R. 1742)

Regulation .04J amended effective September 20, 2010 (37:19 Md. R. 1284)

Regulation .05 repealed and new Regulation .05 adopted effective September 24, 2007 (34:20 Md. R. 1737)

Regulation .05A amended effective April 14, 2003 (30:7 Md. R. 487)

Regulation .05C amended effective April 19, 2010 (37:8 Md. R. 614)

Regulation .05D amended effective March 11, 1985 (12:5 Md. R. 482); April 19, 2010 (37:8 Md. R. 614)

Regulation .05E amended effective March 11, 1985 (12:5 Md. R. 482); March 24, 1997 (24:6 Md. R. 485)

Regulation .05H amended effective June 2, 1997 (24:11 Md. R. 793)

Regulation .05-1 adopted effective September 24, 2007 (34:20 Md. R. 1737)

Regulation .05-1B amended effective April 19, 2010 (37:8 Md. R. 614)

Regulation .05-2 adopted effective September 24, 2007 (34:20 Md. R. 1737)

Regulation .05-2 amended effective April 19, 2010 (37:8 Md. R. 614)

Regulation .05-3 adopted effective September 24, 2007 (34:20 Md. R. 1737)

Regulation .05-3K amended effective October 14, 2013 (40:20 Md. R. 1652)

Regulation .05-4 adopted effective September 24, 2007 (34:20 Md. R. 1737)

Regulation .05-5 adopted effective September 24, 2007 (34:20 Md. R. 1737)

Regulations .06, .07M, .08, .10, .11, .12C, and .15 amended effective May 1, 1986 (13:8 Md. R. 898)

Regulation .07 amended effective April 19, 2010 (37:8 Md. R. 615)

Regulation .07D, M amended effective June 30, 2008 (35:13 Md. R. 1179)

Regulation .07J amended effective October 8, 1991 (18:18 Md. R. 2005)

Regulation .07M amended as an emergency provision effective September 30, 1989 (16:21 Md. R. 2258); adopted permanently effective February 1, 1990 (17:1 Md. R. 69)

Regulation .07N amended as an emergency provision effective July 1, 1984 (11:13 Md. R. 1173); amended permanently effective September 10, 1984 (11:18 Md. R. 1584)

Regulation .07N amended as an emergency provision effective July 1, 1986 (13:14 Md. R. 1628); adopted permanently effective September 8, 1986 (13:18 Md. R. 2020)

Regulation .07N amended effective August 10, 1987 (14:16 Md. R. 1774); July 1, 1988 (15:13 Md. R. 1554)

Regulations .07N and .10E amended as an emergency provision effective July 1, 1985 (12:13 Md. R. 1274); adopted permanently effective November 4, 1985 (12:22 Md. R. 2104)

Regulation .07N amended as an emergency provision effective July 1, 1989 (16:14 Md. R. 1565); amended permanently effective October 30, 1989 (16:21 Md. R. 2261)

Regulation .07N amended as an emergency provision effective July 1, 1990 (17:15 Md. R. 1851); adopted permanently effective November 1, 1990 (17:20 Md. R. 2427)

Regulation .07N amended as an emergency provision effective December 10, 1991 (18:26 Md. R. 2827); amended permanently effective April 1, 1992 (19:5 Md. R. 577)

Regulation .07N amended as an emergency provision effective November 25, 1992 (19:25 Md. R. 2199); amended permanently effective March 29, 1993 (20:4 Md. R. 371)

Regulation .07N amended as an emergency provision effective July 22, 1993 (20:16 Md. R. 1275); amended permanently effective November 1, 1993 (20:21 Md. R. 1654)

Regulation .07N amended as an emergency provision effective August 10, 1994 (21:18 Md. R. 1506); amended permanently effective November 7, 1994 (21:22 Md. R. 1876)

Regulation .08 amended as an emergency provision effective May 15, 1992 (19:11 Md. R. 1012); emergency status extended at 19:19 Md. R. 1702; amended permanently effective September 14, 1992 (19:18 Md. R. 1656)

Regulation .08 amended as an emergency provision effective April 8, 1994 (21:9 Md. R. 744); emergency provision rescinded retroactively to April 8, 1994 (21:14 Md. R. 1226)

Regulation .08 amended effective June 30, 2008 (35:13 Md. R. 1179)

Regulation .08B amended effective September 1, 1993 (20:17 Md. R. 1346); January 12, 1987 (14:1 Md. R. 31); August 22, 1988 (15:17 Md. R. 2049); July 3, 1995 (22:13 Md. R. 967)

Regulation .08G, H amended effective June 2, 1997 (24:11 Md. R. 793)

Regulation .08G, H, and H-1 amended effective January 12, 1987 (14:1 Md. R. 31)

Regulation .08G, H, and I amended effective August 22, 1988 (15:17 Md. R. 2049)

Regulation .08G, H, and K amended effective July 3, 1995 (22:13 Md. R. 967)

Regulation .08G, I amended as an emergency provision effective October 1, 2001 (29:4 Md. R. 413); emergency status extended at 29:8 Md. R. 696; amended permanently effective April 29, 2002 (29:8 Md. R. 700)

Regulation .08J-1 adopted effective September 1, 1993 (20:17 Md. R. 1346)

Regulation .08J-1 amended effective October 14, 2013 (40:20 Md. R. 1652)

Regulation .08L amended effective June 29, 1987 (14:13 Md. R. 1474); January 25, 1988 (15:2 Md. R. 121)

Regulation .08L amended as an emergency provision effective July 1, 1989 (16:14 Md. R. 1565); amended permanently effective October 30, 1989 (16:21 Md. R. 2261)

Regulation .08M amended effective June 29, 1987 (14:13 Md. R. 1474)

Regulations .08 and .10 amended, and new Regulation .10-1 adopted as an emergency provision effective September 30, 1989 (16:21 Md. R. 2259); adopted permanently effective February 1, 1990 (17:1 Md. R. 69) (Regulation .10-1 originally adopted as Regulation .11)

Regulations .08-1 and .08-2 adopted effective July 3, 1995 (22:13 Md. R. 967)

Regulation .08-2 amended effective April 29, 2002 (29:8 Md. R. 700)

Regulation .08-3 adopted effective November 24, 2005 (32:23 Md. R. 1826)

Regulation .09B, C amended effective September 20, 2010 (37:19 Md. R. 1284)

Regulation .10 amended effective November 10, 2003 (30:22 Md. R. 1580)

Regulation .10C and D amended as an emergency provision effective July 1, 1986 (13:14 Md. R. 1628); adopted permanently effective September 8, 1986 (13:18 Md. R. 2020)

Regulation .10C, D amended effective July 1, 1987 (14:13 Md. R. 1474)

Regulation .10C, D amended as an emergency provision effective March 13, 2009 (36:8 Md. R. 591); emergency status expired July 30, 2009

Regulation .10C, D amended effective July 27, 2009 (36:15 Md. R. 1165); September 20, 2010 (37:19 Md. R. 1284); October 14, 2013 (40:20 Md. R. 1652)

Regulation .10E amended as an emergency provision effective May 1, 1983 (10:7 Md. R. 632); adopted permanently effective May 9, 1983 (10:9 Md. R. 791)

Regulation .10-1 amended as an emergency provision effective July 1, 1992 (19:15 Md. R. 1382); amended permanently effective November 1, 1992 (19:21 Md. R. 1891)

Regulation .10-1C amended effective November 10, 2003 (30:22 Md. R. 1580)

Regulation .10-1C, E amended and G adopted effective November 12, 1990 (17:21 Md. R. 2529)

Regulation .10-1D amended effective October 8, 1991 (18:18 Md. R. 2005)

Regulation .11C amended effective September 10, 1994 (11:8 Md. R. 1584) June 2, 1997 (24:11 Md. R. 793)

Regulation .11E amended effective September 10, 1984 (11:18 Md. R. 1584)

Regulation .12B amended effective August 8, 1988 (15:16 Md. R. 1914)

Regulation .12C amended effective September 10, 1984 (11:18 Md. R. 1584)

Regulation .13 repealed and new Regulation .13 adopted effective March 19, 2012 (39:5 Md. R. 382)

Regulation .13C amended effective August 8, 1988 (15:16 Md. R. 1914)

Regulation .14 amended effective August 8, 1988 (15:16 Md. R. 1914)

Regulation .14 amended and recodified to Regulations .14 and .14-1 effective December 1, 1992 (19:23 Md. R. 2041)

Regulation .14B amended as an emergency provision effective May 1, 1984 (11:10 Md. R. 858); emergency status expired August 28, 1984

Regulation .14B amended effective August 29, 1984 (11:17 Md. R. 1492)

Regulation .15 amended effective August 8, 1988 (15:16 Md. R. 1914); July 3, 1995 (22:13 Md. R. 967)

Regulation .15 amended as an emergency provision effective October 13, 1992 (19:22 Md. R. 1979); amended permanently effective February 1, 1993 (20:2 Md. R. 113)

Regulation .15 amended as an emergency provision effective April 8, 1994 (21:9 Md. R. 744); emergency provision rescinded retroactively to April 8, 1994 (21:14 Md. R. 1226)

Regulation .15A-3 amended as an emergency provision effective November 12, 2002 (29:24 Md. R. 1915); amended permanently effective February 17, 2003 (30:3 Md. R. 179)

Regulation .17 adopted effective December 31, 2007 (34:26 Md. R. 2262)

Chapter revised effective January 6, 2014 (40:26 Md. R. 2162)

Regulation .02B amended effective September 11, 2017 (44:18 Md. R. 866); May 20, 2019 (46:10 Md. R. 486); April 4, 2022 (49:7 Md. R. 465); April 13, 2026 (53:7 Md. R. 328)

Regulation .03A amended effective August 5, 2024 (51:15 Md. R. 706)

Regulation .03A, C amended effective May 20, 2019 (46:10 Md. R. 486)

Regulation .03A, F amended effective April 4, 2022 (49:7 Md. R. 465)

Regulation .03F adopted effective May 20, 2019 (46:10 Md. R. 486)

Regulation .03-1 amended effective July 21, 2025 (52:14 Md. R. 712)

Regulation .04F amended effective March 28, 2016 (43:6 Md. R. 406)

Regulation .04-1D amended effective December 31, 2018 (45:26 Md. R. 1243)

Regulation .04-1M adopted effective May 7, 2018 (45:9 Md. R. 461)

Regulation .05-4B amended effective July 4, 2016 (43:13 Md. R. 713)

Regulation .07B, F amended effective April 13, 2026 (53:7 Md. R. 328)

Regulation .08-1B amended effective February 1, 2016 (43:2 Md. R. 127)

Regulation .08-2B, C amended effective April 10, 2017 (44:7 Md. R. 355); May 20, 2019 (46:10 Md. R. 486)

Regulation .08-2C amended effective August 29, 2016 (43:17 Md. R. 954)

Regulation .08-4 adopted effective April 13, 2015 (42:7 Md. R. 568)

Regulation .10C, D amended effective September 11, 2017 (44:18 Md. R. 866)

Regulation .10-2 adopted effective April 13, 2015 (42:7 Md. R. 568)

Regulation .12E adopted effective April 13, 2026 (53:7 Md. R. 328)

Regulation .15A-3 amended effective April 13, 2015 (42:7 Md. R. 568)