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Understanding guardianship and power of attorney in Medicaid

On Behalf of | Feb 18, 2026 | Medicare

When a loved one cannot make decisions, you often need to help with the Medicaid application. You may act as a guardian or as a person with power of attorney (POA). The type of authority you have can affect how quickly the process moves and how difficult it becomes.

How guardianship affects Medicaid applications

Guardianship is a court process. In Maryland, a judge gives you the power as guardian of the property to manage your loved one’s money. Under the state’s law, you often must ask the court before you sell a home or move large assets.

Maryland Medicaid uses a strict 60-month look-back period. Reviewers check financial activity from the last five years. They look for money you gave away or moved without a clear reason. You must keep very clear records. If you cannot explain spending, Medicaid may give you a penalty or deny benefits.

Maryland courts treat guardianship as a last option. However, you may need it if your family does not have a POA or legal plan.

How the power of attorney affects Medicaid applications

You sign a POA while you can still make decisions. This document allows a trusted person to manage your money and handle legal tasks for you. In Maryland, you can often use a POA faster than you can go through court. However, the document must use clear, specific language.

Under the Maryland General and Limited Power of Attorney Act, your agent usually cannot give away assets or do Medicaid planning unless your POA clearly allows it. If your POA is too limited or missing gifting language, your family may still need guardianship to finish the Medicaid process.

What families should consider before applying

Guardianship and POA follow different rules. They also follow different timelines. Maryland Medicaid rules are strict. Small document mistakes can cause long delays in getting care. You may speak with an attorney to help you review documents and check the five-year look-back rules before applying.

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