Home Care Covered by Medicaid

Yes. Maryland Medicaid covers in-home personal care through two main routes, and the difference between them matters more than most families realize.

Community First Choice (CFC) is an entitlement program. If you qualify, you receive services — there is no waiting list.

The Community Options Waiver covers people who need a nursing-home level of care and adds services beyond CFC, but it uses a registry with a wait that can run for years.

Both cover personal care: bathing, dressing, toileting, mobility, meals, and supervision at home. Waiver participants also receive CFC services, so you do not need the waiver to get personal care.

Start at Maryland Access Point — 844-627-5465 — or call us at (443) 402-1039 and we will tell you which route fits. You can also read our full guide to Community First Choice and the no-waiting-list rule.

It depends entirely on which program.

Community First Choice has no waiting list. It is an entitlement, so if you meet the eligibility criteria, services can begin without waiting for a slot.

The Community Options Waiver does have one. More than 20,000 Marylanders were on the registry in early 2026, and only a few hundred are invited to apply each month.

Families are often told “there is a waiting list for Medicaid home care” and give up. That statement is true of the waiver and false of CFC. If someone told you to wait, it is worth a second conversation.

One important exception: if the person is currently in a nursing facility and Medicaid has paid for at least 30 days, they may be able to apply for the Community Options Waiver without going through the registry. Ask the facility's social worker for a referral to an options counselor. We explain this in detail on our Community First Choice page.

Three things have to line up: clinical need, financial eligibility, and Maryland residency.

Clinical need is established through the health department nurse assessment. Financial eligibility uses Medicaid's long-term care rules, which are more generous than standard Medicaid — many people who assume they earn too much still qualify, and married couples have separate protections so the spouse at home is not left without income.

Because the limits change each January, confirm current figures with Maryland Access Point at 844-627-5465 or your local Department of Social Services rather than relying on a number you read online.

Five steps:

1. Start with Maryland Access Point (844-627-5465) or apply for Maryland Medicaid if not already enrolled. MAP is the state's single entry point for long-term services.
2. A nurse from your local health department completes an in-person assessment.
3. The assessment determines eligibility and builds the plan of care, including how many hours are authorized.
4. You choose a Supports Planning Agency — they coordinate services on your behalf.
5. You choose your provider agency. This choice is yours, not the state's.

The most common place families stall is between steps one and two. If you have called and heard nothing, call again — and call us at (443) 402-1039, because we do this weekly.

A waiver lets Medicaid pay for care at home for someone who would otherwise need a nursing facility. Maryland's main one for older adults and adults with physical disabilities is the Community Options Waiver.

It covers what CFC covers, plus additional supports, and can be used in assisted living — though the waiver does not pay room and board there.

The waiver has a registry with a long wait. Community First Choice does not, and it covers the personal care most families are actually looking for. If you are waiting on the waiver for help with bathing and dressing, ask about CFC.

In many cases, yes. Maryland's self-directed option lets a participant hire and manage their own caregiver, and that caregiver can be a family member.

Rules about which relatives can be paid depend on the program and the relationship, and they change — so confirm your specific situation with Maryland Access Point at 844-627-5465 before making plans around it.

We help families set this up, including in cases where the daughter or son providing care is leaving a job to do it. See our full guide to getting paid to care for a family member in Maryland.

Yes, if your parent meets the clinical and financial criteria — and the personal care most families need comes through Community First Choice, which has no waiting list.

Many families rule themselves out on income before checking. Medicaid's long-term care rules are more generous than standard Medicaid, and a spouse remaining at home is protected from being left without income. Start with Maryland Access Point at 844-627-5465, or call us at (443) 402-1039 and we will walk you through it.

Personal care is the core: bathing, dressing, toileting, mobility and transfers, meal preparation, and supervision at home. Community First Choice also covers things that keep someone safely independent, such as help with household tasks and assistive technology.

The Community Options Waiver adds supports on top of that, including respite for family caregivers and environmental modifications, and can be used in assisted living — though it does not pay room and board there.

How many hours you receive is set by the nurse assessment, not by request. We help families understand what the plan of care authorizes and how to ask for a reassessment if needs change.

Yes. Dementia care at home is covered through the same personal care programs — there is no separate dementia waiver to apply for. The assessment accounts for supervision and cueing needs, not just physical assistance, which often means more authorized hours than families expect.

Our caregivers are trained in dementia-specific approaches: consistent routines, redirection rather than correction, and safety monitoring for wandering and falls. See our dementia and Alzheimer's care program.