Maryland Medicaid home care: Community First Choice and how to apply
Maryland pays for personal assistance and other help at home through Community First Choice, a Medicaid state plan benefit run by the Maryland Department of Health. There is no age limit, but you need institutional level of care.
Maryland pays for personal assistance and other help at home mainly through Community First Choice (CFC), a Medicaid state plan benefit run by the Maryland Department of Health. The Department lists no age limit, but you need institutional level of care and full Medicaid.
What CFC is
The Department of Health describes CFC as a state plan home and community-based services benefit that helps you get services and support in your home and community instead of in an institution. The Medicaid Administration runs it under COMAR chapter 10.09.84. See Community First Choice in Maryland.
Who qualifies
The Department says you must meet all three of these.
- Medical: you need institutional level of care.
- Technical: there is no age limit, and you must live in a community setting.
- Financial: you must already have full Medicaid. The Department says you have full Medicaid if you have a red and white card.
The page does not give income or asset limits, and we state none. Maryland's regulation adds that participants must live at home and have an active plan of service, and that eligibility is re-evaluated every 12 months or sooner after a significant change.
What it pays for
Besides all Medicaid covered services and benefits, the Department lists these CFC services: accessibility adaptations, assistive technology, consumer training, environmental assessments, home-delivered meals, nurse monitoring, personal assistance, personal emergency response systems, supports planning and transition services.
The regulation says personal assistance covers help with activities of daily living, delegated nursing functions in the plan of service, judgment-based protection from harm, related instrumental tasks and medication assistance when a physician orders it. It does not cover food costs or general housekeeping, and it may not be given to anyone other than the participant.
How to apply
The Department gives two numbers. Call Maryland Access Point at 844-627-5465, or the CFC Program at 410-767-1739. For general coverage help, Medicaid.gov lists Maryland Health Connection at 855-642-8572. The Department says the best way to know if you are eligible is to apply.
Who can give personal assistance
COMAR 10.09.84 says personal assistance providers must be licensed as a Residential Service Agency under COMAR 10.07.05. A registered nurse must assess new participants and delegate tasks to a certified nursing assistant or certified medication technician, and workers must have verified qualifications and a criminal history records check. The regulation also says the supports planner must support the participant to self-direct services, and that agencies must let participants exercise as much control as desired to select, train and schedule workers.
The regulation bars the agency from assigning the participant's representative, which includes a legal guardian and a parent or foster parent of a dependent minor, to provide services to that participant. It does not otherwise address whether relatives can be paid. We could not verify that from a Department page, so see paid family caregiver in Maryland for what to ask.
Limits in the regulation
The Department sets a personal assistance budget based on assessed need. Personal assistance up to 12 hours a day is paid in 15-minute units, and participants needing more than 12 hours a day are paid a daily rate. Personal assistance outside Maryland is covered for no more than 30 days per calendar year.
What we have not described
We did not read Department pages on Maryland's waivers, including the Home and Community-Based Options Waiver, the Community Pathways waiver for developmental disabilities or the Increased Community Services program, so we do not describe them. We also did not find a Department page about pay rates. Ask the Department.
Where Carevo fits
Carevo is a connection platform and directory. We do not run CFC, assess eligibility or vouch for providers. For paid help now, see home care in Maryland, home health in Maryland, nursing homes in Maryland and developmental disability services in Maryland.
Programs in Maryland
- Community First Choice (CFC): Community First Choice is a Maryland Medicaid benefit that pays for personal assistance and other supports at home. The Department of Health says there is no age limit, but you need institutional level of care.
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Common questions
Who runs Medicaid in Maryland?
The Maryland Department of Health. Medicaid.gov lists Maryland Health Connection at 855-642-8572 for coverage help.
What is Community First Choice?
The Department says Community First Choice (CFC) is a state plan home and community-based services benefit that helps you get services and support in your home and community instead of in an institution.
Who qualifies for CFC?
The Department lists three tests. Medical: you need institutional level of care. Technical: there is no age limit and you must live in a community setting. Financial: you must already have full Medicaid. The Department says the best way to know if you are eligible is to apply.
What does CFC pay for?
The Department lists accessibility adaptations, assistive technology, consumer training, environmental assessments, home-delivered meals, nurse monitoring, personal assistance, personal emergency response systems, supports planning and transition services, plus all Medicaid covered services and benefits.
Can a family member be paid in Maryland?
We could not verify this. The Maryland Department of Health CFC page and the regulation we read do not say which relatives may be paid. The regulation says personal assistance must come from a licensed Residential Service Agency, and bars the agency from assigning the participant's representative. Ask the CFC Program.
Does Carevo enroll people in CFC?
No. Carevo is a connection platform and directory. Call Maryland Access Point or the CFC Program.
Sources
- Maryland Department of Health: Community First Choice accessed October 27, 2026
- Maryland Division of State Documents: COMAR 10.09.84, Community First Choice accessed October 27, 2026
- Medicaid.gov: Where can people get help with Medicaid and CHIP accessed October 27, 2026
Review status: Carevo checked this page against the primary sources listed above. It has not been professionally reviewed by a registered nurse, licensed social worker, benefits counselor or attorney. See our editorial standards.
This page is general information, not financial, legal or medical advice. Rules and services vary by state and by individual circumstances. Use the official sources and decision-maker named on the page. Carevo is a connection platform, not a care provider.