CFC is a Maryland Medicaid entitlement with no waitlist. Qualify and start — no registry, no delays. A family member can often be your paid caregiver.
Eligible family members can provide care and earn income while supporting their loved ones at home. Contact our Maryland team to check eligibility — free, no obligation.
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A Medicaid Program for Older Adults and Persons with Disabilities.
Community First Choice (CFC) helps you stay in your own home and get help with everyday activities. It is part of the Medicaid program (Medical Assistance).
No. You do not have to be on a Medicaid Waiver (like the Home and Community-Based Options Waiver) to get CFC services. While waiver recipients can receive CFC, it is not required. There is no waiting list for CFC services. Even if you were previously told that a registry or waiting list was too long, you should still apply for CFC.
To qualify for the Community First Choice program, you must meet both financial and medical eligibility criteria for Medical Assistance.
You must require significant assistance with at least two Activities of Daily Living (ADLs) to meet the medical necessity criteria:
Bathing
Eating
Dressing
Toileting
Mobility (walking, using stairs, getting in/out of bed)
| Feature | Eligible for CFC |
|---|---|
| Medicaid | |
| Medicaid & Medicare | |
| Medicaid Waiver | |
| Private Insurance Only | |
| Medicare Only | |
| QMB Only | |
| SLMB Only |
The process for determining your plan of service.
A nurse from the local health department evaluates your medical needs. This determines your eligibility and your "personal budget" (how much the State will spend on your care).
A Supports Planner assists you in determining what help you need. They prepare a written "plan of service" based on your budget and needs.
Medicaid staff reviews the assessment and plan. Based on this information, Medicaid will either approve or deny your plan of service.
You have the right to have as much control as possible over the care you receive.
You have the right to develop a plan so you can get personal assistance with life activities, including:
You have the right to:
Durable medical equipment and disposable medical supplies.
Nutritious meals delivered to your door.
Modifications to your home to improve safety and access.
If your plan of service is denied, or if you disagree with any decision about your case made by Medicaid, you have a right to appeal.
Appeal within 10 days of receiving the denial letter to keep current services in place.
Appeal within 90 days of receiving the denial letter.
You can also request a fair hearing online through the Maryland Medicaid appeals portal. Always follow the instructions on your denial notice if they differ.
Real stories from patients and caregivers who chose Cottage Home Care Maryland
“I'm proud to work with Cottage Home Care Maryland LLC. Whether I'm assisting a CFC client or a Private Pay family, the agency ensures we have the resources to provide top-notch care. It's a supportive environment for staff and patients alike.”
Maria Sanchez
“Navigating the Community First Choice (CFC) program seemed complicated until I called Cottage Home Care Maryland LLC. They handled the paperwork and set me up with excellent care. I'm grateful to stay in my own home comfortably.”
Robert Mitchell
“As a caregiver here, I appreciate how Cottage Home Care Maryland LLC manages the Community Options and CFC cases. The communication is excellent, and they truly match us with patients where we can make the biggest difference.”
Sarah Jenkins
“Cottage Home Care Maryland LLC goes above and beyond. From explaining the CFC benefits to ensuring my home care schedule works for me, they have been professional and caring every step of the way.”
Harold Thompson
What Maryland families ask about CFC eligibility, income limits, and paying a family member as a caregiver.
CFC is a Maryland Medicaid program that lets seniors and individuals with disabilities receive nursing-level personal care in their own home — rather than a nursing facility — at no cost to the participant.
No. Unlike the Community Options Waiver, CFC is an entitlement program — if you qualify medically and financially through Medicaid, you can begin receiving services immediately with no waitlist.
You must be enrolled in Maryland Medicaid (Medical Assistance) and require assistance with at least two Activities of Daily Living (ADLs) such as bathing, dressing, eating, toileting, or mobility.
Yes, in most cases. Under CFC self-direction, an adult child, sibling, or qualifying friend can be enrolled as your paid caregiver. Maryland explicitly allows spouses as paid caregivers under self-directed CFC — one of the few states that does. Under the standard agency-directed model, spouses are excluded. Parents of children under 18 are excluded in all cases. All caregivers must pass a background check and complete enrollment before starting.
CFC covers assistance with bathing, dressing, grooming, meal preparation, mobility, toileting, light housekeeping, grocery shopping, medication reminders, and transportation to appointments.
Call (667) 400-0648 or submit our online form. We will verify your Medicaid status, request a needs assessment by a local health department nurse, and guide you through your Plan of Service at no charge.
Yes. You have the right under CFC to choose or change your Supports Planning Agency at any time. Switching providers does not affect your approved plan of service or Medicaid eligibility.
Cottage Home Care Maryland serves families statewide. Select a county to view local programs, service areas, and enrollment support.
