(667) 400-0648maryland@cottagehomecare.commaryland@cottagehomecare.com
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Maryland Community Options Waiver (HCBOW) 2026

The Community Options Waiver (HCBOW) covers services CFC doesn't — assisted living support, adult day care, home modifications, and respite care. The tradeoff: 24,015 people are on the statewide waitlist as of early 2025, with typical waits of several years. We help you apply for CFC immediately and add your name to the Community Options registry at the same time. Call (667) 400-0648.

Call (667) 400-0648Apply for CFC now and skip the waitlist
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Are you currently on Medicaid?

How to Apply

The process differs if you are in the community vs. a nursing home.

  1. 1

    In the Community

    You must join the Service Registry (waitlist). Call Maryland Access Point (MAP) to add your name.

  2. 2

    In a Nursing Home

    Nursing home residents are prioritized and can apply without waiting on the registry. Contact Long Term Care services for details.

  3. 3

    Approval

    The application process can take 3+ months. You must submit documentation including bank statements (60-month look-back period) and proof of income.

Eligibility Criteria

To qualify for the Community Options Waiver, applicants must meet the following strict criteria.

Medical & Demographic

  • Age/Disability: Must be elderly (65+) OR physically disabled (18+).

  • Level of Care: Must require a Nursing Facility Level of Care (NFLOC) as determined by the interRAI Home Care assessment.

  • Functional Need: Requires assistance with Activities of Daily Living (ADLs) such as bathing, grooming, and mobility.

Financial Limits (2026)

  • Income Limit: $2,982/month per applicant (300% of the 2026 Federal Benefit Rate of $994). Significantly higher than standard CFC — many families who don't qualify for CFC may qualify here. health.maryland.gov/mmcp/eligibility/Pages/incomelimits.aspx

  • Asset Limit: $2,000 for an individual applicant.

  • Spousal Rules: Non-applicant spouses can keep up to $157,920 in assets and may receive a Monthly Maintenance Needs Allowance up to $3,948.

Over the limits?

Strategies like "Medically Needy Spend-Down," Irrevocable Funeral Trusts, or Spousal Impoverishment rules may help you qualify. Consult a Medicaid Planner — or call (667) 400-0648 and we'll point you in the right direction.

Services Covered

Services can be received in a home or assisted living setting.

Assisted Living Services

Personal care and homemaker services in an assisted living facility. (Note: Room & board costs are NOT covered).

Adult Day Health Care

Daytime supervision, nursing services, and socialization in a community group setting.

Respite Care

Short-term care to provide relief for a primary unpaid caregiver.

Senior Center Plus

A structured program providing supervision and activities (no medical services provided).

Behavior Consultation

Assistance for caregivers in understanding and managing behavioral issues.

Family Training

Counseling and training services for unpaid family caregivers.

Nutritionist Services

Dietician services to support health needs.

Case Management

Professional coordination of your care plan and services.

What is the Community Options Waiver?

The Community Options Waiver was formerly known as the Waiver for Older Adults.

The Community Options Waiver provides services to prevent or delay nursing home admission. It allows elderly and disabled individuals to receive care in their own home, a relative's home, or an assisted living residence. Unlike other programs, this waiver's services are provided by licensed agencies and currently do not offer a self-directed option for hiring friends or relatives.

CFC vs Community Options Waiver

FeatureCFCCommunity Options
WaitlistNone24,000+ statewide
Income limit$350/month *$2,982/month
Covers home modificationsNoYes
Covers assisted livingNoYes
Covers adult day careNoYes
Family member as paid caregiverYes (self-direction)Limited

* CFC spend-down pathway applies — most Social Security incomes still qualify.

24,015 people are already on the CO Waiver waitlist — apply for CFC now and skip the wait

The Community Options Waiver has a long Service Registry waitlist. CFC is a separate Medicaid program with no waitlist — many families qualify for both. Check in 60 seconds.

Apply for CFC now and skip the waitlist

What if I disagree with a decision?

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.

Current Recipients

Appeal within 10 days of receiving the denial letter to keep current services in place.

New Applicants

Appeal within 90 days of receiving the denial letter.

Submit appeals in writing to

Maryland Department of HealthAttention: Medicaid Appeals
201 West Preston St., L9
Baltimore, MD 21201
Fax:(410) 333-5154
Email:mdh.medicaidappeals@maryland.gov

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.

What Maryland families say about the Community Options Waiver

Real stories from patients and caregivers who chose Cottage Home Care Maryland

  • Sarah Jenkins: 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.
  • Patricia Davis: The Community Options waiver program changed my life, and Cottage Home Care Maryland LLC made it happen. My caregiver is wonderful, and having that extra support for daily tasks has allowed me to maintain my independence.

Community Options frequently asked questions

What Maryland families ask about HCBOW eligibility, the waitlist, and covered services.

The Community Options Waiver is a Maryland Medicaid home and community-based waiver that helps eligible individuals receive services at home or in the community to avoid or delay nursing facility placement.

Yes. Applicants in the community must join the Maryland Service Registry waitlist through Maryland Access Point (MAP). Nursing home residents may be prioritized and can apply without waiting on the registry.

Applicants must meet Maryland Medicaid financial and medical eligibility, require a nursing facility level of care, and meet program-specific criteria reviewed during the application process.

Covered services can include personal care, adult day health care, respite care, assisted living services (excluding room and board), environmental modifications, and other supports defined in an approved plan of care.

Call (667) 400-0648. If you are in the community, MAP will add you to the Service Registry. Nursing home residents can contact Long Term Care services. Cottage Home Care Maryland guides families through eligibility and provider enrollment.

CFC is an entitlement program with no waitlist focused on personal care at home. The Community Options Waiver offers a broader benefit package but has a waitlist and different eligibility pathways.

On the waitlist? CFC may let you start sooner.

(667) 400-0648

Community Options home care by Maryland county

Cottage Home Care Maryland serves families statewide. Select a county to view local programs, service areas, and enrollment support.