When a parent needs daily help and the budget can’t stretch
Most families reach this page after something changed. A fall in the bathroom, a discharge from Johns Hopkins Bayview, or a mother in Highlandtown who can no longer manage the stairs or the shower alone.
The 2024 Genworth/CareScout survey put the Maryland median for a home health aide at $80,080 a year, about $35 an hour at 44 hours a week (Genworth, 2024 Cost of Care Survey). That is statewide market data, not a Baltimore price quote.
For people who qualify, Medicaid home care in Maryland can cover much of that hands-on help. Which program fits depends on care needs, age, income and where the person lives today.
Maryland Medicaid waiver programs compared
People call all of these “waiver programs,” but each has its own entry rules.
| Community First Choice (CFC) | CPAS | Community Options Waiver | ICS | |
|---|---|---|---|---|
| Who qualifies | Full Medicaid, any age, living in the community | Full Medicaid, any age, living in the community | Age 18+, living at home or in the community, income up to 300% of SSI, limited assets | Age 18+, at least 6 months in a nursing facility, income above 300% of SSI, assets up to $2,500 |
| Level of care | Institutional (nursing facility) level | Help needed with at least one activity of daily living | Nursing facility level | Nursing facility level |
| Main services | Personal assistance, supports planning, nurse monitoring, meals, PERS, adaptations, technology, transition services | Personal assistance, nurse monitoring, supports planning | All Medicaid benefits including CFC, plus assisted living, case management, medical day care, family training, Senior Center Plus | Personal assistance, respite, assisted living, medical day care, adaptations, meals, PERS, supports planning |
| How to enter | MAP at 844-627-5465 or the CFC Program at 410-767-1739 | Same two lines as CFC | Join the registry through MAP; nursing facility residents with 30+ Medicaid-paid days can apply directly | Referral from Medicaid’s Eligibility Determination Division only |
| Registry or waitlist | Not described as a registry program; timing depends on the assessment and plan approval | Not described as a registry program | Yes: 23,461 people on June 30, 2025; 23,750 in an MDH table dated Feb. 23, 2026 | Authorized to enroll up to 100 people (June 2025 notice) |
Sources: MDH program pages for Community First Choice, CPAS, the Community Options Waiver and ICS; registry counts from MDH’s End the Wait report (October 2025) and its February 2026 waiver eligibility presentation; ICS enrollment cap from a June 2025 MDH demonstration notice.
CFC and CPAS both require full Medicaid first. MDH’s shorthand: you have full Medicaid if you have a red and white card. Since October 1, 2023, every CFC participant can choose an agency model or a self-directed model (CMS approval of Maryland SPA MD-23-0012). Each program has its own guide:
- Community First Choice in Maryland: services, both models and the family caregiver question.
- How CPAS differs from CFC: personal assistance below a nursing facility level of care.
- Our Community Options Waiver guide: dated registry numbers and the nursing facility route.
- The Increased Community Services program: for nursing facility residents whose income is too high for the CO Waiver.
Who qualifies for Maryland Medicaid home care
Every applicant goes through three checks, per MDH. The medical check uses a level-of-care tool. The technical check confirms permanent Maryland residence, a choice of home and community care over an institution, and a plan of service that supports health and welfare. The financial check reviews income and assets.
These are the 2026 numbers that come up most often:
| Figure | 2026 amount | Where it matters |
|---|---|---|
| SSI federal benefit, one person | $994 a month (SSA) | Base for every “300% of SSI” rule |
| 300% of SSI | $2,982 a month (3 × $994, our calculation) | CO Waiver income ceiling; PACE income ceiling; ICS serves people above it |
| CO Waiver countable assets | $2,000 or $2,500, by eligibility category | CO Waiver |
| ICS countable assets | $2,500 (applicant’s own assets only) | ICS |
| PACE countable assets | $2,000 | PACE, age 55+ |
| Medically needy resource standard | $2,500 one person, $3,000 a couple (COMAR 10.09.24.08) | Aged, blind and disabled medically needy groups |
CFC and CPAS don’t set their own income figure. They require full Medicaid, so the limits of the person’s Medicaid eligibility group apply. Our Maryland Medicaid eligibility page goes through those groups, the 60-month look-back and estate recovery.
Where Baltimore residents start: Maryland Access Point
Maryland Access Point (MAP) is the front door for nearly every program here, and most CFC referrals come from MAP specialists. Call the office where the person receiving care lives.
| Office | Phone | Address | What to ask for |
|---|---|---|---|
| MAP of Baltimore City | 410-396-CARE (2273), Mon–Fri 8:30 a.m.–4:30 p.m. | 417 East Fayette Street, 6th floor, Baltimore, MD 21202 | Options counseling, Benefits CheckUp (age 55+), a CFC or CPAS referral |
| Baltimore County Department of Aging / MAP | 410-887-2594 | 611 Central Avenue, Towson, MD 21204 | Long-term care options counseling, benefits screening, CO Waiver registry |
| Statewide MAP line | 1-844-627-5465 (1-844-MAP-LINK) or dial 211 | marylandaccesspoint.211md.org | Any program, if you’re unsure which office to call |
See the neighborhoods we serve across Baltimore, including Baltimore County.
How Medicaid home care in Baltimore gets started
The order varies by program, but most CFC and CPAS cases follow these steps:
- Call MAP. Describe the care needs and ask about CFC, CPAS or the CO Waiver registry. The Local Health Department or a family member can also refer.
- Confirm full Medicaid. If the person isn’t enrolled yet, MDH says long-term care Medicaid can be applied for online through MDThink.
- Complete the level-of-care assessment. Per a 2019 MDH training deck, a Local Health Department nurse or social worker does the interRAI assessment. It shows whether the person meets a nursing facility level of care or the lower CPAS level.
- Pick a supports planner. This independent case manager builds the person-centered plan of service with you. MDH or its designee reviews and approves every plan before services start.
- Choose a provider. The plan names the personal assistance provider and is signed by the participant or representative, the supports planner and the provider agency.
- Start services. Visits are tracked through electronic visit verification. MDH re-evaluates CFC eligibility every 12 months, or sooner if needs change.
Our step-by-step guide to applying has a documents checklist for each stage. If you’d like someone to go over these steps with you, call our Canton office at 410-421-1041.
How Medicare differs from Medicaid for home care
In Medicare’s own words, “Medicare doesn’t pay for long-term care,” meaning custodial help with daily activities, and Medigap doesn’t either (Medicare.gov, long-term care).
| Medicare home health | Maryland Medicaid home care | |
|---|---|---|
| Who it’s for | Homebound people who need part-time or intermittent skilled care | People with full Medicaid who meet a program’s level of care |
| What it covers | Skilled nursing, PT/OT/speech therapy, medical social services; an aide only alongside skilled care | Personal assistance with daily activities, plus program-specific services |
| What it won’t cover | 24-hour care, home-delivered meals, personal care when it’s the only care needed | Under CFC rules: room and board, and housekeeping unrelated to the person’s own care (COMAR 10.09.84.23) |
| Who orders it | A doctor or provider after an in-person visit | MDH approves a plan of service built with a supports planner |
| Cost to the patient | $0 for covered home health services | Covered when eligible and approved |
On Medicare.gov’s home health page, “homebound” means leaving home is inadvisable or takes significant help and effort. Medical trips and short outings such as religious services are allowed.
After a hospital stay, Medicare home health may send a nurse or therapist for a period of time. Non-medical post-hospital home care can cover the hours in between: meals, bathing help and getting to follow-up appointments.
Other Maryland programs worth asking MAP about
Ask about these during your MAP call too:
- PACE. For people 55 and older at a nursing facility level of care, with income up to 300% of SSI and assets up to $2,000 (MDH PACE page). MDH lists Hopkins ElderPlus, based at Johns Hopkins Bayview, at (410) 550-7044. Its 2021 service-area list included 21224 and 21231, so confirm current coverage with ElderPlus.
- Medical Day Care Services Waiver. Ages 16 and up, nursing facility level of care and a medical order. MDH’s February 2026 table shows no registry for it, and program days run at least four hours.
- DHS In-Home Aide Services. Help with personal care and chores for adults 18 and older, with limited funding prioritized for people at highest risk. In Baltimore City, DSS Adult Services is at 443-423-4214.
- Baltimore City Family Caregivers Program. Grants of $300 to $600 a year, subject to funds, for in-home help, respite and supplies (city caregiver support page). Call 410-396-1337.
The city grants can go toward respite care so a family caregiver can rest.
Where Beulah fits for Baltimore families on Medicaid
Beulah Home Care is a home care agency in Canton, Baltimore at 3700 O’Donnell Street. We serve Baltimore families who use Maryland Medicaid personal assistance programs, and our office helps families through the application steps: what to say on the MAP call, which documents to gather, and what to expect at the assessment.
We don’t decide eligibility. MDH, the Local Health Department and the supports planner do. We also can’t speed up approval or move anyone up the CO Waiver registry.
What we can do is provide the care once a plan is in place. That includes personal care at home and companion care. We also offer homemaker services, dementia home care, disability home care, 24-hour home care and live-in care.
Some families pay privately for a few hours a week while a Medicaid case is pending. The full list is on our home care services page. When you’re ready, request a free in-home consultation.
This page is general information, not legal or benefits advice. Program rules change, so confirm the details with Maryland Medicaid or Maryland Access Point before you act.
