Maryland Medicaid Waiver Programs Explained

A Guide for Families in Baltimore City & Baltimore County

Navigating long-term care options can be overwhelming for families, especially when trying to understand how to pay for services. For many seniors and adults with disabilities in Maryland, Medicaid Waiver Programs offer vital support that helps them remain safely at home rather than entering a nursing facility. As a nurse-owned agency, A Watchful Eye Homecare Agency helps families access and understand these programs every day.

This guide breaks down the major Maryland Medicaid waivers, eligibility basics, and how they help seniors stay independent.

What Is a Medicaid Waiver?

A Medicaid Waiver allows Maryland to “waive” certain federal Medicaid rules so individuals can receive long-term care services at home or in the community instead of a nursing home. These waivers fund services like:

• Personal care assistance

• Help with activities of daily living (ADLs)

• Case management

• Home modifications

• Assistive devices

• Meal support

• Transportation

• Respite services for caregivers

For many families, these waivers provide essential financial support for homecare services.

Major Maryland Medicaid Waiver Programs

1. Community Options Waiver (COW)

This is one of Maryland’s most widely used waivers for seniors.

Who It Helps:

• Adults age 18+ with physical disabilities

• Seniors age 65+ who meet nursing facility level of care

• Individuals who require ongoing personal care

Services May Include:

• Personal assistance (bathing, dressing, mobility)

• Case management

• Assistive technology

• Home modifications

• Home-delivered meals

• Medical supplies and equipment

Key Notes:

• There is a waiting list.

• You must meet both income and medical eligibility criteria.

2. Community First Choice (CFC)

A more flexible program that many Maryland seniors qualify for.

Who It Helps: Individuals who qualify for Medicaid and need help with daily activities.

Services Include:

• Personal care assistance

• Protective oversight

• Nurse monitoring

• Support planning

• Transition services for those leaving nursing facilities

Key Notes:

• No waiting list

• Helps people receive care at home rather than in an institution

3. Home and Community-Based Options Waiver (HCBS)

This program is for individuals who are medically eligible for a nursing home but wish to stay home.

Services Include:

• Personal care

• Respite services

• Adult medical day care

• Supports planning

• Home-delivered meals

• Medical supplies & equipment

Key Notes:

• Similar to the Community Options Waiver but with additional supports

• Often used for seniors with chronic conditions who wish to age in place

4. Model Waiver

Primarily for medically fragile individuals—often younger adults or children.

Who It Helps:

• Individuals under age 22 with complex medical needs

• Those who would otherwise require hospital-level care

Services Include:

• Private duty nursing

• Case management

• Specialized medical services

5. Medical Day Care Services

A benefit available to many waiver participants.

Includes:

• Nursing supervision

• Social activities

• Meals

• Therapy services

• Transportation

This is particularly helpful for seniors needing daily structure and monitoring.

General Eligibility Requirements

While each program has different criteria, most require:

1. Medical Eligibility

The individual must require a “nursing facility level of care,” meaning help is needed with:

• Mobility

• Personal care

• Medication management

• Chronic condition monitoring

• Cognitive safety supervision

2. Financial Eligibility

Medicaid evaluates:

• Monthly income

• Assets

• Insurance coverage

Maryland frequently adjusts these limits. If desired, I can also create a separate blog explaining income and asset rules.

How to Apply for a Medicaid Waiver in Maryland

1. Call Maryland Access Point (MAP) They are the gateway for assessments

2. Request a Level of Care Assessment A nurse or case worker evaluates the individual’s functional needs.

3. Complete a Medicaid Financial Application Through Maryland Health Connection (online or in person).

4. Join the Waiver Waiting List (if applicable) Some programs—like Community Options—have long wait times.

5. Select a Homecare Agency Once approved, families choose a provider like A Watchful Eye Homecare Agency to deliver services.

   
   

How A Watchful Eye Homecare Agency Supports Medicaid Participants

As a nurse-owned homecare agency proudly serving Baltimore City & County, we assist families by:

• Explaining waiver programs in simple terms

• Coordinating with case managers

• Conducting RN assessments and care planning

• Providing personal care, companionship, and medication reminders

• Supporting transitions from hospitals or rehab facilities

• Helping families stay safe, supported, and independent at home

We understand how overwhelming the Medicaid process can feel—and we’re here to guide you every step of the way.

Call to Action

If you think a loved one may qualify for a Maryland Medicaid Waiver, or if you need help starting the process, we are here to support you.

Contact A Watchful Eye Homecare Agency

Phone: 410-989-1135/443-381-3133/443-741-7138

Serving: Baltimore City & Baltimore County