If you are applying for Maryland Medicaid home care, one of the biggest questions is:
“Will we have to wait months before services start?“
The answer depends entirely on which Medicaid program the person receiving care qualifies for.
Some programs have no waitlist. Others have limited enrollment and may require waiting for an available slot.
Understanding the difference can set realistic expectations from the start.
Entitlement Programs: No Waitlist If Eligible
Maryland has two Medicaid home care programs that are considered entitlements:
- Community First Choice (CFC)
- Community Personal Assistance Services (CPAS)
If the person receiving care:
- Has full Maryland Medicaid
- Meets the required level of care
Then there is no enrollment cap and no waitlist under these programs [1].
Services can begin once:
- The state assessment is completed
- The Plan of Service is approved
- An official start date is issued
Approval still takes processing time — but there is no waiting for an open “slot.”
Waiver Programs: Limited Slots May Mean a Waitlist
Maryland also offers Home and Community-Based Services (HCBS) waiver programs, including:
- Community Options Waiver (CO)
- Increased Community Services (ICS)
Unlike entitlement programs, waiver programs have:
- Enrollment limits
- Budget caps
- A defined number of available participant slots
Because of this, individuals placed under CO or ICS may be placed on a waitlist if all slots are filled [2][3].
What Determines Whether You’re Placed in an Entitlement or Waiver Program?
Families cannot choose the program directly.
Placement depends on factors related to the person receiving care, including:
- Whether they meet Nursing Facility Level of Care
- Their Medicaid coverage group
- Financial eligibility rules
- The intensity and type of services required
- State program availability
In practice, many individuals seeking paid family caregiving services are approved under either:
- Community First Choice (CFC), or
- Community Options Waiver (CO)
The assessment and state review process determine the final program.
How Long Does Approval Take?
Even when there is no waitlist, there are still required steps:
- Referral through Maryland Access Point
- Functional assessment
- Plan of Service development
- State review and authorization
Services cannot begin until the official approval letter and start date are issued.
Processing time varies, but entitlement programs typically move faster than waiver programs when eligibility is clear.
Concerned About a Waitlist?
The most important step is understanding which pathway the person receiving care is likely to qualify for.
Our team works with families every day navigating:
- CFC eligibility
- CO placement
- Assessment preparation
- Caregiver onboarding timelines
If you’re unsure whether you may face a waitlist, call Concierge Home Care of Maryland or request a callback. We’ll be happy to help you understand the likely path based on your situation and guide you through the next steps.
References and Resources
[1] Maryland Community First Choice (CFC): Overview of eligibility and entitlement status.
[2] Maryland Community Options Waiver (CO): Program description and waiver enrollment structure.
[3] Maryland Increased Community Services (ICS): Description of ICS waiver and enrollment limitations.
