If you are caring for a loved one at home in Maryland, you may be wondering:
“Can I get paid to take care of my family member?”
The answer is yes — in many cases, Maryland Medicaid allows approved family members or friends to be paid caregivers through specific Home and Community-Based Services (HCBS) programs.
Below is a clear breakdown of which programs allow this and how they work.
Maryland Medicaid Programs That May Pay Family Caregivers
Maryland offers several Medicaid-funded programs that provide in-home personal assistance instead of nursing facility care.
The primary programs that may allow payment to family or friend caregivers are:
- Community First Choice (CFC)
- Community Personal Assistance Services (CPAS)
- Community Options Waiver (CO)
- Increased Community Services (ICS)
All of these operate under Maryland’s Medicaid Home and Community-Based Services (HCBS) structure [1][2].
1. Community First Choice (CFC)
CFC is a Medicaid entitlement program, meaning there is no enrollment cap or waitlist if eligibility requirements are met.
To qualify, the person receiving care must:
- Have full Maryland Medicaid
- Meet a Nursing Facility Level of Care
- Require assistance with activities of daily living (ADLs)
CFC allows personal assistance services to be delivered at home and may allow family or friends (with some restrictions) to be paid caregivers [3].
CFC is one of the most common pathways for families seeking compensation.
2. Community Personal Assistance Services (CPAS)
CPAS is also an entitlement program.
It is designed for individuals who:
- Have full Maryland Medicaid
- Need help with at least one activity of daily living
- Do not meet Nursing Facility Level of Care
Think of CPAS as support for moderate care needs, while CFC supports higher care needs [4].
Like CFC, CPAS may allow payment to eligible family or friend caregivers.
3. Community Options Waiver (CO)
The Community Options Waiver is an HCBS waiver program, not an entitlement.
That means:
- There are limited enrollment slots
- A waitlist may apply
- Additional financial eligibility rules may apply
CO serves individuals who meet Nursing Facility Level of Care and require long-term services and supports in the community [5].
This program may allow family caregivers to be paid if approved.
4. Increased Community Services (ICS)
ICS is another waiver-based HCBS program for individuals who meet Nursing Facility Level of Care and require extensive services to remain in the community [6].
Because it is a waiver program:
- Enrollment capacity is limited
- Waitlists may exist
Family or friend caregivers may be paid depending on eligibility and service approval.
Who Cannot Be Paid As a Family or Friend Caregiver?
Under Maryland Medicaid personal assistance programs, the following individuals generally cannot be paid caregivers:
- A spouse of the person receiving care
- A parent caring for their minor child
- A legal guardian or authorized decision-maker
All caregivers must pass background checks and meet program requirements.
Entitlement vs. Waiver: Why It Matters
Understanding the difference between entitlement programs (CFC, CPAS) and waiver programs (CO, ICS) is critical.
| Program Type | Waitlist? | Enrollment Cap? |
|---|---|---|
| Entitlement (CFC, CPAS) | No | No |
| Waiver (CO, ICS) | Possible | Yes |
If someone qualifies for CFC or CPAS, services can begin once approved.
If someone is placed under CO or ICS, they may need to wait for an available slot.
The state determines placement based on:
- Level of care assessment
- Medicaid coverage group
- Financial eligibility
- Type and intensity of services needed
Families cannot choose the program directly — eligibility determines the pathway.
How to Start the Process
To begin:
- Confirm the person receiving care has full Maryland Medicaid.
- Contact Maryland Access Point (844-627-5465) to initiate an HCBS referral.
- Complete the state functional assessment.
- Develop a Plan of Service.
- Await state approval and proceed with caregiver onboarding with Concierge
- Receive your approval letter with the authorized start date.
- Finish paperwork with Concierge and start services.
Only after state approval can paid services begin.
Not Sure Which Program You’ll Qualify For?
The state determines eligibility — but you don’t have to navigate the process alone.
In our experience, most families we work with are ultimately approved under either:
- Community First Choice (CFC), or
- Community Options Waiver (CO)
The exact program depends on the person receiving care’s Medicaid status, level of care assessment, and financial eligibility.
If you’re caring for a loved one and wondering:
- “Can I get paid for this?”
- “Will we be on a waitlist?”
- “Do we qualify for CFC or something else?”
Our team can help you understand the process, prepare for the assessment, and move forward with confidence.
Call Concierge Home Care of Maryland or request a callback to discuss your situation and next steps.
References and Resources
[1] Maryland Department of Health – Home and Community-Based Services (HCBS): Overview of Maryland’s Medicaid HCBS structure and program framework.
[2] Maryland Medicaid Long-Term Services and Supports (LTSS): State explanation of long-term services and community-based options.
[3] Maryland Community First Choice (CFC) Program: Program details, eligibility criteria, and covered services.
[4] Community Personal Assistance Services (CPAS): Information on eligibility and services for individuals not meeting NFLOC.
[5] Community Options Waiver: Program overview and eligibility information.
[6] Increased Community Services (ICS): Description of ICS waiver services and eligibility requirements.
