CFC caregiver supporting a senior at home in Maryland

Maryland Community First Choice (CFC) Program 2026

CFC is a Maryland Medicaid entitlement with no waitlist. Qualify and start — no registry, no delays. A family member can often be your paid caregiver.

Eligible family members can provide care and earn income while supporting their loved ones at home. Contact our Maryland team to check eligibility — free, no obligation.

Call (667) 400-0648Check CFC Eligibility Free
CHAP Certified BadgeTop Rated BadgeLicensed Badge
★★★★★

5-Star Reviews

Are you looking for care for?
Are you currently on Medicaid?

What is Community First Choice?

A Medicaid Program for Older Adults and Persons with Disabilities.

Community First Choice (CFC) helps you stay in your own home and get help with everyday activities. It is part of the Medicaid program (Medical Assistance).

Do I have to be on a Waiver?

No. You do not have to be on a Medicaid Waiver (like the Home and Community-Based Options Waiver) to get CFC services. While waiver recipients can receive CFC, it is not required. There is no waiting list for CFC services. Even if you were previously told that a registry or waiting list was too long, you should still apply for CFC.

Who is Eligible?

To qualify for the Community First Choice program, you must meet both financial and medical eligibility criteria for Medical Assistance.

Medical Need

You must require significant assistance with at least two Activities of Daily Living (ADLs) to meet the medical necessity criteria:

1

Bathing

2

Eating

3

Dressing

4

Toileting

5

Mobility (walking, using stairs, getting in/out of bed)

Eligibility

FeatureEligible for CFC
Medicaid
Medicaid & Medicare
Medicaid Waiver
Private Insurance Only
Medicare Only
QMB Only
SLMB Only

How is the Plan Determined?

The process for determining your plan of service.

  1. Assessment

    A nurse from the local health department evaluates your medical needs. This determines your eligibility and your "personal budget" (how much the State will spend on your care).

  2. Planning

    A Supports Planner assists you in determining what help you need. They prepare a written "plan of service" based on your budget and needs.

  3. Approval

    Medicaid staff reviews the assessment and plan. Based on this information, Medicaid will either approve or deny your plan of service.

Your Rights Under CFC

You have the right to have as much control as possible over the care you receive.

Plan of Service

You have the right to develop a plan so you can get personal assistance with life activities, including:

  • Planning and preparing meals
  • Light chores & grocery shopping
  • Traveling & using the phone
  • Managing finances

Choice & Control

You have the right to:

  • Choose your Supports Planning Agency.
  • Choose the person who provides care for you.
  • Decide the schedule for that person.
  • Decide you no longer want someone to care for you.

Additional Services

Medical Equipment

Durable medical equipment and disposable medical supplies.

Home Delivered Meals

Nutritious meals delivered to your door.

Accessibility Adaptations

Modifications to your home to improve safety and access.

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 Community First Choice home care

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

FAQ

CFC is a Maryland Medicaid program that lets seniors and individuals with disabilities receive nursing-level personal care in their own home — rather than a nursing facility — at no cost to the participant.

No. Unlike the Community Options Waiver, CFC is an entitlement program — if you qualify medically and financially through Medicaid, you can begin receiving services immediately with no waitlist.

You must be enrolled in Maryland Medicaid (Medical Assistance) and require assistance with at least two Activities of Daily Living (ADLs) such as bathing, dressing, eating, toileting, or mobility.

Yes, in most cases. Under CFC self-direction, an adult child, sibling, or qualifying friend can be enrolled as your paid caregiver. Maryland explicitly allows spouses as paid caregivers under self-directed CFC — one of the few states that does. Under the standard agency-directed model, spouses are excluded. Parents of children under 18 are excluded in all cases. All caregivers must pass a background check and complete enrollment before starting.

CFC covers assistance with bathing, dressing, grooming, meal preparation, mobility, toileting, light housekeeping, grocery shopping, medication reminders, and transportation to appointments.

Call (667) 400-0648 or submit our online form. We will verify your Medicaid status, request a needs assessment by a local health department nurse, and guide you through your Plan of Service at no charge.

Yes. You have the right under CFC to choose or change your Supports Planning Agency at any time. Switching providers does not affect your approved plan of service or Medicaid eligibility.

Ready to Live Independently?

Get the support you need in your own home.

Call (667) 400-0648
Statewide in Maryland

Counties We Serve

Community First Choice, Community Options Waiver, and Private Pay home care — available in every county below. Select yours to see programs and how we help local families.

24

Counties

Click any to learn more

Not sure which program fits your family? Our advisors serve all 24 counties at no cost.

Call (667) 400-0648