Community Options Waiver (HCBOW)
Providing home and community-based supports for Maryland residents who are at risk of nursing home placement.
To get the service, please fill out the form.
Overview of the Community Options Waiver
Formerly known as the Waiver for Older Adults.
The Community Options Waiver provides services to prevent or delay nursing home admission. It allows elderly and disabled individuals to receive care in their own home, a relative's home, or an assisted living residence. Unlike other programs, waiver services are provided by licensed agencies and currently do not offer a self-directed option for hiring friends or relatives.
Important: Waitlist Information
This is not an entitlement program. Meeting eligibility requirements does not guarantee immediate benefits. As of Jan 31, 2025, there are 24,015 persons on the Service Registry (waitlist). The state invites approximately 700 people to apply each month.
Eligibility Criteria
To qualify for the Community Options Waiver, applicants must meet the following strict criteria.
Medical & Demographic
Age/Disability: Must be elderly (65+) OR physically disabled (18+).
Level of Care: Must require a Nursing Facility Level of Care (NFLOC) as determined by the interRAI Home Care assessment.
Functional Need: Requires assistance with Activities of Daily Living (ADLs) such as bathing, grooming, and mobility.
Financial Limits
Income Limit: $2,901 / month per applicant (300% of Federal Benefit Rate).
Asset Limit: $2,000 for an individual applicant.
Spousal Rules: Non-applicant spouses can keep up to $157,920 in assets and may receive a Monthly Maintenance Needs Allowance up to $3,948.
Over the limits?
Strategies like "Medically Needy Spend-Down," Irrevocable Funeral Trusts, or Spousal Impoverishment rules may help you qualify. Consult a Medicaid Planner.Services Covered
Services can be received in a home or assisted living setting.
Assisted Living Services
Personal care and homemaker services in an assisted living facility. (Note: Room & board costs are NOT covered).
Adult Day Health Care
Daytime supervision, nursing services, and socialization in a community group setting.
Respite Care
Short-term care to provide relief for a primary unpaid caregiver.
Senior Center Plus
A structured program providing supervision and activities (no medical services provided).
Behavior Consultation
Assistance for caregivers in understanding and managing behavioral issues.
Family Training
Counseling and training services for unpaid family caregivers.
Nutritionist Services
Dietician services to support health needs.
Case Management
Professional coordination of your care plan and services.
How to Apply
The process differs if you are in the community vs. a nursing home.
In the Community
You must join the Service Registry (waitlist). Call Maryland Access Point (MAP) at (667) 400-0648 to add your name.
In a Nursing Home
Nursing home residents are prioritized and can apply without waiting on the registry. Contact Long Term Care services at (667) 400-0648.
Approval
The application process can take 3+ months. You must submit documentation including bank statements (60-month look-back period) and proof of income.
Frequently Asked Questions
You may be eligible for Homecare.
To qualify for home care services, please complete the form. A member of our team will reach out to you at a convenient time.
Discuss Your Care Options Today
We can help you determine the best payment path for your needs.