Community Options Waiver
Maryland's Medicaid Home and Community-Based Services waiver: how it works, who qualifies, and how to apply.
Community Options Waiver
Medicaid Waiver / HCBS, Home and Community-Based Services Waiver
What Is the Community Options Waiver?
It is Maryland's Medicaid program that helps pay for care in an assisted living facility for adults who need a nursing home level of care but would rather stay in the community. It is run by the Maryland Department of Health and funded jointly by the state and federal government.
The waiver pays your facility, not you. It covers assisted living services. It does not cover room and board, which you pay from your own income.
You may also see this program called:
- Home and Community-Based Services Waiver
- Medicaid Waiver
- Medicaid Community Options Waiver
- HCBS
- HCBS Waiver
Who May Qualify
- Age 18 or older, with no upper age limit
- Need a nursing home level of care, confirmed by an in-home assessment
- Enrolled in Maryland Medicaid, or eligible to enroll
- Meet the Medicaid income and asset limits shown below
- Choose to receive care in an assisted living facility rather than a nursing home
Only certain assisted living facilities accept the Community Options Waiver
Facilities have to apply for and maintain a separate state certification to take part, and many Maryland facilities are not certified. A facility being licensed does not mean it accepts the waiver. If you move into one that is not certified, the waiver cannot pay for your care there, so check before you choose.
Financial Eligibility
These are the 2026 limits Maryland uses to decide whether you qualify financially.
Income limit
$2,982
per month
Per person. 300% of the 2026 SSI rate.
Asset limit
$2,000
to $2,500 per person
Depends on your eligibility category. $3,000 for a couple.
Room and board you pay
Up to $420
per month
Paid from your own income, not by the waiver.
How much the waiver pays
Maryland does not send you a monthly check. It reimburses your assisted living facility for services, up to a maximum daily rate set by state regulation and based on your level of care. Level I assisted living is not covered by the waiver.
| Level of care | Maximum per day | Roughly per month |
|---|---|---|
| Level II | $90.74 | about $2,720 |
| Level III | $114.51 | about $3,435 |
Rates are set by COMAR 10.09.54.22, effective July 1, 2024, and are adjusted with the state budget. Confirm the current rate with your Maryland Access Point office.
How to Apply
If you have never dealt with Medicaid before, start here. The whole process begins with one phone call.
- 1
Call Maryland Access Point
Call your county office from the list below, or the statewide line at 1-844-627-5465. You do not need to know any jargon. Tell them: “I would like to get on the Community Options Waiver registry.” They will explain that a short screening has to happen first.
- 2
Complete the screening
A counselor asks about roughly 31 questions covering health and medical conditions, day-to-day tasks you need help with, your living situation, the help you already get from family or caregivers, and anything making it unsafe to stay where you are. Staff call this the Level 1 Screen. Completing it puts you on the registry.
- 3
Ask how you will be notified
Maryland sorts the registry into priority groups based on risk, and priority group 1 is the most urgent. Your score is not published, so staff may not be able to tell you your group. Ask instead what happens next and how you will be contacted, and confirm they have a phone number and address that will still reach you in a year.
- 4
Watch for your invitation and respond right away
Being on the registry is not the same as being approved. When your invitation arrives you still have to complete an application, an in-home assessment, and a separate Medicaid financial review. Invitations expire, and Maryland has estimated that only about a quarter of people invited respond in time. This is the single most avoidable way to lose a place you waited years for.
Be realistic about the wait
The registry is long. At the end of the 2025 fiscal year, 23,461 people were on it. Maryland's federal waiver application estimates that people in priority group 1 are usually invited to apply within about three months. Maryland does not publish estimates for any other group, and lower-priority applicants often wait years. Get on the registry as early as you can, because a share of invitations still go in the order people signed up.
Already in a nursing home? You can skip the registry
If you have had 30 or more days of nursing facility care paid by Medicaid, you can apply for the waiver directly instead of waiting on the registry, and use it to move into assisted living. Ask the nursing home's social worker to start this for you.
Has Your Situation Changed?
Call your Maryland Access Point office if health declines, a caregiver is no longer able to help, housing becomes unstable, or home stops feeling safe. Maryland recalculates registry priority automatically from the information it has on file, so an out-of-date record can hold you in a lower priority group than your situation warrants.
Keep your phone number and address current for the same reason. People who cannot be reached have been removed from the registry in the past, and there is no benefit to discovering that years later.
Maryland Access Point (MAP) / Information & Assistance
This is the county office that screens you for the Community Options Waiver. Counties use both names for it. Call yours to start, or use the statewide line if you are not sure which office covers you.
Not sure which office to call? Statewide help line
1-844-627-5465 (1-844-MAP-LINK)
Also see
SOAR (Supporting Older Adults with Resources) Guide