Maryland
Community Options Waiver (CO Waiver)
Self-directed care programs in Maryland that let you choose your own personal assistant or pay a family member as your caregiver.
Community Options Waiver
Wait: 24,000+PA Hourly Rate
$15.00 - $20.00
per hour
Monthly Benefit
$1,200 - $4,000
estimated range
What You Can & Can't Do
What You Can Do
- Hire your spouse or family members as paid caregivers
- Self-direct your services and choose your providers
- Receive personal assistance, respite, and environmental adaptations
- Access Community First Choice while waiting for CO Waiver
- Have a supports planner help coordinate your care
- Request changes to your service plan at any time
What You Can't Do
- Skip the waitlist for the CO Waiver
- Use waiver funds for room, board, or rent
- Receive services while in a nursing facility
- Use funds for medical or skilled nursing care
- Hire a caregiver who fails the background check
- Exceed your approved budget or service hours
How to Apply
Apply for Maryland Medicaid
Ensure Medicaid enrollment through Maryland Health Connection or local Department of Social Services.
Contact Maryland Access Point (MAP)
Call (844) 627-5465 to request a referral for the Community Options Waiver.
Complete level of care assessment
A nurse evaluates whether you meet nursing facility level of care criteria.
Join the CO Waiver waitlist
If eligible, you'll be placed on the waitlist (24,000+ people). Consider CFC as an immediate alternative.
Receive waiver enrollment
When a slot opens, you'll be contacted to begin the enrollment process.
Develop service plan with supports planner
Create an individualized plan specifying your services, providers, and self-directed budget.
Hire and enroll caregivers
Recruit caregivers and complete enrollment through the fiscal management service.
PA Documents & Requirements
What your personal assistant needs to get started in Maryland
Government-issued photo ID
Valid Maryland driver's license, state ID, or passport
Social Security card
For payroll processing
W-4 tax withholding form
Federal tax withholding
I-9 Employment Eligibility
Work authorization documentation
Maryland criminal background check
CJIS background check through Maryland State Police
OIG exclusion check
Clearance from the Office of Inspector General exclusion list
Direct deposit form
Banking details for payroll
Frequently Asked Questions
What is the Community Options Waiver in Maryland?
The CO Waiver provides home and community-based services as an alternative to nursing home placement, with a self-directed option that lets you hire and manage your own caregivers.
Can my spouse be my caregiver in Maryland?
Yes. Maryland allows spouses to serve as paid caregivers under the Community Options Waiver self-directed services.
How long is Maryland's waitlist?
Maryland's CO Waiver has one of the longest waitlists in the country with over 24,000 people waiting. The wait can extend for many years.
Are there alternative programs while I wait?
Yes. Maryland's Community First Choice (CFC) program is a Medicaid state plan option with no waiver waitlist. It provides personal assistance services including a self-directed option.
What services does the CO Waiver cover?
Personal assistance, respite care, environmental accessibility adaptations, assistive technology, family training, and more — all designed to support community living.
What is the Supports Planning role?
A supports planner helps you develop your individual plan of service, coordinate your care, and monitor your satisfaction with services.
Ready to check your eligibility?
Answer a few questions and we'll tell you if you qualify for Maryland's CO Waiver program.