How to Pay for In-Home Care
How to Pay for Home Care in Maryland
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
Maryland families typically start with Maryland Access Point (MAP) to screen for the Community First Choice (CFC) and Community Personal Assistance Services (CPAS) Medicaid programs, then look at the Community Options waiver and Increased Community Services (ICS) for nursing-home-level care at home. Veterans and their spouses should check VA Aid and Attendance alongside Structured Family Caregiving-style Attendant Care options, while adults with developmental disabilities can pursue DDA self-direction and Living Independently Support Services (LISS). Family caregivers can also look at caregiver support programs and other cost-offset options that stack with these core pathways.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Maryland Medicaid / CFC
Community First Choice (CFC)
YesHelps pay for: State-plan HCBS that helps Medicaid participants who need an institutional level of care receive supports at home and in the community.
Who qualifies: Full Maryland Medicaid, institutional level of care, and community residence. No age limit.
How to start: Call Maryland Access Point and request CFC screening/assessment.
Good to know: Family caregiver payment: Not a direct family stipend; a relative may only be paid if allowed under current provider/employment rules
CFC Personal Assistance
YesHelps pay for: Hands-on help with ADLs/IADLs such as bathing, dressing, meal preparation, light chores and community access when authorized in the plan of service.
Who qualifies: CFC eligibility plus assessed need and plan authorization.
How to start: Ask the supports planner to assess personal-assistance hours and provider options.
Good to know: Family caregiver payment: Potentially only through an approved provider/employment arrangement; verify the specific relative before hiring
CFC Assistive Technology / PERS
Indirect cost offsetHelps pay for: Can cover approved assistive technology and personal emergency response systems that reduce safety and supervision burdens.
Who qualifies: Must be medically/functionally necessary and authorized in the CFC plan.
How to start: Discuss safety technology and emergency-response needs with the supports planner.
Good to know: Family caregiver payment: No
CFC Accessibility Adaptations
Indirect cost offsetHelps pay for: Approved accessibility changes can make the home safer and reduce dependence on hands-on assistance.
Who qualifies: CFC eligibility, environmental assessment as required, medical necessity and prior authorization.
How to start: Ask the supports planner about an environmental assessment before purchasing work.
Good to know: Family caregiver payment: No
CFC Home-Delivered Meals
Indirect cost offsetHelps pay for: May cover authorized home-delivered meals as part of the person-centered service plan.
Who qualifies: Must be enrolled in CFC and have the service authorized based on assessed need.
How to start: Ask the supports planner whether meals can be added to the plan.
Good to know: Family caregiver payment: No
CFC Nurse Monitoring / Consumer Training
Indirect / clinical supportHelps pay for: Nurse monitoring and consumer training can support safe use of personal assistance and reduce avoidable complications.
Who qualifies: CFC eligibility and service-plan authorization.
How to start: Discuss nursing oversight and training needs during planning.
Good to know: Family caregiver payment: No
CFC Transition Services
Indirect transition supportHelps pay for: Can help eligible people transition from an institution to a community setting and establish needed supports.
Who qualifies: CFC/Money Follows the Person transition criteria and approved transition plan may apply.
How to start: Ask facility social work or MAP for transition counseling and CFC screening.
Good to know: Family caregiver payment: No
Maryland Medicaid / CPAS
Community Personal Assistance Services (CPAS)
YesHelps pay for: State-plan HCBS for full-Medicaid participants who need help with at least one activity of daily living and live in the community.
Who qualifies: Full Medicaid, community residence and need for help with at least one ADL. No age limit.
How to start: Call MAP or the CFC/CPAS office for assessment.
Good to know: Family caregiver payment: Not a direct family stipend; verify whether a specific relative can work through an approved provider
CPAS Personal Assistance
YesHelps pay for: Personal assistance with approved daily-living needs in the home and community.
Who qualifies: CPAS eligibility and plan authorization.
How to start: Ask the supports planner to assess personal-assistance needs.
Good to know: Family caregiver payment: Potentially only through an approved provider employment arrangement; confirm current relationship rules
CPAS Nurse Monitoring / Supports Planning
Indirect supportHelps pay for: Provides nurse monitoring and supports planning around authorized personal-assistance services.
Who qualifies: CPAS enrollment and service-plan authorization.
How to start: Request supports planning through the CPAS intake process.
Good to know: Family caregiver payment: No
Maryland Medicaid / Waiver
Community Options Waiver
YesHelps pay for: HCBS waiver for adults 18+ who need nursing-facility level of care and can live safely in the community. Includes CFC plus waiver services.
Who qualifies: Nursing-facility level of care; age 18+; income generally up to 300% of SSI; asset limits apply. The waiver has a registry/waitlist.
How to start: Call MAP to join the Community Options Waiver Registry.
Good to know: Family caregiver payment: Depends on the CFC/personal-assistance provider model and current worker rules
Community Options Assisted Living Services
Residential cost offsetHelps pay for: Can pay Medicaid-authorized assisted-living services when that setting is the appropriate community alternative to nursing-facility care.
Who qualifies: Community Options enrollment and service authorization; cannot be enrolled in PACE at the same time.
How to start: Discuss assisted-living eligibility with MAP/supports planning.
Good to know: Family caregiver payment: No direct family wage
Community Options Medical Day Care
Indirect / day careHelps pay for: Medical day care can provide daytime nursing, therapy, meals and supervision, reducing the amount of paid or unpaid care needed at home.
Who qualifies: Community Options enrollment and authorization.
How to start: Ask the case manager about medical day care in the plan.
Good to know: Family caregiver payment: No
Community Options Family Training / Senior Center Plus
Indirect cost offsetHelps pay for: Family training and Senior Center Plus can improve caregiver capacity and provide structured daytime support.
Who qualifies: Community Options enrollment and assessed need.
How to start: Ask the case manager which waiver supports fit the care plan.
Good to know: Family caregiver payment: No
Maryland Medicaid / ICS
Increased Community Services (ICS)
YesHelps pay for: HCBS demonstration for certain nursing-facility residents whose income is above the standard Community Options limit; a contribution to care is required.
Who qualifies: Age 18+; nursing-facility level of care; generally in a nursing facility at least 6 months and Medicaid eligible for at least 30 consecutive days; must not qualify for another waiver or PACE.
How to start: ICS is referral-based through Medicaid Eligibility Determination Division; ask facility social work/MAP.
Good to know: Family caregiver payment: Depends on authorized personal-assistance/provider rules
ICS Personal Assistance / Respite
YesHelps pay for: Can authorize personal assistance and respite to support a transition from institutional care and continued community living.
Who qualifies: ICS enrollment, assessed need and service-plan authorization.
How to start: Ask the ICS supports planner about personal assistance and respite.
Good to know: Family caregiver payment: Potentially only under approved provider rules; respite pays the provider, not the family caregiver receiving relief
ICS Assistive Technology / Accessibility / PERS
Indirect cost offsetHelps pay for: Can cover approved assistive technology, environmental accessibility adaptations and personal emergency response systems.
Who qualifies: ICS enrollment, assessed need, documentation and authorization.
How to start: Discuss safety, access and technology barriers before purchasing equipment or work.
Good to know: Family caregiver payment: No
ICS Meals / Medical Day Care / Senior Center Plus
Indirect cost offsetHelps pay for: Authorized meals and structured daytime services can offset food, supervision and caregiver-hour costs.
Who qualifies: ICS enrollment and service-plan authorization.
How to start: Ask the supports planner which supplemental services are available in the transition plan.
Good to know: Family caregiver payment: No
Maryland Medicaid / DDA
Community Pathways Waiver (CPW)
YesHelps pay for: Maryland DDA waiver for people with developmental disabilities who meet ICF/IID level-of-care and financial criteria; supports community living and self-direction.
Who qualifies: Developmental disability, ICF/IID level of care, Medicaid waiver financial rules and DDA eligibility.
How to start: Contact a DDA Regional Office for eligibility and waiver application assistance.
Good to know: Family caregiver payment: Potentially through self-direction or approved waiver service arrangements; relative-specific rules apply
DDA Self-Directed Service Model
YesHelps pay for: Lets Community Pathways participants act as common-law employer, select staff/vendors, set allowed wages and manage an allocated waiver budget with required fiscal-management support.
Who qualifies: Must be enrolled in Community Pathways and elect self-direction for eligible services; FMCS participation is required.
How to start: Tell the Coordinator of Community Services that you want to explore self-direction.
Good to know: Family caregiver payment: Yes, qualifying relatives may be possible; current relative/legally responsible person rules and reporting requirements must be checked
DDA Personal Supports
YesHelps pay for: Supports independent-living skills, community participation and overnight needs; the service offers both budget and employer authority under self-direction.
Who qualifies: Community Pathways enrollment and PCP authorization.
How to start: Ask the CCS to assess Personal Supports and self-direction options.
Good to know: Family caregiver payment: Potentially yes under self-direction if the worker is allowed and qualified
DDA Live-In Caregiver Supports
Indirect caregiver supportHelps pay for: Helps cover rent and food costs for a person who lives in the participant home and provides supports and services.
Who qualifies: Community Pathways enrollment and PCP authorization; service-specific rules apply.
How to start: Ask the CCS whether Live-In Caregiver Supports fits the plan.
Good to know: Family caregiver payment: Supports a live-in caregiver, but it is not a standard hourly family-caregiver wage
DDA Respite Care Services
Yes - respiteHelps pay for: Temporary care to relieve unpaid caregivers and sustain community living.
Who qualifies: Community Pathways enrollment, assessed need and PCP authorization.
How to start: Request respite during person-centered planning.
Good to know: Family caregiver payment: No direct wage to the caregiver receiving the break; an approved respite worker/provider is paid
Individual and Family Directed Goods and Services (IFDGS)
Indirect cost offsetHelps pay for: Unused self-directed budget may fund approved services, equipment, activities or supplies not otherwise covered that support community participation and independence.
Who qualifies: Available to people who self-direct; expenses must meet waiver rules and fit within the approved budget.
How to start: Ask the support broker/CCS whether a proposed purchase is allowable before spending.
Good to know: Family caregiver payment: No direct caregiver wage
DDA Environmental Modifications / Assistive and Remote Supports
Indirect cost offsetHelps pay for: Community Pathways can authorize environmental modifications, assistive technology and remote supports that reduce hands-on care and improve safety.
Who qualifies: Community Pathways enrollment, assessed need and PCP authorization.
How to start: Document the barrier and request the applicable service through the CCS.
Good to know: Family caregiver payment: No
Maryland Medicaid / Autism
Autism Waiver
Yes / supportive servicesHelps pay for: HCBS waiver for eligible children and youth with autism who meet institutional level-of-care and school-program criteria.
Who qualifies: Age 1 through the end of the school year in which the participant turns 21; IFSP/IEP and other medical/financial criteria. A waitlist applies.
How to start: Call the Autism Waiver Registry to add the child to the waitlist.
Good to know: Family caregiver payment: No direct family wage; services are delivered under waiver/provider rules
Autism Waiver Respite Care
Yes - respiteHelps pay for: Short-term care that gives family caregivers relief.
Who qualifies: Autism Waiver enrollment and service-plan authorization.
How to start: Ask the Autism Waiver coordinator about respite.
Good to know: Family caregiver payment: No direct wage to the caregiver receiving the break
Autism Waiver Intensive Supports / Accessibility
Indirect / supportive careHelps pay for: Intensive individual support, therapeutic integration and environmental accessibility adaptations can reduce family supervision and home-safety costs.
Who qualifies: Autism Waiver enrollment and service authorization.
How to start: Discuss support intensity and accessibility needs with the waiver coordinator.
Good to know: Family caregiver payment: No
Maryland Medicaid / Children
Model Waiver for Medically Fragile Children
YesHelps pay for: HCBS waiver for medically fragile children who need nursing-facility or chronic-hospital level of care; parental income/assets are not counted in the usual way.
Who qualifies: Child must be 21 or younger when approved, meet level-of-care and cost-neutrality rules, and meet child-only financial standards. A waitlist applies.
How to start: Call The Coordinating Center and ask for the Model Waiver Intake Team.
Good to know: Family caregiver payment: No direct family stipend
Model Waiver Home Health Aide
YesHelps pay for: Can cover medically necessary home health aide services for an enrolled medically fragile child.
Who qualifies: Model Waiver enrollment, physician plan of care and medical necessity.
How to start: Coordinate through the Model Waiver case manager/provider.
Good to know: Family caregiver payment: No direct family wage under the waiver description; provider qualification rules apply
Model Waiver Private Duty Nursing
Yes - skilled nursingHelps pay for: Can cover medically necessary private-duty nursing in the home for eligible medically fragile children.
Who qualifies: Model Waiver enrollment, physician order and medical necessity/authorization.
How to start: Ask the Model Waiver team about private-duty nursing authorization.
Good to know: Family caregiver payment: No
Maryland Medicaid / Day Services
Medical Day Care Services Waiver
Indirect / day careHelps pay for: For Medicaid participants age 16+ who need nursing-facility level of care and have a medical order for medical day care; can provide nursing, therapy, meals and transportation.
Who qualifies: Full Medicaid, nursing-facility level of care, age 16+, medical order, and not enrolled in another waiver.
How to start: Request a medical assessment through the local health department or MAP.
Good to know: Family caregiver payment: No
Integrated Care
Maryland PACE
Yes - comprehensiveHelps pay for: Comprehensive medical and long-term-care model for eligible adults 55+ who need nursing-facility level of care and can live safely in the community. Maryland currently has four PACE sites.
Who qualifies: Age 55+, nursing-facility level of care, live in a PACE service area, and meet financial/program rules or pay privately. Cannot combine with Community Options Waiver.
How to start: Contact the PACE organization serving the residence.
Good to know: Family caregiver payment: No direct family wage
State-Funded Aging Support
Supporting Older Adults with Resources (SOAR)
Yes / cost offsetHelps pay for: Maryland 2026 state-funded program that provides light-touch LTSS to help older adults remain independent when Medicaid is unavailable or delayed.
Who qualifies: Generally age 62+, income below 60% of state median, assets below program thresholds, and need help with ADLs; funding availability applies.
How to start: Contact MAP or the local Area Agency on Aging for screening.
Good to know: Family caregiver payment: No standard family-caregiver wage
SOAR Personal Care / Homemaker / Chore Services
YesHelps pay for: Can provide or subsidize personal care and homemaker/chore supports that reduce private-pay home-care hours.
Who qualifies: SOAR eligibility, local assessment, service availability and state grant funding.
How to start: Ask the local AAA/MAP to assess home-support needs.
Good to know: Family caregiver payment: No standard family wage
SOAR Respite / Meals / Transportation / Safety Supports
Indirect / respiteHelps pay for: SOAR may support respite, meals, transportation, minor home repairs/modifications, medical supplies, emergency response and adult day care.
Who qualifies: SOAR eligibility and local funding/service availability.
How to start: Ask MAP for a person-centered screening across all SOAR supports.
Good to know: Family caregiver payment: No direct family wage
State Disability Program
Attendant Care Program (ACP)
YesHelps pay for: State-funded reimbursement for attendant services for eligible adults with severe chronic or permanent physical disabilities who need help in the home, school, workplace or community.
Who qualifies: Maryland resident age 18-64 with severe physical disability and qualifying employment/education, transition or nursing-home-risk status; no duplicate attendant-care funding.
How to start: Create a Maryland OneStop account and complete the registry application.
Good to know: Family caregiver payment: Potentially; participant selects service providers, but confirm relationship and documentation rules before using a relative
ACP Participant-Directed Provider Choice
YesHelps pay for: ACP is designed for people who can direct their own care and select their attendant-care service providers, making it a flexible bridge for qualifying adults.
Who qualifies: Must meet ACP eligibility and available funding/registry requirements.
How to start: Ask MDOD how provider selection, payroll/reimbursement and documentation work for your chosen attendant.
Good to know: Family caregiver payment: Potentially if the selected person meets ACP rules; confirm before arranging care
Caregiver Support
Maryland DHS Respite Care Program
Yes - respiteHelps pay for: Financial assistance for short-term periodic care for people with developmental or functional disabilities, giving family caregivers a period of rest and renewal.
Who qualifies: Program/funding and local contractor eligibility apply; family caregiver identifies someone to provide care.
How to start: Call DHS Constituent Services to identify the contracted respite agency serving the area.
Good to know: Family caregiver payment: Pays the respite care arrangement, not the unpaid caregiver taking the break
Maryland Family Caregiver Support Program / NFCSP
Indirect / respiteHelps pay for: Information, counseling, training, respite and supplemental services for eligible family caregivers through local Area Agencies on Aging.
Who qualifies: Includes adult informal caregivers of people age 60+ and qualifying older relative caregivers; local priority and funding rules apply.
How to start: Contact MAP or the local AAA for caregiver screening.
Good to know: Family caregiver payment: No ongoing caregiver wage
Adult Services
DHS In-Home Aide Services (IHAS)
YesHelps pay for: Personal care and chore services for adults with functional disabilities to help them remain safely in the community; availability is funding-based and may use a sliding fee.
Who qualifies: Adults 18+ with functional disabilities; local DSS assessment, need/risk priority and available funding.
How to start: Call the local Department of Social Services Adult Services unit for an in-home assessment.
Good to know: Family caregiver payment: No standard direct family wage
DDA Grant
Low Intensity Support Services (LISS)
Indirect / may include support servicesHelps pay for: Flexible DDA grant of up to $1,000 for eligible children/adults with developmental or intellectual disabilities who are not receiving DDA support services; can fund eligible supports/items.
Who qualifies: Applicant lives at home/own home in the community and is not receiving DDA support services. FY2027 Round 1 application is open Aug. 1-Sept. 15, 2026; random selection Oct. 1.
How to start: Submit the electronic random-selection application during the open round.
Good to know: Family caregiver payment: No ongoing wage; eligible support purchases depend on LISS rules
Home Accessibility
Accessible Homes for Seniors
Indirect cost offsetHelps pay for: Zero-interest deferred loans and grants for accessibility improvements such as ramps, grab bars, widened doorways and accessible showers. Grants up to $25,000 may be available when loan funding is not feasible.
Who qualifies: Maryland household with a resident age 55+; ownership/occupancy, property condition and income rules apply. Generally income cannot exceed 80% of statewide or DC-area median.
How to start: Apply through a local county housing office or Maryland Access Point.
Good to know: Family caregiver payment: No
Medicaid Eligibility
Employed Individuals with Disabilities (EID)
Indirect / coverageHelps pay for: Medicaid buy-in for workers with disabilities whose earnings would otherwise make them ineligible; Medicaid coverage can unlock covered medical and LTSS benefits when program criteria are met.
Who qualifies: Age 16 to under 65, working for pay, Social Security-level disability, Maryland residency and EID asset rules. Maryland lists no maximum income limit; premiums apply.
How to start: Submit the EID application to the Medicaid Eligibility Determination Division.
Good to know: Family caregiver payment: No
Aged, Blind or Disabled Medicaid / Spenddown Screening
Indirect / coverageHelps pay for: Regular Medicaid or medically needy/spenddown pathways can reduce medical costs and may be a gateway to covered home-health or LTSS services.
Who qualifies: Income, assets, age/disability and program rules vary; Maryland updates limits annually.
How to start: Apply through the Department of Human Services and ask specifically about ABD and spenddown options.
Good to know: Family caregiver payment: No
Medicare Cost Offset
Medicare Savings Program - QMB
Indirect cost offsetHelps pay for: Can pay Medicare Part B premiums and generally Medicare deductibles/coinsurance for eligible beneficiaries, freeing income for care costs.
Who qualifies: Medicare beneficiary meeting current Maryland QMB income/resource rules.
How to start: Apply through Maryland Medicaid/DHS or get free screening from SHIP.
Good to know: Family caregiver payment: No
Medicare Savings Program - SLMB
Indirect cost offsetHelps pay for: Can pay Medicare Part B premiums for eligible lower-income Medicare beneficiaries.
Who qualifies: Medicare beneficiary meeting current SLMB income/resource rules.
How to start: Ask SHIP or Medicaid for MSP screening.
Good to know: Family caregiver payment: No
Medicare Savings Program - QI
Indirect cost offsetHelps pay for: Can pay Medicare Part B premiums for eligible beneficiaries; QI funding is limited and eligibility must be renewed.
Who qualifies: Medicare beneficiary meeting current QI income/resource rules and not otherwise Medicaid eligible under conflicting categories.
How to start: Apply through Maryland Medicaid/DHS or SHIP.
Good to know: Family caregiver payment: No
Medicare Part D Extra Help
Indirect cost offsetHelps pay for: Federal Low-Income Subsidy can reduce Part D premiums, deductibles and copays, preserving income for home-care needs.
Who qualifies: Medicare beneficiary meeting federal income/resource criteria or deemed eligible through certain assistance programs.
How to start: Apply through Social Security or ask SHIP for screening.
Good to know: Family caregiver payment: No
Prescription Cost Offset
Senior Prescription Drug Assistance Program (SPDAP)
Indirect cost offsetHelps pay for: Maryland subsidy for eligible Medicare Part D or Medicare Advantage drug-plan members; 2026 guidance states it can pay up to $75 per month toward an approved prescription-drug plan premium.
Who qualifies: Maryland resident, Medicare drug coverage and SPDAP income/program criteria. 2026 state guidance shows no asset test.
How to start: Contact Maryland SHIP/SPDAP for screening and application help.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health
Yes - limited skilled home careHelps pay for: Can cover intermittent skilled nursing, therapy and qualifying home health aide services for homebound beneficiaries under a Medicare-certified plan of care.
Who qualifies: Medicare eligibility, homebound status, need for intermittent skilled care and physician/practitioner certification. Does not cover 24/7 custodial care.
How to start: Ask the treating clinician for a Medicare home-health evaluation.
Good to know: Family caregiver payment: No direct family wage
Medicare Hospice Benefit
Yes - hospice home careHelps pay for: For eligible terminally ill beneficiaries, hospice can cover home-based nursing, aides, equipment, medications related to the terminal condition and caregiver support/respite.
Who qualifies: Medicare hospice eligibility and election; services relate to the terminal illness and plan of care.
How to start: Request a hospice evaluation from the physician or a Medicare-certified hospice.
Good to know: Family caregiver payment: No direct family wage
Medicare Dementia Support
CMS GUIDE Dementia Care Model
Indirect / respiteHelps pay for: Participating dementia-care organizations can provide care coordination, caregiver education/support and respite services for eligible Medicare beneficiaries with dementia.
Who qualifies: Traditional Medicare or applicable model eligibility plus enrollment with a participating GUIDE organization; local availability varies.
How to start: Ask Medicare/health system whether a GUIDE participant serves the area.
Good to know: Family caregiver payment: No direct family wage
Food Cost Offset
SNAP / Supplemental Nutrition Assistance Program
Indirect cost offsetHelps pay for: Monthly food benefits can reduce grocery expenses and preserve household cash for care.
Who qualifies: Household income and other SNAP rules apply.
How to start: Apply through Maryland Benefits / Department of Human Services.
Good to know: Family caregiver payment: No
Energy Cost Offset
Maryland Energy Assistance Program (MEAP)
Indirect cost offsetHelps pay for: OHEP grant toward home heating bills; payment is made to the supplier/utility on the household behalf.
Who qualifies: Income and household rules apply; FY27 guidance is current for the July 2026-June 2027 program year.
How to start: Apply through Maryland Benefits or the local OHEP office.
Good to know: Family caregiver payment: No
Electric Universal Service Program (EUSP)
Indirect cost offsetHelps pay for: OHEP electric-bill assistance grant that can lower ongoing utility costs.
Who qualifies: Income/household rules apply; generally available once per program year.
How to start: Apply through OHEP/Maryland Benefits.
Good to know: Family caregiver payment: No
OHEP Arrearage Retirement / Utility Service Protection
Indirect cost offsetHelps pay for: Arrearage assistance can pay up to $2,000 toward qualifying past-due electric/gas bills; USPP can protect eligible households from winter shutoff when requirements are met.
Who qualifies: OHEP/EUSP eligibility and arrearage/USPP-specific rules apply; arrearage assistance is generally limited to once every five years with exceptions.
How to start: Ask the local OHEP office for arrearage and shutoff-protection screening.
Good to know: Family caregiver payment: No
Home Cost Offset
Maryland Weatherization / EmPOWER Limited-Income Energy Efficiency
Indirect cost offsetHelps pay for: No-cost or subsidized energy-efficiency improvements can reduce utility bills and improve home safety; older adults and people with disabilities receive priority under WAP.
Who qualifies: Income/program rules apply; automatic/categorical pathways exist for some benefit recipients.
How to start: Contact a local weatherization agency or DHCD energy program.
Good to know: Family caregiver payment: No
Tax / Housing Cost Offset
Maryland Homeowners Property Tax Credit
Indirect cost offsetHelps pay for: Limits property-tax burden for qualifying homeowners based on household income and property taxes, preserving cash for care needs.
Who qualifies: Principal-residence and income/property-tax rules apply; 2026 filing deadline is October 1, 2026.
How to start: Apply through Maryland Department of Assessments and Taxation.
Good to know: Family caregiver payment: No
Maryland Renters Tax Credit
Indirect cost offsetHelps pay for: State credit for qualifying renters, including many renters age 60+ or permanently disabled, based on rent and income rules.
Who qualifies: Maryland renter and program income/eligibility rules; annual application required.
How to start: Apply through Maryland Department of Assessments and Taxation.
Good to know: Family caregiver payment: No
Private Insurance
Long-Term Care Insurance
Yes - policy dependentHelps pay for: Existing policies may reimburse or pay for qualifying home-care, personal-care or care-management services according to policy terms.
Who qualifies: Must have an in-force policy and satisfy benefit triggers, elimination periods and provider rules.
How to start: Request the policy certificate and start a claim before care begins when possible.
Good to know: Family caregiver payment: Sometimes, if the policy permits informal/family caregivers; many do not
Home Equity
FHA Home Equity Conversion Mortgage (HECM)
Indirect / private fundsHelps pay for: A federally insured reverse mortgage can convert home equity to cash that may be used for care, taxes, accessibility work or household costs.
Who qualifies: Homeowner generally age 62+, sufficient equity, HUD counseling and FHA property/financial requirements. Loan reduces home equity and carries costs.
How to start: Speak with a HUD-approved HECM counselor before choosing a lender.
Good to know: Family caregiver payment: No
Veterans
Veteran-Directed Care (VDC)
YesHelps pay for: Self-directed VA home- and community-based services budget that may let an eligible Veteran hire workers and purchase approved supports.
Who qualifies: VA enrollment, clinical need, community-care eligibility and local VDC availability.
How to start: Ask the VA Maryland care team or social worker whether VDC is available.
Good to know: Family caregiver payment: Yes, subject to VA/VDC worker rules
VA Pension - Aid & Attendance / Housebound
Indirect cash benefitHelps pay for: Additional monthly VA pension amounts can help eligible wartime Veterans or survivors pay for personal care and other living costs.
Who qualifies: Pension eligibility plus Aid & Attendance or Housebound medical/functional criteria; income/net-worth rules apply.
How to start: Apply through VA or an accredited Veterans Service Officer.
Good to know: Family caregiver payment: Can be used toward privately arranged care; benefit is paid to the eligible claimant
Veterans / Caregiver
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Indirect / caregiver stipendHelps pay for: May provide training, enhanced services and a monthly stipend to an approved Primary Family Caregiver of an eligible Veteran.
Who qualifies: Veteran and caregiver must meet current PCAFC eligibility and assessment requirements.
How to start: Apply through VA caregiver programs or the local caregiver support team.
Good to know: Family caregiver payment: Yes
VA Benefits
VA Homemaker & Home Health Aide
YesHelps pay for: VA may authorize community-based aides to help an eligible Veteran with ADLs and selected daily tasks at home.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply. Ask VA primary care/social work for assessment and authorization.
How to start: Ask the VA social worker or care team about VA Homemaker & Home Health Aide.
Good to know: Family caregiver payment: No
Veteran-Directed Care
YesHelps pay for: Flexible self-directed budget for eligible Veterans needing personal care; participant can choose workers and services.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local VDC availability. Ask the VA care team whether VDC is available in the Veteran Maryland service area.
How to start: Ask the VA social worker or care team about Veteran-Directed Care.
Good to know: Family caregiver payment: Yes
VA Skilled Home Health
Yes - skilled careHelps pay for: VA may purchase skilled nursing, therapy and related home-health services from authorized community providers.
Who qualifies: Clinical need, VA eligibility/authorization and provider availability. Request through the VA care team.
How to start: Ask the VA social worker or care team about VA Skilled Home Health.
Good to know: Family caregiver payment: No
VA Respite Care
Yes - respiteHelps pay for: VA may provide in-home, adult-day or facility respite to give caregivers a break.
Who qualifies: VA enrollment, clinical need and local availability/authorization. Ask VA social work/caregiver support about respite.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No direct wage
VA Home Based Primary Care (HBPC)
Yes - clinical home careHelps pay for: Interdisciplinary VA primary care delivered at home for Veterans with complex chronic conditions who have difficulty using clinic-based care.
Who qualifies: VA clinical eligibility and local HBPC availability. Ask the Veteran primary care team for HBPC screening.
How to start: Ask the VA social worker or care team about VA Home Based Primary Care (HBPC).
Good to know: Family caregiver payment: No
VA Adult Day Health Care
Indirect / day careHelps pay for: Structured daytime health, rehabilitation and social services can reduce caregiver supervision hours and support community living.
Who qualifies: VA clinical eligibility, authorization and local/community availability. Ask VA social work about Adult Day Health Care options.
How to start: Ask the VA social worker or care team about VA Adult Day Health Care.
Good to know: Family caregiver payment: No
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Indirect / stipendHelps pay for: May provide training, enhanced support and a monthly stipend to an approved Primary Family Caregiver of an eligible Veteran.
Who qualifies: Veteran/caregiver must meet PCAFC eligibility, assessment and participation requirements. Apply through VA caregiver programs or contact the local Caregiver Support Team.
How to start: Ask the VA social worker or care team about Program of Comprehensive Assistance for Family Caregivers (PCAFC).
Good to know: Family caregiver payment: Yes
Program of General Caregiver Support Services (PGCSS)
Indirect supportHelps pay for: Coaching, education, peer support and resources for caregivers of enrolled Veterans.
Who qualifies: Caregiver supports a Veteran enrolled in VA health care; program rules apply. Contact the VA Caregiver Support Line or Maryland Caregiver Support Team.
How to start: Ask the VA social worker or care team about Program of General Caregiver Support Services (PGCSS).
Good to know: Family caregiver payment: No stipend
VA Medical Foster Home
Residential alternativeHelps pay for: Adult family-style home with caregiver support plus VA Home Based Primary Care for eligible Veterans who need substantial assistance.
Who qualifies: Clinical eligibility, local program availability, home approval and private-pay/benefit arrangements may apply. Ask VA Maryland social work or Geriatrics and Extended Care.
How to start: Ask the VA social worker or care team about VA Medical Foster Home.
Good to know: Family caregiver payment: Caregiver is an approved paid Medical Foster Home caregiver, not usually the Veteran family caregiver
VA Hospice & Palliative Care
Yes - hospice/palliativeHelps pay for: VA can provide or purchase hospice/palliative services, including home-based support when clinically appropriate.
Who qualifies: VA enrollment, clinical eligibility and care-plan authorization. Ask VA primary care, palliative care or social work for referral.
How to start: Ask the VA social worker or care team about VA Hospice & Palliative Care.
Good to know: Family caregiver payment: No
VA Aid & Attendance / Housebound
Indirect cash benefitHelps pay for: Additional VA pension payment for qualifying Veterans or survivors who need personal assistance or are substantially confined to home.
Who qualifies: Must first meet VA pension eligibility plus A&A or Housebound criteria and financial rules. File a pension claim with supporting medical evidence or use an accredited VSO.
How to start: Ask the VA social worker or care team about VA Aid & Attendance / Housebound.
Good to know: Family caregiver payment: Can help pay privately arranged care
VA Community Care Network - Region 1
Indirect / authorized careHelps pay for: VA may purchase authorized community care when eligibility criteria are met. Maryland is in CCN Region 1, administered by Optum.
Who qualifies: Requires VA community-care eligibility and authorization; not a general reimbursement program. Coordinate through the VA referral/community-care process before receiving non-VA care.
How to start: Ask the VA social worker or care team about VA Community Care Network - Region 1.
Good to know: Family caregiver payment: No
Where Maryland Families Can Start
Not sure where to begin? Match your situation to a contact below.
No-wrong-door screening for LTSS, CFC/CPAS, Community Options registry, SOAR, caregiver supports and local aging/disability resources
Maryland Access Point (MAP)
CFC, CPAS, Community Options and Increased Community Services questions
Maryland Medicaid LTSS / CFC Office
DDA eligibility, Community Pathways waiver, self-direction and regional-office navigation
Developmental Disabilities Administration (DDA)
Add an eligible child to the Autism Waiver waiting list / registry
Autism Waiver Registry
Model Waiver registry/intake for medically fragile children
The Coordinating Center - Model Waiver
SOAR, caregiver programs, MAP/AAA navigation and statewide aging resources
Maryland Department of Aging
ACP registry, eligibility and participant-directed attendant reimbursement
Maryland Department of Disabilities - Attendant Care
Medicaid ABD, SNAP, Adult Services/IHAS, respite contractor navigation and general benefits
Maryland Department of Human Services
Status and questions for Employed Individuals with Disabilities Medicaid buy-in
EID Eligibility Determination Division
MEAP, EUSP, arrearage assistance and utility shutoff protection
Office of Home Energy Programs (OHEP)
Accessible Homes for Seniors, home repair and accessibility financing
DHCD Special Loan / Accessibility Programs
VA caregiver support, PCAFC/PGCSS, in-home and extended-care navigation
VA Maryland Caregiver Support
Before You Rely on Any Payment Source
Planning Point
Why It Matters
Community Options has a registry/waitlist
Maryland states that the Community Options Waiver has a waitlist. A person in a nursing facility whose Medicaid has paid for services for at least 30 days may be able to apply without waiting, so facility transition cases should be screened immediately.
ICS is a narrow nursing-facility transition pathway
Increased Community Services is not a general higher-income home-care waiver. It is designed for qualifying adults transitioning from nursing facilities, generally after at least six months in the facility and at least 30 consecutive days of Medicaid coverage, and requires a contribution to care based on income.
CFC and CPAS have different medical thresholds
CFC requires institutional level of care, while CPAS requires need for help with at least one ADL. Both require full Medicaid and community residence, so screen both rather than assuming one replaces the other.
CFC/CPAS personal assistance is not a simple family cash benefit
Maryland no longer accepts new applications to become an Independent Personal Assistance provider under CFC/CPAS. Families should verify whether a specific relative can be employed through an approved provider arrangement before relying on paid-family-caregiver income.
DDA has 2026 changes pending CMS approval
DDA submitted a Community Pathways amendment to CMS on July 1, 2026. Maryland says reasonable-and-customary wage implementation for self-direction is extended and allowable wages remain at June 30, 2026 levels until CMS approval; do not assume proposed changes are already effective.
DDA relatives and legally responsible persons require careful rule checking
DDA now maintains 2026 reporting materials for relatives, legally responsible persons and legal guardians providing waiver services. A relative may be possible in some self-directed arrangements, but the exact relationship, service and authorization rules must be confirmed before hire.
LISS has a live FY2027 application window
As of August 14, 2026, LISS Round 1 is open through September 15, 2026, with random selection scheduled October 1. The benefit is up to $1,000 and is for eligible people not receiving DDA support services, so this is time-sensitive.
Autism Waiver has a waitlist
Maryland directs families to call the Autism Waiver Registry at 866-417-3480. Add an eligible child early and maintain current contact information while waiting.
Model Waiver has a waitlist
The Model Waiver for medically fragile children also uses a registry/waitlist. Parents should contact The Coordinating Center at 410-987-1048 and keep medical documentation current.
SOAR is new in 2026 and replaces older state-funded structures
Maryland consolidated three state-funded aging programs into SOAR in 2026. Use the current SOAR criteria and service menu rather than older Senior Care or assisted-living subsidy descriptions; services remain subject to annual funding availability.
PACE is geographically limited and mutually exclusive with some waiver enrollment
Maryland currently lists four PACE sites. A person must live in a PACE service area and agree to receive covered care through PACE; Community Options enrollment cannot be held at the same time.
Accessible Homes for Seniors can materially reduce home-modification costs
For qualifying households with a resident age 55+, the program offers zero-interest deferred loans and, in some cases, grants up to $25,000 for accessibility work. Apply before starting construction and confirm 2026 income/property requirements.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in Maryland to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in Maryland
These providers serve families in Maryland and can help you apply what you've learned above to your specific situation.
A Plus Personal Home Care – Gaithersburg, MD
Serving Maryland
A Plus Personal Home Care provides home care services in Gaithersburg, MD and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Baltimore City, Baltimore County, Pikesville and surrounding areas
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A Plus Personal Home Care – Pikesville, MD
Serving Maryland
A Plus Personal Home Care provides home care services in Pikesville, MD and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Baltimore City, Baltimore County, Pikesville and surrounding areas
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Daystar Healthcare LLC
Serving Maryland
Daystar Healthcare LLC provides home care services in Elkridge, MD and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Elkridge, Baltimore, Bethesda and surrounding areas
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Mercy Care Providers – Columbia, MD
Serving 2 states
Mercy Care Providers provides home care services in Columbia, MD and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Montgomery County, Howard County, Prince George’s County and surrounding areas
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Paragon PRP
Serving Maryland
Paragon PRP provides home care services in Pikesville, MD and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Annapolis, Baltimore, Catonsville and surrounding areas
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Primacare Companions
Serving Maryland
Primacare Companions provides home care services in Catonsville, MD and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Baltimore County, Howard County, Anne Arundel County
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Renaissance Medical Adult Day Care
Serving Maryland
Renaissance Medical Adult Day Care provides home care services in Pikesville, MD and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Baltimore, Catonsville, Columbia and surrounding areas
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