Medicaid's Assisted Living Benefits: Availability and Eligibility

Page Reviewed / Updated - Dec. 2013

 In 44 states, Medicaid offers some level of assistance for individuals in assisted living or other non-nursing home, residential care.

Medicaid's Benefit for Assisted Living

Medicaid is funded in part by the federal government and in part by the states. The federal Center for Medicaid Services sets certain guidelines on how each state must spend their Medicaid dollars but the states are permitted considerable latitude within those guidelines. Therefore the available Medicaid assistance for assisted living changes with each state. Adding to the complexity is the fact that most states that help with the cost of assisted living do so through their Medicaid waivers instead of with general Medicaid dollars. Waivers have enrollment caps, so a limited number of individuals can receive assistance at any given time and waiting lists are common.

Forty-four states now provide some level of financial assistance to individuals in assisted living. However, the term "assisted living" is not used consistently across these states, nor are their definitions or benefits the same. Other terms which are used include: residential care, adult foster care, personal care homes, supported living and several other variations.  Some states pay only for personal care services received in assisted living, others include nursing services and still others include room and board costs.

 In some states, Medicaid pays only for care services in assisted living and in other states it covers room and board.

The past ten years have seen a dramatic increase in the number of states whose Medicaid's programs provide financial assistance for assisted living residents. We expect this trend to continue until all 50 states and D.C. are included.

It is important to recognize that Medicaid may not be the best source of funding for assisted living for every family. As Medicaid payment rates for assisted living (in Medicaid language called "reimbursement rates") are not high, not every assisted living community accepts Medicaid.  Also, given the limited range of services for which Medicaid provides assistance and the enrollment caps and waiting lists for Medicaid waivers, many families might benefit by finding affordable assisted living outside of the Medicaid system.

State by State Guide to Medicaid Coverage for Assisted Living Benefits

Did You Know?
Assisted living is referred to by many different names.  There may be subtle differences between the names on this list, they can all be categorized as assisted living residences.

Adult Family Homes
Adult Foster Care
Adult Living Facilities
Board and Care
Domiciliary Care
Eldercare Facilities
Group Homes
Memory Care Facilities
Personal Care Homes
Residential Care Facilities
Senior Living Residences
Sheltered Housing

 

2013 State Medicaid Assisted Living Benefits

State

Medicaid Policy on Assisted Living

Other Options for Residents

Alabama Alabama has several Medicaid programs that help individuals remain living in their homes but does not currently provide assistance for those in assisted living.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
SAIL Program Waiver
Alabama Personal Choices

Alaska The state of Alaska will pay for assisted living or "Residential Supported Living Services" through the Older Alaskans Medicaid Waiver. Enrollment may be capped and therefore waiting lists for services may exist.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Personal Care Assistance

 

Arizona Arizona, through the Arizona Long Term Care System (ALTCS) will pay for services for individuals residing in an assisted living community provided there is space available in the program. Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Self Directed Attendant Care

 

Arkansas Arkansas pays for assisted living for Medicaid beneficiaries through the specifically designed Living Choices Assisted Living Waiver.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
DAAS ElderChoices Waiver
Independent Choices Program

California Medi-Cal (California Medicaid) pays for assisted living via the Assisted Living Waiver (ALW). However, this waiver is not available statewide as of 2012, only in 7 major counties.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Multipurpose Senior Services Program
In-Home Supportive Services

Colorado Colorado pays for assisted living through the Elderly, Blind and Disabled Waiver. Be aware that assisted living is referred to
alternative care facilities.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Colorado CDASS Program
Old Age Pension
CO Adult Foster Care

Connecticut

Medicaid in Connecticut pays for assisted living which it called congregate housing through the Home Care Program for the Elderly. Worth noting is that this program is open to both Medicaid eligible and ineligible persons. There is also a Medicaid demonstration program called the Connecticut Assisted Living Program.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Personal Care Assistance (PCA)
Congregate Housing Services Program


 

Delaware Delaware's Amended Elderly and Disabled (E&D) Waiver pays for assisted living. This waiver is a consolidation of several previous waiver including one referred to as the Assisted Living Waiver. Medicaid managed care does as well through Diamond State Health Plan Plus.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living

 

D.C.

The District of Columbia Medicaid program offers the Elderly and Persons with Disabilities Waiver which now covers assisted living in limited situations.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living

 

Florida Florida’s Assisted Living for the Elderly (ALE) Waiver will help participants with their residential care costs, although participation is limited.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Aged and Disabled Adult Waiver Consumer Directed Care Plus

Georgia Under Georgia's Community Care Services Program, a version of assisted living referred to as Community Living Homes is included. The Georgia SOURCE Waiver also includes this benefit, however this waiver is not available statewide.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
SOURCE Waiver

 

Hawaii Hawaii offers the QUEST Expanded Medicaid (QExA) Waiver which will pay for an individual's nursing services in assisted living residences. This waiver is due for a major amendment in the next few years and is expected to expand coverage.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Kupuna Care

 

Idaho

Idaho Medicaid provides two programs that pay for participants' personal care regardless of the location in which they reside (at home or in assisted living) provided they do not live in a nursing home. These programs are the
HCBS Aged & Disabled Waiver and the Personal Care Services Program.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living

 

Illinois Illinois offers the HCBS Waiver for Supportive Living Facilities. While there is an enrollment cap on the program, the state does offer a large number of slots and has many more residences under development.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
HCBS Waiver for the Elderly

 

Indiana Indiana includes assisted living as a benefit under its Aged and Disabled Waiver (A&D) provided participants reside in Medicaid approved assisted living communities.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Indiana Choice

Iowa Iowa allows residents to consumer direct their attendant care. Attendant or personal care can be provided at home or in assisted living. The HCBS Elderly Waiver is name of the program that provides funding.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living

 

Kansas Medicaid in Kansas offers payment for nursing services regarding of the location in which an individual resides, be that at home or in assisted living. Funding is provided by the HCBS/ FE Waiver.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Senior Care Act

Kentucky

Kentucky Medicaid has the Supports for Community Living Waiver which pays for assisted living and adult foster care, though it is not appropriate for all seniors. There is also a non-Medicaid alternative that may provide assistance called Hart-Supported Living. It is unclear at this point if this program will continue to be funded.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Hart Supported Living

 

Louisiana Louisiana Medicaid does not currently provide assistance to individuals to help with the cost of assisted living. However, Medicaid in the state is undergoing major changes and the national trend is to begin funding persons in assisted living as an alternative to nursing home care.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Louisiana LT-PCS Waiver

Maine MaineCare (Medicaid's name in Maine) offers the Older Adults and Adults with Disabilities Waiver which provides for personal care regardless of the location in which the recipient lives.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Consumer Directed Attendant Services

Maryland For Medicaid (called Medical Assistance in Maryland) eligible individuals who are assessed as requiring a higher level of care but not have a need so great that it would be less expensive for them to live in nursing home, Maryland Medicaid will pay for assisted living. The Medicaid waiver that provides this service is called the Waiver for Older Adults.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Assisted Living Subsidy

 

Massachusetts In Massachusetts, state Medicaid is called MassHealth. MassHealth pays for personal care for individuals living at home or in an assisted living community. Read more about MassHealth's Personal Care Attendant program. Massachusetts also offers a program called Caregiver Homes in which participants receive a similar level of 24/7 care but do so in the private homes of caregivers. Finally, Group Adult Foster Care covers personal care but not rent.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Frail Elder HCBS

 

Michigan Through the Michigan Choice Waiver Program, the state will pay for assisted living. However, the state may refer to it as adult foster care or homes for the aged.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Home Help Program

Minnesota Minnesota pays for assisted living through the Medicaid Waiver called the Elderly Waiver. As with most waivers, participation is limited.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Personal Care Assistance

Mississippi Mississippi has a Medicaid Waiver specifically designed to help individuals reside in assisted living residences. Read more about the Assisted Living Waiver.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Elderly and Disabled (E&D) Waiver

Missouri Missouri Medicaid covers the cost of personal care for qualified individuals through its Aged and Disabled Waiver. The waiver does not specifically designate the residential location of the care recipient other than to exclude personal care from being provided in a nursing home.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living

 

Montana Montana Home and Community Based Services Medicaid Waiver will cover the cost of assisted living for its participants. Note that this waiver refers to assisted living as Adult Residential Living.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Self-Directed Personal Assistance Services

Nebraska Nebraska offers residents the Aged and Disabled Medicaid Waiver. Under this waiver, assisted living is an included benefit.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living

Nevada Nevada Medicaid pays for two levels of non-nursing home, residential care. The
HCB Waiver for Assisted Living covers the cost of assisted living and the Waiver for the Elderly in Adult Residential Care (WEARC) pays for individuals that require the level of care offered in intermediate care facilities.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
CHIP and COPE

 

New Hampshire New Hampshire, through the Choices For Independence Medicaid program pays for assisted living. However, it is referred to as adult family care in the list of the program's benefits.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Transitions in Caregiving

New Mexico New Mexico offers the CoLTS C Waiver which is a Medicaid program that includes payments to assisted living communities for waiver participants.

Other Financial Assistance
Affordable Care Options
Mi Via Program

New Jersey New Jersey's Global Options Waiver includes services to individuals residing in assisted living residences. Each participant residing in such a residence must elect to receive care from a managed care provider.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Personal Preference Program

 

New York New York offers two ways to help individuals in assisted living under its Medicaid program. First the state offers the Assisted Living Program (ALP), which provides approximately 5,500 units statewide in licensed assisted living communities. Alternatively, persons receiving personal care services under the Consumer-Directed Personal Assistance Program can elect to receive those personal care services at home or in an assisted living community that does not participate in the ALP.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Managed Long Term Care Program

 

North Carolina North Carolina, through the CAP/ DA Medicaid Waiver, pays for personal care for participants regardless of the type of housing or assisted living community in which they reside. Like most Medicaid Waivers, the exception to this is if they live in a nursing home.

Other Financial Assistance
Affordable Care Options
Adult Care Home Assistance
Loans for Assisted Living

 

North Dakota

North Dakota has a somewhat unique model when it comes to Medicaid funding of assisted living. Individuals can receive personal care services from Medicaid provided to them in an assisted living community, but not money for room and board. However, there are state programs that can provide assistance for room and board.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Older Americans Act Services

 

Ohio Ohio offers a Medicaid waiver specifically for assisted living called the Assisted Living Waiver Program. This program pays for care services in residential care communities but does not pay for the room and board cost. There are a limited number of slots available and participants must select from approved providers.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Choices Home Care Waiver
Residential State Supplement
PASSPORT Waiver

 

 

Oklahoma Through Oklahoma Medicaid's ADvantage Program Waiver, services in assisted living communities are covered.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Personal Care Program

Oregon Oregon has a Medicaid Waiver called Aged & Physically Disabled Waiver that pays for assisted living. There are a limited number of slots available.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Independent Choices Program
Client-Employed Provider

Pennsylvania At present the state of Pennsylvania does not provide financial assistance or care services funded by Medicaid to residents that live in assisted living communities, however there is a similar program called PA Dom Care (Domiciliary Care Program).

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Department of Aging Waiver
Services My Way

Rhode Island Rhode Island has a program called SSI Enhanced Assisted Living Program that provides up to approximately $1,200 / month to be put toward the cost of assisted living. However, this is not a Medicaid program. RI does have a Medicaid program called RIte @ Home which offers 24/7 personal care in a residential environment but not in assisted living communities. Finally, the state's Home and Community Care Medicaid Waiver also covers assisted living.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
SSI Enhanced Assisted Living
Home & Community Care Co-Pay

 

South Carolina South Carolina Medicaid does not currently cover services or room and board costs for assisted living.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Community Choices Waiver

South Dakota Under South Dakota's HCBS Waiver for the Elderly, services in assisted living communities are covered.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living

Tennessee TennCare CHOICES in Long-Term Care Program helps participants that wish to reside in assisted living communities by paying for nursing and personal care services in those communities. Room and board however are not considered eligible expenses for the Medicaid Waiver.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Elderly and Disabled HCBS

 

Texas

Texas Medicaid will cover the cost of services provided in an assisted living community through the state's Community Based Alternatives Waiver (CBA). However, the cost of room and board is not included.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Star Plus Waiver

Utah Utah Medicaid pays for services in assisted living residences as a benefit of several of its waivers. Most relevantly, the Aging Waiver for Individuals Age 65 or Older. Worth noting is that this benefit may be referred to as adult foster care.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
The Alternatives Program

 

Vermont Vermont's Choices for Care Medicaid Waiver pays for services in non-nursing home, residential care facilities.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Attendant Services

Virginia Virginia does pay for assisted living but not through the primary EDCD Waiver. Instead, individuals with Alzheimer's have a specific waiver called the Alzheimer's Assisted Living (AAL) Waiver.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
VA Adult Services

Washington Washington has two Medicaid Waivers, relevant to our audience, that provide help for residents in assisted living or adult family care. The COPES Program (Community Options Program Entry System Waiver) and Medicaid Personal Care program. The second of which offers personal care services but does not distinguish the location in which they can be provided other than to specify it cannot be in a nursing home.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Nurse Delegation Program
New Freedom Program

 

West Virginia West Virginia does not include assisted living or any form of non-nursing home, residential care paid for by its Medicaid waivers.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Medicaid Personal Care

Wisconsin Wisconsin, in a limited capacity, provides for services to state residents that live in assisted living communities through the COP-W, Medicaid Waiver. Worth noting is that Wisconsin offers a non-Medicaid program called Family Care that also provides limited assistance and help for families with Alzheimer's.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Alzheimer’s Family and Caregiver Support
Family Care

 

Wyoming

Wyoming Medicaid offers the Assisted Living Facility Waiver. This program will pay for a variety of personal care and nursing services for residents in assisted living but notably does not pay for their room and board costs.

Other Financial Assistance
Affordable Care Options
Loans for Assisted Living
Wyoming HCBS Waiver

Other Financial Assistance Options

Medicaid is not the only financial assistance option for assisted living.  Many states offer alternative programs and there are federal, non-profit and private assistance options available.  Use our Resource Locator Tool to find other programs and options for which you or your loved one is eligible.  Answer specific questions about your circumstances and receive a customized list of options in your geographic area.  Start here.

 

 

Finding Affordable Care

 Assisted living costs can vary as much as 50% even in the same town.

For persons not eligible for Medicaid or wait-listed for their state's assisted living benefits, finding quality, affordable care is critical.  As care costs can vary by as much as 50% in the same city, state or town, it is helpful to contact multiple care residences.  Our organization provides a free service to help families find the most affordable care that meets their needs.  Find affordable care now.

 

 

Assisted Living Family Loans

There are short and long term loans available designed specifically to help families afford the cost of assisted living.  One of these loans allows multiple family members to share the cost of assisted living for their loved ones.  More information on eligibility, fees and the application process is available here.