What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through Medicaid Waivers. Medicaid waivers are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.
Connecticut’s Assisted Living Program is contained within the Connecticut Home Care Program for Elders (CHCPE), a state Medicaid waiver. Given that care is provided in assisted living residences instead of at home, we have included it separately on this page. This financial assistance program helps low income, elderly state residents afford the high cost of assisted living (non-skilled nursing, residential care).
Presently, all of Connecticut’s Medicaid funding for assisted living is administered through the CHCPE. The Assisted Living Program is a collection of four smaller programs that offer assisted living support in different locations. Many Connecticut seniors prefer assisted living to other long term care options. This is because it allows them to continue living independently, in an individual studio, or one bedroom apartment, while gaining a team of onsite caregivers and services in a social environment.
This program is unusual in that it is open to both Medicaid eligible and ineligible Connecticut residents.
The Assisted Living Program is available to all Connecticut residents who are at least 65 years of age. Program participants must need assistance to complete activities of daily living and must be “in need of short or long term nursing home care.” For those who don’t yet require this level of care, they may be placed on a waiting list.
The Assisted Living Program is open to both Medicaid eligible individuals and those who are not Medicaid eligible. There are different financial requirements depending on whether the applicant is enrolled or seeking to enroll in Connecticut’s Medicaid program.
The program does not have a hard income limit. However, persons with incomes over 200% of the Federal Poverty Guidelines will be required to contribute to the cost of their care. In 2023, this means individuals with incomes greater than $29,160 a year ($2,430 a month) must pay a percentage of their income. An applicant’s assets are also considered. The 2023 asset limits for individuals and married couples are $44,586 and $59,448, respectively.
To qualify, an individual must have total assets of less than $1,600. If married and one’s spouse is also seeking or receiving assistance from Medicaid, then their combined total assets must be less than $3,200. Monthly income for a single applicant must be below $2,742 per month in 2023. Married couples with both spouses applying for benefits are each allowed up to $2,742 a month in income.
As with non-Medicaid program participants, Medicaid program participants must contribute income over 200% of the Federal Poverty Guidelines toward their cost of care. This means, in 2023, all monthly income over $2,430 must go toward care costs. For those couples in which only one spouse receives Medicaid, the non-applicant spouses may receive an income allowance from the applicant spouse, as well as a greater portion of the couples’ assets to ensure the non-applicant spouse can continue to afford to live independently. These are known as spousal impoverishment rules.
Persons unsure if they or their loved one will meet the eligibility criteria for this program should consider consulting with a Medicaid planning professional. Read more.
Benefits and Services
Typically, assisted living communities provide nursing / personal care, 24-hour security, meal services, housekeeping, laundry, recreational activities, and medication oversight. Unfortunately, this program will not cover the cost of room and board (rent and meals). However, it may be possible for persons with very low income and no significant assets to reside in a state funded congregate housing facility or a federally funded Department of Housing and Urban Development (HUD) facility and receive care services. Both non-Medicaid and Medicaid program participants may be required to make co-payments, based on one’s monthly income level.
Did you know?
According to Genworth’s 2021 Cost of Care Survey, the average monthly cost for assisted living in Connecticut is $5,129. This amount far exceeds the typical monthly Social Security income. Find out the cost of care in your area of Connecticut.
How to Apply / Learn More
To apply online for the Assisted Living benefits from the CHCPE, go to the new online application. Those who prefer to apply in person can find the local field offices for the Department of Social Services available here. Be aware that there is a cap on the number of participants allowed in the program. Therefore, a waiting list may exist.
To learn more about the assisted living option, a pdf with additional information is available for download here.
Free assistance is also available to help Connecticut seniors find affordable assisted living communities.