Medicaid Assisted Living Benefits by State
- Discover older adults' entitlement to assisted living benefits by state, including different types of Medicaid waivers and eligibility criteria for Medicaid.
Paying for older adults' care can be challenging, and making sense of the various benefits is confusing for many families. Luckily, plenty of support is available to make the process easier for everyone. Medicaid is a federally funded and state-funded health insurance program for low-income people, including older adults. You or your loved one might be able to save money on assisted living care if you have a Medicaid plan.
Some state Medicaid plans cover personal care assistance in assisted living facilities, but most are covered by Home and Community-Based Services Medicaid waivers, managed care waivers and Section 1115 demonstrations. The aim of these waivers is to delay the transition into nursing care, which is usually around double the cost of assisted living and much more expensive than home care or adult day care.
Keep reading to discover Medicaid assisted living benefits by state and find out more about HCBS waivers, eligibility criteria and how to apply.
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Guide to Medicaid Assisted Living Benefits by State
While most states offer some form of support in the form of an assisted living waiver, you should make sure the facility you choose is Medicaid-approved. Below is an explanation of the various assisted living benefits by state.
|
State |
Assisted Living Waiver |
|
Alabama |
There is currently no financial support available to individuals residing in assisted living facilities in Alabama, but there are Medicaid plans available to help older adults remain in their homes. |
|
Alaska |
Alaskans Living Independently Waiver (ALI) is the main assisted living benefit in Alaska, but there are additional options for financial assistance with senior care available. |
|
Arizona |
Arizona's Long Term Care System (ALTCS) is available to help eligible older adults pay for services in assisted living facilities. The Self-Directed Attendant Care program can assist older adults with hiring a personal care attendant. |
|
Arkansas |
Living Choices Assisted Living and the Arkansas state Personal Care Program can help older adults pay for assisted living services. |
|
California |
The Medi-Cal Assisted Living Waiver (ALW) can help some qualifying older adults pay for assisted living, however, support is limited to specific counties. Luckily, eligible Californians can apply to live in a facility in any county. |
|
Colorado |
Colorado's Elderly, Blind and Disabled Waiver permits participants in assisted living residences to get financial help with personal care services. Older adults can choose their own care providers using Colorado Consumer Directed Attendant Support Services (CDASS). |
|
Connecticut |
Connecticut's Assisted Living Program under CHCPE helps older adults in assisted living, known locally as congregate housing. The Connecticut Adult Family Living (AFL) Program provides support specifically for individuals in adult foster care. |
|
Delaware |
The Diamond State Health Plan Plus can help eligible Delaware residents get support paying for services in assisted living communities. |
|
District of Columbia |
In the District of Columbia, the DC Elderly and Persons with Physical Disabilities (EPD) Waiver is available to low-income older adults who need help paying for certain services within an assisted living setting. |
|
Florida |
While Florida used to rely on HCBS waivers, it now covers assisted living with the Statewide Medicaid Managed Care Long-Term Care Program (SMMC LTC). |
|
Georgia |
Georgia's CCSP and SOURCE Programs provide financial aid to eligible older adults for assisted living personal care services, which it refers to as alternative living services. |
|
Hawaii |
Medicaid managed care in Hawaii curates the Med-QUEST Integration Program, which covers nursing services in assisted living facilities. It's also possible to access Adult Foster Care services, which are similar to assisted living. |
|
Idaho |
In Idaho, there are three options for older adults who require support with assisted living care. The Aged and Disabled Waiver, Idaho Medicaid Medicare Coordinated Plan and the Personal Care Services Program. |
|
Illinois |
Illinois older adults can access assisted living benefits via the HCBS Waiver for Supportive Living Facilities. There's an enrollment cap in place, but the state has made sure there are plenty of slots and is in the process of developing more eligible residences. |
|
Indiana |
The Aged and Disabled (A&D) Waiver offers support to older adults residing in Medicaid-approved assisted living facilities in Indiana. It also provides alternative but similar provisions to individuals who would prefer structured family caregiving support in an adult foster home. |
|
Iowa |
Residents in Iowa can self-direct their care and get support with personal assistance at home or in an assisted living home. The Home and Community-Based Services (HCBS) Waiver provides funding to eligible people. Older adults under age 65 can get help using the Iowa Medicaid Health & Disability Waiver |
|
Kansas |
KanCare is the name of Medicaid in Kansas, and it oversees the Frail Elderly Waiver Program. It's available to older adults who live at home or in an assisted living facility. |
|
Kentucky |
There is currently no financial aid for most individuals residing in assisted living facilities in Kentucky, but there are Medicaid plans available to cover adult foster care for individuals with developmental or intellectual challenges that developed before age 22. |
|
Louisiana |
While Louisiana's Community Choices Waiver doesn't explicitly offer support paying for assisted living personal care, there's an option for "monitored in-home caregiving," which is akin to adult foster care. |
|
Maine |
There is currently no support for individuals residing in assisted living homes in Maine, but there are Medicaid plans available to help some older adults remain at home. |
|
Maryland |
Maryland's Community Options Waiver provides financial support to individuals who require some nursing care but would be able to get their needs met in an assisted living facility. Additionally, state Medicaid and the Increased Community Services program exist to help older adults remain in an AL community. |
|
Massachusetts |
Massachusetts has three options for older adults to get help paying for care in assisted living homes: Massachusetts Personal Care Attendant Program: Cash & Counseling, Massachusetts Group Adult Foster Care (GAFC) and SSI-G. |
|
Michigan |
In Michigan, the Choice Waiver Program provides support for eligible low-income older adults who can get the care they need in an assisted living facility. Facilities might be referred to as homes for the aged or adult foster homes. |
|
Minnesota |
If you live in Minnesota, you can benefit from the Elderly Waiver (EW) and the CADI Waiver. The state Medicaid program also offers support for personal care services in assisted living. |
|
Mississippi |
Mississippi's Assisted Living (AL) Waiver is specifically designed for older adults in an assisted living residence. |
|
Missouri |
There are a number of options available to support qualifying Missouri residents who need help paying for personal care in non-nursing care settings. The Home and Community Based Program, Missouri Consumer Directed State Plan Personal Care and the Aged and Disabled Waiver. The Missouri Supplemental Nursing Care Assistance Program provides assistance for those in nursing care and assisted living facilities. |
|
Montana |
In Montana, assisted living is referred to as adult residential living. The Big Sky Medicaid Waiver can help eligible older adults cover costs associated with care in assisted living communities. |
|
Nebraska |
Nebraska's Aged and Disabled Medicaid Waiver includes personal care in assisted living facilities as one of its benefits. |
|
Nevada |
Nevada older adults are covered for support with augmented personal care from the HCBS Waiver for the Frail Elderly (HCBS-FE) if they reside in an assisted living facility. The Nevada Medicaid HCBW for Persons with Physical Disabilities is another option for qualifying candidates. |
|
New Hampshire |
Assisted living is listed as adult family care in the list of Choices for Independence (CFI) Waiver's benefits, and it can help with the cost of personal care in these settings. |
|
New Jersey |
In New Jersey, the Managed Long-Term Services and Supports (MLTSS) is available to low-income seniors who need help paying for long-term care. |
|
New Mexico |
New Mexico's Centennial Care Community Benefit covers personal care in an assisted living center. |
|
New York |
In New York, Medicaid's Assisted Living Program covers support in more than 4,200 units, including assisted living facilities. |
|
North Carolina |
Older adults in North Carolina who need help paying for assisted living care can use North Carolina's Medicaid Personal Care Services. |
|
North Dakota |
North Dakota Medicaid State Plan Personal Care Services program provides financial support for the cost of services in any type of residence apart from care homes. |
|
Ohio |
Ohio has a program specifically formulated for assisted living, known as the Assisted Living Waiver Program. MyCare Ohio offers support to individuals in some counties who are eligible for Medicaid and Medicare. |
|
Oklahoma |
Oklahoma's ADvantage Waiver covers personal care services for eligible older adults in AL facilities. The state Medicaid plan can also help some people gain support with care services. |
|
Oregon |
Older adults who require financial assistance staying in any type of residence other than a nursing home can take advantage of K Plan benefits. |
|
Pennsylvania |
The Pennsylvania Medicaid Community HealthChoices Program and Pennsylvania Department of Aging (PDA) Waiver help older adults pay for personal care in domiciliary care homes. |
|
Rhode Island |
Medicaid's Section 1115 Comprehensive Demonstration Waiver can help eligible older adults cover care costs in assisted living facilities. |
|
South Carolina |
In South Carolina, the Community Choices Waiver can cover some of the costs of care in an assisted living community. |
|
South Dakota |
South Dakota's Home & Community-Based Options and Person Centered Excellence Waiver (HOPE) includes coverage for specific personal care costs in assisted living homes. |
|
Tennessee |
Participants in assisted living facilities can get support from the CHOICES in Long-Term Services and Supports Program to cover personal care and nursing costs. |
|
Texas |
Older adults in Texas can use the STAR+PLUS HCBS Medicaid Waiver to get help paying for personal care services in assisted living. |
|
Utah |
The Utah Medicaid New Choices Waiver pays for assisted living care for eligible older adults. |
|
Vermont |
Vermont's Choices for Care Program pays for non-nursing home residential facilities for individuals who meet Medicaid requirements. |
|
Virginia |
There is currently no support for individuals residing in assisted living facilities in Virginia, but older adults can get assisted living assessments from Adult Services. |
|
Washington |
Several options are available to help older adults in Washington pay for assisted living. The Community Options Program Entry System Waiver (COPES) and Specialized Dementia Care Program both include assisted living in their lists of benefits. |
|
West Virginia |
Older adults living at home or in assisted living can take advantage of West Virginia's Medicaid Personal Care to help cover the cost of personal care. |
|
Wisconsin |
There are a number of options available to help Wisconsin older adults pay for assisted living services. The Wisconsin Include, Respect, I Self-Direct (IRIS) Program, Wisconsin Medicaid Personal Care and Wisconsin Family Care and Family Care Partnership Programs all provide specific services to local residents. |
|
Wyoming |
Some personal care and nursing care services are covered by the Wyoming Medicaid Community Choices Waiver for individuals living in assisted living settings. |
Does Medicaid Pay for Assisted Living?
Medicaid can help you pay for assisted living care if you meet the eligibility criteria. This might include homemaker assistance, personal care, skilled nursing and emergency response systems. Medicaid is operated in part by the federal government and partly by each state, so benefits can vary considerably depending on location.
States have a lot of flexibility when it comes to how they operate Medicaid programs. Some might offer support for assisted living through the state plan alone, but most rely on 1915(c) Medicaid waivers, Section 1915(b) waivers and 1115 demonstration waivers. A few states offer care assistance through both the state plan and the HCBS waivers. It's important to note that while all states provide personal care assistance to some extent, not all of them cover it in relation to assisted living.
State Medicaid
Medicaid is an entitlement program from the federal government that provides health care benefits to eligible persons. Each state can choose the specific benefits it offers provided they remain within the parameters set by the federal government.
Regular state Medicaid assistance is usually only given if a participant has a nursing care level of need. However, in many cases, enrollment can't be capped, there are never wait lists and geographic location isn't limited to the state of residence.
HCBS Medicaid Waivers
Most states use HCBS waivers to help older adults slow the transition from community living into nursing care. With this type of waiver, an individual can reside in a variety of settings and get support with housekeeping, personal care assistance, respite care, emergency response systems and other services that promote independent living.
With HCBS waivers, enrollment is limited and there might be wait lists for assisted living services. Some states base prioritization on level of need while others operate a first-come, first-served system. Section 1115 demonstration waivers and Section 1915(b) waivers may also be subject to wait lists.
Eligibility Requirements for Medicaid Assisted Living Waivers
There are income and asset limits when it comes to eligibility for Medicaid assisted living waivers. Exact limits vary from state to state but generally don't vary much from the following guidelines. As of 2021, an applicant must not have an income higher than 300% of the Federal Benefit Rate of $2,382 per month. The individual asset level is $2,000 per applicant, but some assets are exempt and don't count towards the limit.
When it comes to level of care, applicants should have a demonstrable need for assistance from the waiver programs. For many states, this involves a nursing care level of requirement, but level of care isn't always easy to determine. Each state has a different definition, so check with your local Area Agency on Aging for specific requirements in your state.
Can AL Waivers Help Pay for Room and Board?
Assisted living waivers never cover the cost of room and board in any state. Waivers are designed to help older adults get access to benefits, not pay for residential care. Services covered include help with daily tasks such as eating, toileting, mobility, grooming, dressing and bathing. Custodial care, attendant care and personal care assistance are some commonly used terms to describe these services.
Waivers also often cover medication management, homemaking, social, educational and recreational activities and transportation.
Other Names for Assisted Living
Assisted living facilities are residential, long-term care providers for older adults. They usually provide meals, assistance with daily tasks, transport, activities, companionship and have limited medical staff on-hand. There are different names for assisted living, and not all waivers are called assisted living waivers.
Let's take a look at some alternative names for assisted living facilities. While some of the following offer slightly different services, they all fall under the AL umbrella:
- Adult foster care
- Adult family homes
- Adult living facilities
- Board and care
- Domiciliary care
- Memory care facilities
- Eldercare facilities
- Personal care homes
- Group homes
- Sheltered housing
- Homes for the aged
- Senior living residences
- Residential care facilities
How to Apply for an Assisted Living Waiver
The exact application process for assisted living waivers varies by state. Before you apply for assistance, it's worth using a no-obligation Medicaid eligibility test to determine if you're likely to receive sufficient support. Once you've determined eligibility, contact your local Medicaid agency to find out how to apply for Medicaid.
