How Does Assisted Living Differ State to State?
Medicaid & Assisted Living – Quick Facts
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Do all states offer Medicaid-funded assisted living?
No—Alabama, Kentucky, and Louisiana do not provide this benefit.
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Does Medicaid pay for room & board?
No—states may set affordability policies, but Medicaid never covers room and board costs.
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How is coverage provided?
Through HCBS Waivers, State Plan Medicaid, or State Plan Options like CFC and 1915(i).
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Are there waitlists?
Yes—waiver programs often have limited slots; State Plan programs generally do not.
What Is Medicaid-Funded Assisted Living?
Medicaid-funded assisted living is part of Home and Community Based Services (HCBS), designed to help seniors and people with disabilities receive care in a residential setting rather than a nursing home. While most states offer it, Alabama, Kentucky, and Louisiana do not. The program covers services like personal care, homemaker support, non-emergency transportation, and memory care, but never room and board.Through Which Programs Do States Cover Assisted Living?
Most states provide assisted living services via 1915(c) HCBS Waivers or 1115 Demonstration Waivers. These target specific populations and often have participant caps, leading to waitlists. Other states offer personal care services through State Plan Medicaid or State Plan Options like 1915(k) Community First Choice and 1915(i) HCBS. State Plan benefits are an entitlement with no waitlist, but not all states permit these services in assisted living facilities.What Are the Eligibility Requirements?
Applicants must meet both financial and functional criteria, which vary by state and program. Functional eligibility usually requires assistance with Activities of Daily Living (ADLs). For memory care coverage, applicants must have a diagnosed cognitive impairment or dementia. States may have additional requirements based on the specific Medicaid program.Which States Offer Assisted Living via HCBS Waivers?
Many states—such as California, Florida, New York, Texas, and Washington—cover assisted living under HCBS or 1115 waivers. Program names vary, from California’s Assisted Living Waiver to Texas’s STAR+PLUS HCBS. Because program availability and scope can change, applicants should confirm details with their state Medicaid agency.Which States Offer Personal Care Through State Plan Medicaid?
States like Maine, Michigan, Minnesota, New Jersey, North Carolina, North Dakota, Oregon, Washington, West Virginia, and Wisconsin provide personal care services via State Plan or Community First Choice in assisted living facilities. However, not all assisted living residences accept Medicaid or allow outside caregivers to provide services.What Services Can Be Covered?
- Personal care (bathing, dressing, toileting, eating)
- Round-the-clock supervision
- Case management
- Nursing services
- Equipment, technology, and modifications
- Non-medical transportation
- Home-based services
- Day services or adult day health
- Home-delivered meals
- Caregiver support (respite, training, counseling)
How Do State Benefits Differ?
According to the KFF Medicaid HCBS Program Survey 2024, personal care is the most common benefit, followed by 24/7 services, case management, and nursing care. Some states offer specialized services like caregiver counseling or home modifications, while others focus primarily on core personal care and supervision.What Should Applicants Do Next?
- Confirm whether your state offers Medicaid-assisted living and in what form (waiver or State Plan).
- Check if the assisted living facility you’re interested in accepts Medicaid payments.
- Ask about waitlists for waiver-based programs and explore State Plan options if available.
| State | Available Assisted Living Services for Seniors & Individuals with Disabilities |
|---|---|
| Alabama | Not offered |
| Alaska | Case coordination, day programs, adaptive equipment & home modifications, transportation (non-medical), nursing services, 24-hour care |
| Arizona | 24-hour care |
| Arkansas | 24-hour care |
| California | Personal assistance, case coordination, adaptive equipment & home modifications, nursing services, 24-hour care |
| Colorado | Personal assistance, 24-hour care |
| Connecticut | Personal assistance, adaptive equipment & home modifications |
| Delaware | Personal assistance, 24-hour care |
| District of Columbia | Personal assistance, home-based care |
| Florida | No data available |
| Georgia | Personal assistance, case coordination, day programs, adaptive equipment & home modifications, home-based care, transportation (non-medical), nursing services, 24-hour care |
| Hawaii | Personal assistance, case coordination, nursing services, 24-hour care |
| Idaho | No data available |
| Illinois | Personal assistance, nursing services, 24-hour care |
| Indiana | No data available |
| Iowa | Personal assistance, case coordination, day programs, adaptive equipment & home modifications, home-based care, meal delivery, 24-hour care |
| Kansas | Personal assistance, day programs, 24-hour care |
| Kentucky | Not offered |
| Louisiana | Not offered |
| Maine | Personal assistance |
| Maryland | 24-hour care |
| Massachusetts | Personal assistance, case coordination, home-based care, adaptive equipment & home modifications, transportation (non-medical), nursing services, 24-hour care |
| Michigan | Personal assistance, case coordination, adaptive equipment & home modifications, home-based care, meal delivery, transportation (non-medical), nursing services |
| Minnesota | Personal assistance, adaptive equipment & home modifications, home-based care, meal delivery, transportation (non-medical), nursing services, 24-hour care |
| Mississippi | Personal assistance, case coordination, transportation (non-medical), nursing services, 24-hour care |
| Missouri | Not offered |
| Montana | Personal assistance, case coordination, adaptive equipment & home modifications, transportation (non-medical), nursing services, 24-hour care |
| Nebraska | Personal assistance, case coordination, day programs, home-based care, meal delivery, transportation (non-medical), 24-hour care |
| Nevada | Personal assistance, case coordination, home-based care, transportation (non-medical), 24-hour care |
| New Hampshire | Personal assistance, adaptive equipment & home modifications, home-based care, transportation (non-medical), nursing services, 24-hour care |
| New Jersey | Personal assistance, caregiver support, case coordination, day programs, adaptive equipment & home modifications, home-based care, transportation (non-medical), nursing services, 24-hour care |
| New Mexico | Personal assistance, case coordination, day programs, adaptive equipment & home modifications, home-based care, nursing services |
| New York | Not offered |
| North Carolina | Personal assistance |
| North Dakota | Personal assistance |
| Ohio | Case coordination, nursing services, 24-hour care |
| Oklahoma | Personal assistance, case coordination, adaptive equipment & home modifications |
| Oregon | No services reported |
| Pennsylvania | Personal assistance, case coordination |
| Rhode Island | Personal assistance, day programs, home-based care, meal delivery, 24-hour care |
| South Carolina | Personal assistance, case coordination, meal delivery |
| South Dakota | Day programs, adaptive equipment & home modifications, 24-hour care |
| Tennessee | Not offered |
| Texas | Personal assistance, case coordination, day programs, adaptive equipment & home modifications, home-based care, transportation (non-medical), nursing services, 24-hour care |
| Utah | No data available |
| Vermont | Personal assistance, case coordination, day programs, nursing services |
| Virginia | No services reported |
| Washington | Personal assistance, caregiver support, case coordination, day programs, adaptive equipment & home modifications, transportation (non-medical), nursing services, 24-hour care |
| West Virginia | Personal assistance |
| Wisconsin | Personal assistance, caregiver support, case coordination, day programs, adaptive equipment & home modifications, home-based care, transportation (non-medical), nursing services, 24-hour care |
| Wyoming | Personal assistance, case coordination, day programs, adaptive equipment & home modifications, home-based care, meal delivery, transportation (non-medical), nursing services, 24-hour care |
