Will Medicaid Pay for Assisted Living?
Medicaid & Assisted Living – Quick Facts
Yes—most states cover services in assisted living, but never room and board.
Average assisted living costs $5,900/month; memory care averages $7,899/month.
Through State Plan Medicaid or HCBS Waivers—rules vary by state.
Yes—waivers may have limited slots; State Plan services usually do not.
Will Medicaid Pay for Assisted Living?
Assisted living offers housing, personal care, and support for seniors and people with disabilities who can’t live independently but don’t require full nursing home care. While Medicaid will cover certain services—like personal care and health supports—it never covers room and board. Costs for assisted living average nearly $71,000 per year, and memory care is even higher.
How Does Medicaid Cover Assisted Living?
Coverage varies by state because Medicaid is jointly funded by federal and state governments. Most states provide assisted living benefits through Home and Community Based Services (HCBS) Waivers, while others may also offer them via their Regular State Plan Medicaid programs.
What Is Regular State Medicaid and How Can It Help?
Regular State Plan Medicaid is an entitlement—if you qualify, you receive services without a waitlist. Some states include personal care services in assisted living under this plan, either directly or through State Plan Options like Community First Choice (1915(k)) or 1915(i) HCBS programs. These options ensure access statewide without enrollment caps.
What Are HCBS Medicaid Waivers?
HCBS Waivers help people remain in community settings, including assisted living, instead of moving into nursing homes. They can cover personal care, emergency response systems, adult day care, home modifications, and more. Unlike State Plan benefits, HCBS Waivers are not guaranteed and may have limited enrollment, leading to long waitlists.
Which Services Does Medicaid Fund in Assisted Living?
- 24/7 staff availability
- Personal care assistance (bathing, dressing, mobility, toileting, eating)
- Homemaker services (laundry, meal preparation, light housekeeping)
- Medication management
- Transportation for non-medical needs
- Nursing and case management
- Emergency response systems
Memory care adds dementia-specific staff training, secure facilities, and cognitive stimulation activities.
How Much Will Medicaid Pay?
The amount depends on state rules, program type, and assessed care needs. Those with greater needs may receive more service hours, but room and board remain the resident’s responsibility.
What Are the Financial Eligibility Rules?
Income and asset limits vary by program type. In 2025, State Plan Medicaid income limits are around $967–$1,304/month, while HCBS Waiver limits are up to $2,901/month. Assets are typically capped at $2,000. Planning strategies can help applicants qualify without violating Medicaid’s Look-Back rules.
What Are the Functional Eligibility Rules?
HCBS Waivers usually require a nursing home level of care, while State Plan personal care services require documented medical necessity. Memory care residents generally must have a diagnosed cognitive impairment.
Do All States Cover Assisted Living Under Medicaid?
No. States like Alabama, Kentucky, and Louisiana do not fund assisted living services via Medicaid. Even in states that do, not all facilities accept Medicaid, and those that do may limit the number of Medicaid beds.
How Can I Find an Assisted Living Residence That Accepts Medicaid?
Check with your local Area Agency on Aging for lists of Medicaid-certified facilities. Ask directly about Medicaid acceptance, bed availability, and whether outside caregivers are allowed if the facility itself doesn’t have Medicaid beds.
What Are the Next Steps?
- Take a Medicaid pre-screening test to see if you might qualify.
- Discuss payment options with a Medicaid Planning Professional.
- Contact facilities to confirm Medicaid acceptance and availability.
