Medicaid Benefits for Assisted Living
Currently, 46 states and Washington, D.C. offer some Medicaid coverage for assisted living expenses. The states that do not are Alabama, Kentucky, Louisiana, and Pennsylvania.
Because each state has authority over its own programs, the terminology used by state Medicaid administrators may confuse older adults and their families. If you’re looking for coverage options in your state’s Medicaid benefits information, try searching the documents for phrases other states have designated for assisted living, such as residential care, supported living, alternative care facilities, adult foster care, and nonprofit personal care homes.
Assisted living residents with incomes above the maximum amount allowed for Medicaid recipients may still be able to receive Medicaid’s financial help through a variety of waivers available in each state. In many states, the allowance for increased income is as high as three times the typical maximum.
The 1915c Medicaid Home and Community Based Services and 1915b Managed Care waivers are among the most well-known and frequently used, but their availability varies greatly from state to state.
There are assisted living costs — specifically room and board — that Medicaid simply does not cover, whether you receive Medicaid through financial eligibility or a waiver. If you're lucky, you may live in a state that places a legal limit on the amount assisted living communities can charge for services government programs don’t cover.
Size Matters: Smaller assisted living communities with fewer beds typically cost less due to differences in regulatory requirements.