It’s a common question for seniors sorting through the expenses of assisted living: Does Medicaid cover assisted living? Who qualifies, and how much does Medicaid cover?
Medicaid covers the cost of care services in assisted living through state-specific home- and community-based services (HCBS) waivers, but it does not cover the cost of room and board.
Here, we’ll examine the ins and outs of Medicaid options for assisted living so you can budget accordingly.
[READ: What Is Medicare-Medicaid Dual Eligibility?]
How Medicaid Covers Assisted Living
Most states provide Medicaid coverage for assisted living costs through waiver programs, known as HCBS or 1915(c) Medicaid waivers. These programs help cover some of the services and supports that older adults and some people with certain disabilities need but cannot otherwise afford.
Currently there are 636 Medicaid state waiver programs across the country. Who’s eligible, which services covered and which program are available vary by state and the individual waiver program. This makes it difficult to generalize what and who is covered, so you’ll have to do some investigation about the options in your state. Here are just a few examples that show the complexity and localized nature of these programs:
— In Florida: HCBS waivers have been eliminated, and assisted living is covered through the Statewide Medicaid Managed Care Long-Term Care program.
— In Louisiana: Medicaid does not currently pay for assisted living costs, but the Community Choices Waiver benefit does cover monitored in-home caregiving, which is similar to adult foster care.
— In Maryland: The Community Options Waiver supports eligible individuals who need assisted living care but don’t yet need nursing home care.
— In New York: The Assisted Living Program provides about 4,200 assisted living units statewide, but these units are not restricted to Medicaid participants.
— In Texas: The Star Plus program will cover the cost of services provided in an assisted living community, but room and board are not included.
Medicaid beneficiaries who are enrolled in their state’s HCBS waiver program often receive long-term care services and support in their own homes rather than in an institutional setting. Providing care in the person’s house or in an assisted living facility is usually less expensive than providing the same care in a nursing home.
Medicaid.gov provides a list of all state waiver programs with more information about which programs are available in each state, what’s covered and how to find out more about qualifying and applying.
[Read: Medicaid Coverage for Nursing Home Care.]
What Assisted Living Services Does Medicaid Cover?
Medicaid, or more specifically HCBS waivers, may cover some or all of the following senior care services for those who are unable to pay:
— Activities of daily living (ADLs), such as toileting and personal hygiene
— Nursing care
— Medical supplies and equipment
— Medication management
— Medical assessments and exams, such as preventive care, checkups and diagnostic tests
— Case management services (coordination with medical providers)
— Respite care for a primary caregiver
— Mental health services
— Access to senior centers or adult day care services
— Transportation services, particularly to and from medical appointments
Limitations of Medicaid waivers
These waivers can provide a lifeline for many older adults in assisted living situations, but they come with limitations beyond coverage, according to the National Council on Aging:
— Caps: Some states cap the number of waivers that are available at any one time as a means of controlling costs.
— Waitlists: Some people who meet all the requirements for a waiver will end up on a waiting list until a slot becomes available. These waiting lists can be lengthy, and placement is prioritized based on level of care needed — they are not first come, first served. According to data from independent health policy research organization KFF, more than 710,000 people were on HCBS waiting lists in 2024.
If you find yourself on an HCBS waiver waiting list, you may be able to access other Medicaid services in the meantime. But because each state administers waivers and Medicaid benefits differently, you’ll have to inquire with your state’s Medicaid agency or department of health and human services for what services you may qualify for while you wait.
[SEE: Financial Planning Timeline by Year: A Step-by-Step Guide to Affording Senior Living]
Do Assisted Living Facilities Accept Medicaid?
No, not all assisted living facilities accept Medicaid, and some may limit the number of beds available to Medicaid beneficiaries.
However, some assisted living communities that don’t accept Medicaid may still allow healthcare providers into the community to care for residents enrolled in Medicaid. It can be complicated, so be sure to ask any facility you’re considering about their Medicaid coverage policies.
Medicaid Eligibility Requirements for Assisted Living
According to the Centers for Medicare & Medicaid Services, to qualify for Medicaid, you must meet several criteria:
— Your income must be below your state’s Medicaid income limit, or your medical-related care expenses must exceed your income.
— Your countable assets (cash, stocks, bonds, investments, bank accounts and real estate holdings that are not your primary residence) must fall within a certain range.
— You must be a citizen of the U.S. or a permanent resident.
— You must reside in the same state where you’re seeking benefits.
— You must have a qualifying medical need.
2026 Medicaid Eligibility: Can You Qualify?
To qualify for a Medicaid HCBS waiver for assisted living, you must meet certain financial and functional requirements set by the state where you live. Many states set the income limit at no more than of 300% of the Federal Benefit Rate (FBR) — the maximum monthly federal payment for individuals who qualify for Supplemental Security Income.
In 2026, the FBR is $994 for a single individual and $1,491 for an eligible couple. So, if you’re taking in more than $2,982 per month as an individual or $4,473 as a married couple, Medicaid won’t be able to help you.
Specific criteria, however, can vary by state. For instance:
— In Alabama: The $2,982 per month limit is generally a strict cap for Medicaid waiver programs in 2026.
— In California: The qualifying income limit for these programs is lower, at $1,836 per month in 2026.
Some individuals have incomes that are too high to qualify for Medicaid but too low to afford long-term care out of pocket. These individuals may need to navigate a complex Medicaid spend down process, where they reduce countable income or assets to meet eligibility requirements. Income eligibility limits vary by state and by waiver program.
Kate Granigan, CEO of LifeCare Advocates in Newton, Massachusetts, and president of the board of directors with the Aging Life Care Association, recommends working with an elder law attorney who specializes in Medicaid. They can help ensure you meet the strict criteria and avoid “unknowingly disqualifying yourself by making financial gifts” or stumbling into other pitfalls that could affect your qualification status.
She adds that senior living facilities that accept Medicaid often have someone on staff who can help you navigate the process of applying.
Also worth noting: If you qualify for Supplemental Security Income benefits, you’ll also qualify for Medicaid benefits in some states, according to the Social Security Administration.
How to Apply for Medicaid and an HCBS Waiver
The application process for HCBS waivers varies by state, but general steps may include:
— Verify Medicaid enrollment: If you aren’t already enrolled, you must apply for Medicaid.
— Assess medical needs: A healthcare professional must certify that you have a nursing facility level of care, also known as NFLOC.
— Contact your local Area Agency on Aging: They can help you figure out which communities near you accept Medicaid and how to find the right place for your needs.
— Join the waitlist: If a waiver’s cap has been reached, make sure you’re officially placed on the waitlist.
You can contact your state Medicaid agency for more specific instructions on how to apply.
Alternatives to Medicaid for Assisted Living Costs
Many people will assume that Medicare, the federal health insurance program, will cover senior care expenses, but this can be an expensive miscalculation, says Diane J. Omdahl, Wisconsin-based president and co-founder of the Medicare consulting firm 65 Incorporated.
“In fact, 56% of middle-income baby boomers believe that Medicare will pay for their ongoing long-term care,” she points out.
Instead, Omdahl recommends looking to other programs and products for help in paying for senior living expenses, including:
— Traditional long-term care insurance
— Deferred long-term care annuities
— Combination insurance products
— Reverse mortgages
— Charitable remainder trusts
You may also need to consider these options if you have qualified for but anticipate losing Medicaid coverage as a result of the passage of the One Big Beautiful Bill Act in July 2025.
Medicare vs. Medicaid: Understanding long-term care coverage
It’s also worth noting Medicare focuses on short-term rehabilitative care rather than the longer-term custodial care that Medicaid provides coverage for. Medicare only pays for up to 100 days in a skilled nursing facility if the patient requires medically necessary post-hospital care. The patient must continue making improvements in health or physical function for Medicare to continue coverage.
Medicaid kicks in when someone needs long-term care that’s not focused on regaining function but is rather on maintaining the status quo and supporting ADLs.
More from U.S. News
What Is a Long-Term Care Facility? Types and Costs
10 Steps to Plan Ahead for Long-Term Care
What Are the Levels of Senior Living? A 2026 Family Guide
Medicaid Coverage for Assisted Living: 2026 Costs and Eligibility Guide originally appeared on usnews.com
Correction 05/20/26: This story was previously published at an earlier date and has been updated with new information.
