For qualified residents of assisted living facilities, Medicaid will pay for care and products that are part of a health care provider’s documented care plan. This may include physical and occupational therapy, hearing aids, prescription medications, assistance with activities of daily living (ADLs), and more. In some states, Medicaid will also pay for room and board in an assisted living facility. In 2025, the median cost for assisted living is $5,190 per month.
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In general, Medicaid covers the cost of assisted living for eligible seniors in two ways: through a state’s regular Medicaid plan or through Medicaid waivers.
State Medicaid plans cover medically necessary care for people who require a high level of care and/or supervision. Federal requirements ensure that certain aspects of these plans are the same across all states, such as coverage of home health care and institutional nursing home care.[01] State Medicaid plans are entitlement programs, meaning that all seniors who meet the eligibility requirements for covered services are entitled to receive those services.
Some states provide optional benefits such as Home and Community Based Services (HCBS) to their state plan.[02] These benefits help seniors avoid or delay moving to a nursing home by providing the care they need in other settings.
Some states also offer waivers, which allow them to “waive certain Medicaid eligibility requirements, covering care for people who might not otherwise be eligible for Medicaid.”[03] States design their own waiver programs (within federal guidelines) to expand access to specific services for specific groups of people beyond what’s permitted by their state’s regular plan.
Waiver availability, coverage, and eligibility requirements vary widely from state to state. Unlike regular state Medicaid plans, waivers aren’t entitlement programs. This means that enrollment is usually limited. Even if a senior qualifies for a waiver program, there may be long waitlists. Availability of waiver programs may vary by location within a state, too.
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For qualified seniors, Medicaid will pay for services and products that are part of a documented care plan. This may include:
The specific amount that Medicaid will pay for medically necessary expenses varies by state. Some states require copayments, coinsurance, deductibles, and other similar charges for nonemergency services based on an individual’s income.[04] For example:
Check with your loved one’s state Medicaid office to understand what assisted living costs are covered.
Applying for Medicaid for long-term care can be a complex process, and it varies by state. It’s important to contact your state’s Medicaid assistance office for more details. You can also contact an elder law attorney who can walk you through the nuances of eligibility for Medicaid benefits. Be sure to request a list of all Medicaid programs in your state to determine what your loved one may be eligible for.
It’s important to note that not all assisted living communities will accept payments through Medicaid or a Medicaid wavier. To find a community that does, contact your local Medicaid office, Department of Aging, Department of Elder Affairs, Area Agency on Aging (AAA), or social service agency. They can help you understand available care options.
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It’s common for seniors and families to combine several payment sources to cover the cost of assisted living. These include but aren’t limited to the following:
When considering payment options, know that you’ll likely have to pay some assisted living costs out of pocket or through other means. Even with a waiver, Medicaid won’t cover the full cost of assisted living.
Read more:Medicare, Medicaid, and Long-Term Care
If you want to consider other care options, Medicaid waivers may cover some alternatives to assisted living, such as:
While the cost of assisted living continues to increase, there are several resources to help low-income seniors pay for care. If you have additional questions or need guidance searching for assisted living options, a Senior Living Advisor at A Place for Mom can help. They’ll provide information to help you find the communities that best fit your family’s financial and care needs. This service comes at no cost to you or your loved one.
No, Medicaid won’t cover room and board in an assisted living community, but it may pay for certain dementia care services.
No, rent in assisted living isn’t considered a deductible medical expense, but unreimbursed medical expenses that exceed 7.5% of the adjusted gross income are deductible on a federal tax return.
Yes, although you may need to move to a community that accepts Medicaid if your current one doesn’t accept it. To qualify for Medicaid, you may need to reduce your countable income and assets through a spend down plan if they’re higher than your state’s threshold.
As you tour assisted living facilities, ask whether they coordinate with any public programs that may help cover the cost of care services. They may note some that you haven’t considered.
Key Takeaways
Centers for Medicaid & Medicare Services. Eligibility.
Centers for Medicare & Medicaid Services. Home and community based services.
Centers for Medicare & Medicaid Services. State Medicaid plans and waivers.
Centers for Medicare & Medicaid Services. Cost sharing out of pocket costs.
Florida Agency for Health Care Administration. Statewide Medicaid managed care long-term care recipient FAQs.
North Carolina Department of Health and Human Services. (2024, December). Special assistance help for North Carolinians who need care in a residential facility.
The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.
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