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Does Medicaid Pay for Assisted Living?

8 minute readLast updated May 10, 2025
Written by Kevin Ryan
fact checkedby
Tori Newhouse
Reviewed by Letha McDowell, CELA, CAPCertified Elder Law Attorney Letha Sgritta McDowell is a past president of the National Academy of Elder Law Attorneys.
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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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Key Takeaways

  1. Medicaid will cover medically necessary services and products for seniors in assisted living, and in some states, it will pay for room and board.
  2. State Medicaid programs differ in how they cover assisted living, with some states providing waivers and others covering services through their regular Medicaid plan.
  3. Medicaid may also cover home care and adult day services, as well as other alternatives to assisted living.

How does Medicaid cover medically necessary expenses in assisted living?

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

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.

Medicaid waivers

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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What assisted living costs will Medicaid pay?

For qualified seniors, Medicaid will pay for services and products that are part of a documented care plan. This may include:

  • Nursing care services
  • Home health services
  • Prescription drugs
  • Physical, occupational, and speech therapies
  • Eyeglasses and hearing aids
  • Personal care services
  • Medication management

How much will Medicaid pay for assisted living?

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:

  • Florida’s Statewide Medicaid Managed Care Long-Term Care program will cover the cost of “personal care, homemaker, chore, attendant care, companion care, medication oversight, periodic nursing evaluations, and therapeutic social and recreational programming” services for eligible residents in an assisted living facility. The state’s optional state supplementation (OSS) program provides cash payments to qualified seniors. This money can be used to pay room and board in an assisted living facility.[05]
  • North Carolina’s State and County Special Assistance program is used by some people who live in an assisted living facility and receive Supplemental Social Security (SSI). North Carolina ABD Medicaid will also pay for medically necessary services and supports that are documented in a senior’s care plan.[06]

Check with your loved one’s state Medicaid office to understand what assisted living costs are covered.

How to apply for Medicaid

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.

What assisted living facilities accept Medicaid?

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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Other ways to pay for assisted living

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.

Alternatives to assisted living that may be covered by Medicaid

If you want to consider other care options, Medicaid waivers may cover some alternatives to assisted living, such as:

  • Adult day services
  • Home health care and therapy services
  • Care coordination and case management
  • In-home care, which may include help with cooking, cleaning, or other daily activities

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.

Families also ask

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.

SHARE THE ARTICLE

  1. Centers for Medicaid & Medicare Services. Eligibility.

  2. Centers for Medicare & Medicaid Services. Home and community based services.

  3. Centers for Medicare & Medicaid Services. State Medicaid plans and waivers.

  4. Centers for Medicare & Medicaid Services. Cost sharing out of pocket costs.

  5. Florida Agency for Health Care Administration. Statewide Medicaid managed care long-term care recipient FAQs.

  6. North Carolina Department of Health and Human Services. (2024, December). Special assistance help for North Carolinians who need care in a residential facility.

Written by
Kevin Ryan
Kevin Ryan is a content specialist at A Place for Mom, focused on home care topics that include defining the differences between home care and other senior care types, home care costs, and how to pay. Kevin’s desire to support seniors and their families stems from his previous career as a teacher, plus his experience as a writer and community journalist.
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Edited by
Tori Newhouse
Tori Newhouse is a Manager of Content Strategy at A Place for Mom. She has more than 15 years' experience in publishing and creating content. With a background in financial services and elder law, her passion is to help readers to plan ahead and plan for their ideal retirement. She holds a bachelor's degree in English from Gordon College.
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Certified Elder Law Attorney Letha Sgritta McDowell is an elder law attorney and past president of the National Academy of Elder Law Attorneys.
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