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How Many Levels of Care Are There for Assisted Living Medicaid Waiver Programs?
Date Updated: July 26, 2024
Written by:
Rachel Lustbader is a writer and editor with a background in healthcare and technology. Her work has been published on websites including HealthCare.com, BiteSizeBio.com, BetterHelp.com, Caring.com, and PayingforSeniorCare.com. She studied health science and public health at Boston University.
Both of Rachel’s grandmothers had very positive experiences in senior living communities, and Rachel saw firsthand the impact that kind, committed caregivers and community managers can have on seniors’ and their family members’ lives. With her work at Caring, Rachel hopes to help other families find communities, caregivers, and at-home products that benefit elderly loved ones and make life less stressful for family caregivers
Reviewed by:
Kristi Bickmann, a licensed Long-Term Care Specialist, represents top-rated "Traditional" & "Hybrid" LTC companies. Serving associations such as the American Nurses Association, she's a licensed insurance agent in 27 states. Specializing in insurance products for seniors, Kristi helps hundreds of families every year protect assets, retirement, and loved ones. She understands aging concerns firsthand, having assisted her own parents. Kristi ensures accuracy on topics about senior long-term care and its consequences.
Four levels of care are typically used in assisted living Medicaid waiver programs. Your loved one may be fully independent, or they may need minimal, moderate or complete assistance. Medicaid assesses how much help a person needs with activities of daily living to assign the appropriate level.
How does Medicaid define each level of assisted living care?
Each state that has a Medicaid assisted living waiver defines its own levels of care. In general, however:
- “Fully independent” means someone can do most or all daily activities by themselves, without help or planning from someone else.
- “Minimal assistance” means the person needs light assistance, such as an aide to remind them to perform a task or stand by to make sure they can do it safely.
- “Moderate assistance” refers to the need for actual physical assistance performing the task, such as help getting dressed or bathing.
- “Complete assistance” means the person needs a caregiver to do the entire task for them.
Assisted living communities typically provide minimal-to-moderate assistance. If your loved one needs complete assistance, they may require long-term care at a skilled nursing facility.
How does Medicaid evaluate a person’s level of care?
Medicaid evaluates a person’s level of care based on their ability to perform basic and instrumental activities of daily living. Basic ADLs include
- Using the toilet
- Controlling bowel and bladder functions
- Performing personal hygiene
- Getting dressed
- Eating
- Mobility