How much will Medicaid pay for assisted living?

1 answer | Last updated: Nov 12, 2016
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How much will Medicaid pay for assisted living?

Expert Answers

Whether Medicaid will help pay for assisted living, under what circumstances, and how much it will contribute, depend on the state where you live. If you live in one of the states that currently have some Medicaid coverage for assisted living, there may be many restrictions and limitations on that coverage. These may include: payment for some personal care services but not for room and board; tiered payments that depend on the services needed or the resident's income; a monthly payment cap; eligibility only for residents who'd otherwise have to be in a nursing home; and/or a very small number of people covered by the program at any one time.

Even if your state has some Medicaid coverage for assisted living and you are eligible for it, the coverage will not be available in every assisted-living facility. Most states limit their coverage to certain facilities. And even if an assisted-living facility could qualify, not all facilities choose to participate in the program.

To find out about your state's Medicaid assisted living coverage -- often called the Medicaid Home and Community-Based Services (HCBS) waiver -- contact the state's Medicaid office or the state department of health (which oversees assisted-living facilities). To find your state's Medicaid website, go online to any search engine and enter Medicaid and the name of your state. Or you can call the Eldercare Locator toll-free at (800) 677-1116 and ask for contact information for your state's Medicaid office.