If you or an older loved one requires daily care in a residential living facility, you may have wondered, "Does Medicaid cover assisted living?" Unfortunately, it depends. Medicaid does not cover room and board at assisted living facilities. However, via state waivers or managed care programs, Medicaid may help pay for personal care and supportive services in these settings. Since each state administers Medicaid, regional requirements and waiver programs can help some older adults cover assisted living costs.

 

With the various senior living options available — nursing homes, independent living, memory care — you may find it confusing to tell them apart. This guide focuses on one type of senior residential living: assisted living. 

The term "assisted living" applies to residential settings for seniors who may need help with their activities of daily living (ADLs) — such as bathing, dressing, or preparing and eating nutritious meals — who don't require the more extensive medical and nursing care provided by a nursing home.

Assisted living facilities may feature private or shared apartments or bedrooms, along with shared living and dining spaces. These settings are best suited for seniors who are in fairly good health and enjoy some independence but are not able to live in their own homes. 

If you or your loved one receives Medicaid, you may wonder if Medicaid pays for assisted living. The answer isn't a simple "yes" or "no," due to the various costs that may occur in an assisted living setting, which Medicaid doesn't always cover. 

For example, Medicaid does not cover room and board, but some nursing care may be approved. Additionally, Medicaid waivers can pay for assisted living through Home and Community Based Services (HCBS) waivers. 

Explore details on coverage for various types of care below.

In most states, Medicaid covers assistance with ADLs, such as bathing, toileting, and dressing, for those who are in assisted living facilities. It may also pay for services such as medication management and transportation to medical appointments. In many regions, these services are paid for through state-specific waivers, and thus, eligibility varies.

Homemaker services are also known as "in-home care." This type of senior support includes non-medical assistance and companionship. If you live in an assisted living facility, for example, you may have a companion who visits regularly to help you avoid feeling isolated or depressed. Homemaker services may also assist with laundry, meal preparation, and shopping. A state-specific HCBS waiver or benefit may cover these costs. 

Skilled nursing care refers to medical services provided by a nurse or other health professional. This type of care differs from care delivered by a home health aide. These aides are trained professionals (generally not nurses) who provide help with daily tasks and some basic medical care under the supervision of nurses. 

When an assisted living facility resident needs skilled nursing services, such as wound care, medication management, or other medical attention, an HCBS waiver or state-based benefit may pay for this service. In most cases, skilled services must be provided by a licensed provider, and provider availability may depend on contracts between the assisted living facility and third-party care agencies. Residents who need minor help from a health care aide, especially if the care is ordered by a physician, may also use HCBS waivers for some of these services. 

Medicaid waivers in some states pay for non-emergency transportation to medical appointments. According to the Kaiser Family Foundation (KFF), 19 states offer this benefit through Medicaid. 

For emergency medical transportation, assisted living residents should always call 911. Medicaid does not cover non-medical transportation, such as for shopping or other purposes, in any state.

Dental and vision care benefits vary by state. For example, in Alabama, dental care is not covered. Kentucky, on the other hand, covers oral exams, x-rays, and more. The Center for Health Care Strategies maintains a list that covers Medicaid dental benefits by state. Many states pay for an annual eye exam, while several cover costs for eyeglasses. Some states, however, require participants to share costs with Medicaid benefits.

Medicaid does not cover all assisted living costs. The program will not, for example, pay for cosmetic surgery or experimental treatments. Non-prescription drugs and health supplements are not covered, nor are personal comfort items. Medicaid will not pay for home modifications (unless your state has a waiver program to cover them), such as handicap-accessible bathrooms or hospital beds. 

To know exactly what Medicaid covers and does not cover in your region, contact your state's Medicaid office or local Area Agency on Aging.

Although it may be the largest cost associated with assisted living, Medicaid does not pay for room and board in these facilities. Although it may be challenging to know how to pay for assisted living room and board, there may be financial assistance available. 

For example, veterans may be able to receive an Aid and Attendance allowance from the Veterans Administration. Others may take advantage of pensions, Social Security, and/or reverse mortgages on their homes. 

While Medicaid recipients are likely to have coverage for some personal care services, including help with the activities of daily living, not all personal care needs are covered in some states. For example, 29 states cover 24/7 services, according to KFF, while home-delivered meals are only funded in seven states.

Functional services address an individual's limitations due to aging, chronic illness, or disability. The activities of daily living are an example of functional supports. As we've noted above, HCBS waivers offer help with these services. For details on your region, the Medicaid website has a list of state waivers detailing available options.

Amendments to Medicaid change or expire frequently, making it difficult to provide broad statements about their availability. In addition, 2025's H.R. 1, a complex law signed by President Trump on July 4, 2025, made significant cuts to Medicaid, which will begin to phase in over the next few years. These cuts will likely result in extensive changes to waiver programs, in some cases making them nonexistent. Changes may vary by state and take effect in stages over 2026 - 2028.

Medicaid has alternative names across the country because of these waivers. In Alaska, for example, it's known as DenaliCare, while California has Medi-Cal, and Hawaii uses the term Med-QUEST. Knowing Medicaid's name in your home state is the first step in researching benefits and eligibility. 

Medicaid eligibility also varies from state to state. Most states start with the federal poverty levels to determine whether you qualify. In 2025, for example, the government cites a federal poverty guide for a household of one of $15,650, while a household of two is $21,150. 

Each state uses these figures to determine what your household income must be to qualify for Medicaid, with the cutoff generally being some percentage of the federal numbers. If you're uncertain of your eligibility, it may be helpful to have an elder law attorney help you determine your coverage. 

Other requirements may include the following:

• You must be a resident of the state in which you're requesting services.
• You must be a U.S. citizen or lawful permanent resident.
• For some programs, there are age requirements.
• You must be "medically needy" for some programs.
• You must have limited assets.

H.R. 1 lowered the eligibility for Medicaid based on home equity limits. Depending on the state, an applicant may not have a home worth more than between $730,000 and $1,097,000. Individuals with low income levels who own higher-value properties like farms are likely to be affected most significantly by this change. 

When signing up for Medicaid, assisted living residents must first determine their eligibility. These requirements may vary based on location but generally include financial and functional assessment. 

Applying for HCBS waivers is also state-dependent. Contact your local Area Agency on Aging office for assistance with applying for federal or state funding. Consider the following steps to apply for Medicaid: 

• Determine Financial Eligibility: In most states, you cannot have more than $2,000 in assets (though some assets, like your home, do not count), and your income cannot be above your state's eligibility level, which is based on the federal poverty level. This eligibility tool from Medicaid has enrollment information and state requirements.
• Determine Functional Eligibility: You must be able to demonstrate your need for the specific service. This determination is made by a health care professional who works with Medicaid. 
• Apply for Medicaid: You can apply either via your home state's Medicaid agency or through the Health Insurance Marketplace. Required documents may include proof of citizenship or lawful residence, proof of income and assets, or a birth certificate. 
• Apply for Applicable Waivers: Applying for an assisted living waiver program can often occur as part of the basic Medicaid application or as a separate application. Waivers may have limited enrollment, and you may be placed on a waiting list.

Medicaid, the joint federal/state health insurance program for low-income individuals and families, may pay for some of the costs of assisted living — but not room and board and several other services. 

Financial assistance is based on the state you live in and your demonstrated need, as well as your income. In many states, Medicaid will pay for personal care with activities of daily living, round-the-clock services, and skilled nursing. Some dental and vision services may also qualify for funding.

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