Medicaid in Assisted Living for Alzheimer’s & Dementia Patients
What is Medicaid?
Medicaid is a public insurance program for financially limited Americans of all ages. Medicaid can be especially helpful for people with Alzheimer’s disease and other dementias, because it will cover care in nursing homes, in beneficiary’s homes and other places in the community, like assisted living. You must meet certain financial requirements to be eligible for Medicaid, but anyone who doesn’t meet the requirements can use Medicaid Planning strategies to eventually qualify.
What Medicaid Covers in Assisted Living for Alzheimer’s & Dementia Patients
Medicaid will cover certain care expenses in assisted living residences, including non-medical, long-term care services and supports that can be crucial for seniors with Alzheimer’s disease and other dementias. Medicaid does not cover room and board expenses for assisted living.
Some assisted living residences can be adequate for people in the early stages of dementia, especially if they are receiving some of the Medicaid benefits described below. When the disease progresses, a memory care facility may be necessary. To learn more about Medicaid coverage in memory care, click here for our article on the topic.
Medicaid will cover care for seniors in assisted living through two programs – Home and Community Based Services (HCBS) Waivers, and Aged, Blind and Disabled (ABD) Medicaid. The benefits, eligibility requirements and even the names of these two programs can all change depending on the state.
ABD Medicaid
This is also known as state or regular Medicaid, but it should not be confused with the regular Medicaid that is available to financially limited people of all ages. There is no functional, or medical, requirement for general healthcare coverage through ABD Medicaid (doctor’s visits, medication, short-term hospital stays, etc.), but in order to receive long-term care benefits through ABD Medicaid, individuals must show a need for those benefits. That includes the type of long-term care services and supports that might be covered in assisted living. ABD Medicaid is an entitlement, which means all eligible applicants are guaranteed coverage without wait.
HCBS Waivers
HCBS Waivers cover long-term care for beneficiaries who require Nursing Facility Level of Care, but choose to live in the community instead of a nursing home. HCBS Waivers in all states cover care in the beneficiary’s home or the home of a loved one, and in many states they also cover care in assisted living residences. HCBS Waivers are not an entitlement. Instead, they have a limited number of enrollment spots. If those spots are full, additional applicants will be placed on a waitlist.
Medicaid Benefits for Assisted Living Residents with Dementia
HCBS Waivers typically offer a wider range of coverage for assisted living residents than ABD Medicaid programs. But, as mentioned above, the benefits for both programs can vary by state. In general, Medicaid benefits in assisted living/memory care might include:
- Personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting)
- In-home nursing services
- Medication management
- Adult Day Care
- Assistive technology and devices
- Durable medical equipment and supplies
- Meal delivery
- Personal Emergency Response Systems (PERS)
- Respite care for unpaid caregivers
- Transportation
Medicaid will not cover these benefits if the residence is already covering them, but it might add to the existing coverage. For example, if the residence provides 15 hours/week of personal care assistance, Medicaid coverage might increase it to 20 hours/week.
The state can assign a caregiver to provide these services, but some HCBS Waivers and ABD Medicaid programs allow beneficiaries to self-direct their care. This means they can select a caregiver of their choice to provide some benefits, most often the personal care assistance. These caregivers can include family members and even spouses in some states. This is called Consumer Directed Care, Self-Directed Care, Participant Direction and other names, depending on the state, and it was previously referred to as Cash and Counseling. Learn more about Medicaid paying family members to provide care.
Medicaid Eligibility Requirements in Assisted Living
Home and Community Based Services (HCBS) Waivers
Financial Criteria
Applicants have to meet two financial requirements to qualify for HCBS Waivers – an income limit and an asset limit. In most states in 2026, the individual income limit is $2,982/month. Almost all income is counted – pension payments, Social Security benefits, salary, rental income, alimony, etc. The asset limit is $2,000 in most states in 2026. Some assets can be exempt, like a primary vehicle, clothes, personal items, household furniture and appliance and, in many cases, a primary home. People who don’t meet these limits can still find ways to qualify, as discussed below.
These limits can all change depending on the state, and the applicant’s marital status. In California, for example, the individual asset limit is $130,000 as of 2026, and the individual income limit for HCBS Waivers is $1,801/month. In New York, the individual asset limit is $33,038 and the income limit is $1,836/month. To see if you or a loved one meet the eligibility requirements in your state, take this free Medicaid eligibility test.
In most cases these limits double for married couples with both spouses applying for HCBS Waivers, but there are special rules for married couples with one spouse applying. The non-applicant spouse, also known as the community spouse, is entitled to keep up $162,660 in assets (in most states in 2026) even though Medicaid considers the assets of a married couple to be jointly owned, thanks to the Community Spouse Resource Allowance. And the applicant spouse can transfer some or all of their income to low-income community spouses to help prevent them from living in poverty, which is known as the Monthly Maintenance Resource Allowance.
Functional criteria
The functional, or medical, requirement for most HCBS Waivers is needing a Nursing Facility Level of Care (NFLOC). This means the type of constant supervision and access to skilled care that is associated with a nursing home. The exact definition of a NFLOC and how it’s evaluated can vary by state. In some states, needing help with three of the five Activities of Daily Living (mobility, bathing, dressing, eating, toileting) is required for a NFLOC designation, in other states it’s only two of the five. Some states may place extra emphasis on the in-person evaluation, others might place extra value on the primary care provider’s recommendation.
Please Note: A diagnosis of Alzheimer’s disease or another dementia does not guarantee a NFLOC designation. Most states assess cognitive function as part of their NFLOC evaluation process, and dementia patients will likely have other symptoms that lead them to requiring a NFLOC, but dementia does not automatically equate to a NFLOC.
In some states, applicants are only required to be at risk of needing a NFLOC to meet the medical requirement for HCBS Waivers.
ABD Medicaid
Financial Criteria
ABD Medicaid applicants also have to meet an asset and income limit. In most states in 2026, the individual asset limit for ABD Medicaid is $2,000, but it can vary significantly. In Florida, for example, it’s $5,000, and it’s $17,500 in Illinois. Most assets are counted, but there are some major exemptions, like a primary vehicle, personal items and, in many cases, a home. The individual income limit for ABD Medicaid ranges from $994/month to $1,845/month, depending on the state.
For married ABD Medicaid applicants, the assets and income of both spouses are counted whether one or both spouses are applying. The married income limit for ABD Medicaid in 2026 ranges from $1,491/month to $2,732/month, depending on the state. The married asset limit is a combined $3,000 in most states in 2026, but it can also vary significantly.
Functional Criteria
There is no functional requirement to receive basic healthcare coverage (primary care visits, prescription medication, short-term hospital stays, etc.) through ABD Medicaid. However, in order to receive long-term care benefits via ABD Medicaid, applicants have to show a need for that benefit. In other words, you qualify for long-term care benefits bit by bit, instead of all at once, like with HCBS Waivers benefits.
Qualifying for Medicaid When Over the Requirements
Seniors who are over their asset or income limits can still qualify for HCBS Waivers or ABD Medicaid by employing Medicaid Planning techniques. People who are over their income limit can use a Qualified Income Trust or the Medically Needy Pathway, depending on the state and program, to become income-eligible for Medicaid. Individuals over their asset limit can “spend down” their assets, but they can’t simply give them away, that would be a violation of the Look-Back Period.
These strategies tend to be complicated, and making a mistake using them can lead to an application being being denied and a penalty period of ineligibility. That’s why consulting with a Medicaid Planning professional is strongly recommended before attempting to use any of them on your own. Not only can these experts help dementia patients qualify for Medicaid and get the long-term care they need, they can also help maximize resources so seniors can enjoy a better quality of life or save something to leave for their family or both. Click here to find a Certified Medicaid Planner.
Which States Have Assisted Living Waivers
Below is a state-by-state list of HCBS Waivers relevant to people with Alzheimer’s disease and other dementias. There are links with additional details, including how to apply. Not all states offer HCBS Waivers that cover care in assisted living.
| Medicaid Assisted Living Waivers for Alzheimer’s / Dementia (Updated Jan. 2023) | |
| Alaska | Alaskans Living Independently Waiver (ALI)
One of the benefits under the ALI waiver is assisted living home services (formally called residential supported living in Alaska) for persons 21+ years old who require a nursing home level of care. This includes 24-hour supervision and security, assistance with ADLs, medication management, social and recreational activities, and transportation as determined by one’s care plan. |
| Alabama | Alabama’s Elderly and Disabled Waiver (E&D Waiver) Through this Home and Community-Based Services program, people can stay in their homes instead of moving into a nursing home. The definition of home can include the individual’s residence or adult foster care. The covered benefits are support services and vary depending on one’s needs. They can range from respite care to in-home care. |
| Arizona | Arizona Long Term Care System (ALTCS) Through ALTCS, seniors and disabled individuals who require a nursing home level of care can receive supportive long-term care services in assisted living residences. This may include personal care assistance, homemaker services, home health care, and in-home nursing. Certain conditions, such as Alzheimer’s disease and related dementias, are considered when assessing an applicant’s functional ability and the need for assistance with daily living activities. |
| Arkansas | Living Choices Assisted Living
The Living Choices Assisted Living Waiver allows eligible applicants (physically disabled adults 21-64 years old and all adults 65 and over who meet the financial criteria) to live in private apartments within an assisted living facility. Around-the-clock supervision, attendant care, nursing evaluations, limited nursing services, non-medical transportation, medication oversight, and activities (therapeutic, recreational, and social) are provided. |
| California | Medi-Cal Assisted Living Waiver (ALW)
Medi-Cal’s (California’s Medicaid program) ALW is intended for adults 21 years and older who require the level of care provided in a nursing home. This waiver provides a variety of supportive assistance, such as personal care, health-related services, and housekeeping, in three types of assisted living facilities: Residential Care Facilities for the Elderly (RCFE), Adult Residential Facilities (ARF), and Public Subsidized Housing (PSH). Some of these settings offer home-like memory care for persons with dementia. In some instances, even a memory care facility adjacent to an assisted living facility is an option. Unfortunately, this program is currently only available in 15 counties within the state. More info. |
| Colorado | Colorado Elderly, Blind and Disabled Waiver
The Elderly, Blind, & Disabled Waiver (EBD) offers a variety of long-term care services and supports, and receiving such benefits in an alternative care facility (ACF) is one such support. While this waiver does not offer services that are specific to Alzheimer’s disease or related dementias, persons with these neurological diseases are eligible to live in ACFs. Based on the alternative care facility, special programming may be offered for persons with these conditions. |
| Connecticut | Assisted Living Program under CHCPE
Assisted living services are provided in “Managed Residential Communities” (MRC) under the Connecticut Home Care Program for the Elderly (CHCPE) for persons who require assistance with daily living activities. Intended for persons 65 years of age and over, this waiver program is unique because people who are not eligible for Medicaid may also be program participants (though some financial limits still apply). For persons with Alzheimer’s disease or related dementia, memory care is an option. |
| Delaware | Diamond State Health Plan Plus
DSHP Plus, a long-term managed care program, provides a variety of supportive services for elderly and disabled persons who are at risk of nursing home admission. Although it is unclear if specific dementia-related benefits are provided, cognitive services are included. Program participants can reside and receive care assistance in assisted living communities. |
| District of Columbia | DC Elderly and Persons with Physical Disabilities (EPD) Waiver
In addition to providing home-based services and supports, the EPD Waiver Program also provides benefits in assisted living facilities for elderly and disabled individuals who need assistance with activities of daily living (ADLs). Given people with Alzheimer’s disease or related dementias meet the functional and financial requirements, they are eligible for assisted living services. It is not specifically stated if assisted living services can be provided in a memory care unit, but this could be a possibility. |
| Florida | Statewide Medicaid Managed Care Long Term Care Program (SMMC- LTC)
Florida previously had an Assisted Living for the Elderly Waiver, but it has been incorporated into the SMMC-LTC Program. The current program provides a variety of long-term care services for physically disabled adults and frail elderly residents who require a nursing home level of care. This is demonstrated as a need for assistance with ADLs. For people who have dementia, but are not physically limited, cognitive issues resulting in the need for supervision are considered. One of the benefits of SMMC-LTC is assisted living facility services. This includes personal care assistance, homemaker and chore services, and medication management. More info. |
| Georgia | CCSP and SOURCE Programs
The Community Care Services Program and the Service Options Using Resources in a Community Environment Program operate under Georgia’s Elderly and Disabled Waiver. Both programs offer alternative living services, also known as assisted living services, and these services are provided in personal care homes, also known as assisted living residences. Both programs have a level of care requirement that is lower than needing a full-time Nursing Facility Level of Care while considering both cognitive and physical limitations that can result from dementia. The difference between the two programs is that SOURCE is strictly for persons receiving SSI. Both CCSP and SOURCE program participants pay a monthly share of the cost. More info on CCSP and more on SOURCE. |
| Hawaii | Med-QUEST Integration Program
Med QUEST (Quality Care, Universal access, Efficient utilization, Stabilizing costs, and Transform how health care is provided) is a managed care program for elderly, blind, and disabled HI residents. This program offers a variety of benefits, including home and community-based services and support in assisted living. In these home-like assisted living facilities, residents are provided with attendant care, light house cleaning, laundry, and preparation of meals. While a diagnosis of Alzheimer’s disease or related dementia, such as Lewy Body dementia or Parkinson’s disease dementia, does not meet the functional eligibility requirement by itself, persons with these diseases can qualify based on their level of care need. |
| Idaho | Aged and Disabled Waiver
Via the Idaho HCBS waiver, a variety of benefits are available for the frail elderly and disabled that promote independent living intending to prevent and delay nursing home placement. One such benefit is residential care services, of which assisted living facilities are an appropriate setting. In assisted living, assistance with daily living activities, medication management, housekeeping, laundry, meals, and social and recreational activities are provided. Program participants must require a nursing home level of care. Cognitive functioning level is considered when determining if an applicant requires this level of care. |
| Illinois | HCBS Waiver for Supportive Living Facilities
The Supportive Living Program (SLP) provides “supportive living” benefits, such as personal care assistance and homemaker services, for physically disabled adults and seniors who require a nursing home level of care. Program participants can reside in board and care homes, assisted living residences, or residential memory care, the latter specifically for Illinois residents diagnosed with Alzheimer’s disease and similar dementias. More info. |
| Indiana | Aged and Disabled (A&D) Waiver
The A&D Waiver offers a variety of home and community-based services, including assisted living services, for elderly and disabled Indiana residents who require a nursing home level of care. People with dementia are eligible to receive benefits, which include attendant care, homemaker and chore services, recreational activities, and onsite staff 24 hours per day in assisted living. |
| Iowa | Home and Community Based Services (HCBS) Elderly Waiver
The HCBS Elderly Waiver is intended for aged Iowa residents (65 and over) who without appropriate care assistance and supportive services would have to relocate to a nursing home facility. While several benefits allow program participants to live independently in their homes, assisted living services are also an option, allowing them access to 24-hour care. |
| Kentucky | Home and Community Based Waiver
Individuals who are 65 and older and meet the financial requirements, as well as requirements for care in a nursing facility, are eligible to receive support in a community under the Kentucky Home and Community Based Waiver. Intellectual disabilities are among the qualifications listed under Kentucky’s waiver program, and Alzheimer’s disease and related dementia may apply. |
| Kansas | Frail Elderly Waiver Program
The FE Medicaid Waiver also called the Home and Community-Based Services for the Frail Elderly Waiver, is for seniors 65 and over who require nursing home-level care. Services via this waiver can be provided in a variety of settings, including one’s home, a residential health care facility, a boarding care home, or an assisted living residence. |
| Louisiana | Community Choices Waiver
While primarily designed to help nursing home-eligible people to remain living in their homes. Louisiana’s Community Choices Waiver (CCW) defines “home” broadly and can include persons living in assisted living or memory care residences. |
| Maryland | Community Options Waiver
The Community Options Waiver is also called the Home and Community-Based Options Waiver (HCBOW). This waiver provides assisted living facility services for adults 18 and over, including those with Alzheimer’s disease, who need assistance with their daily living activities and require a nursing home level of care. Memory care, specific to patients with dementia can be a possibility if there is a facility that is on the approved provider list and provides this type of care. Applicants may be placed on a waitlist. |
| Maine | Maine Medicaid Home and Community Benefits Waiver for the Elderly and Adults with Disabilities (MaineCare)
This program is intended to help people avoid nursing homes by staying in their homes as long as possible. That is done via long-term care and support. This can include in-home care, meals delivered to one’s home, and medical equipment. Participants must live in their own homes or that of a loved one. That means to be eligible for this waiver, one can not reside in an assisted living community. Meeting the waiver’s requirements does not mean your loved one will receive benefits. There can be a waitlist list for MaineCare because there is limited space in this program. |
| Massachusetts | MassHealth Personal Care Attendant Program (PCA)
This program gives recipients benefits with help with activities of daily living (ADL). That means there can be extra help with everyday living like going to the bathroom, getting dressed, meal prep, and light housework. Through extra support and in-home care, patients can stay in their homes longer and avoid an early move into a nursing home. FEW is part of Home and Community-Based Services and provides extra care and support services so participants stay in their own homes as long as possible and avoid a costly move into a nursing home. Individualized care plans are created offering each patient a unique long-term care plan. Support benefits can range from in-home care to medical devices and respite care. Enrollees must live in their own home, that of a loved one, adult foster care, or some other home-like setting. Meeting the program’s qualifications does not guarantee coverage. This waiver has a cap on how many participants it can enroll, so there might be a waitlist. |
| Michigan | Choice Waiver Program
Via the MI Choice Waiver, previously called the Home and Community-Based Services for the Elderly and Disabled Waiver Program, “community living supports” are available to physically disabled state residents a minimum of 18 years old and frail elderly individuals 65 and over. Provided in one’s home or a community setting, such as an assisted living residence, dementia care is offered in addition to assistance with personal care, managing finances, shopping for groceries, and preparing meals. More info. MI Health Link HCBS Waiver |
| Minnesota | Elderly Waiver (EW) & CADI Waiver
The Elderly Waiver and the Community Access for Disability Inclusion Waiver (CADI), also called the Community Alternatives for Disabled Individuals Waiver, offer “customized living services”, which can include services in assisted living residences. One important distinction between the two waivers is that CADI is intended for persons under 65 years old at the time of enrollment, while the EW is for those 65 and over. In addition to “customized living services”, there is also the option of “24-hour customized living services”, which includes around-the-clock supervision. For 24-hour customized living services, the level of care needed is greater than for customized living services. With this option, services can be provided in memory care units. |
| Mississippi | Assisted Living (AL) Waiver
The AL Waiver provides assistive services in personal care home-assisted living facilities, abbreviated as PCH-AL, for disabled adults and frail seniors who meet the level of care need that is provided in nursing homes. When considering functional eligibility, cognitive deficits and behavioral issues, which are commonly seen in persons with Alzheimer’s disease, are considered. The safety of dementia patients is taken into account when creating one’s care plan. |
| Missouri | Missouri Medicaid Aged and Disabled Waiver (ADW)
The ADW is meant to offer long-term support services to enrollees enabling patients to stay in their homes. The thought is that with additional support services, your loved one will not need to move into a nursing home. Participants must live in their own homes or that of a loved one. Through this program, there can be benefits in the form of adult day care, meal delivery, respite care, and help with household chores. There is an enrollment cap with this waiver, so there could be a waitlist. More info. MO HealthNet Structured Family Caregiving Waiver (SFCW) |
| Montana | Big Sky Medicaid Waiver
This Home and Community-Based Services Medicaid waiver is for elderly and disabled Montana residents. Residential habilitation is one of many benefits. A variety of services are provided in assisted living residences, including personal care assistance, homemaker services, medication management, 24-hour supervision, and medical escort. Both physical and cognitive functioning is considered when determining the functional need for waiver services. |
| Nebraska | Aged and Disabled Medicaid Waiver
Formally called the HCBS Waiver for Aged and Adults and Children with Disabilities assisted living services (housecleaning and laundry, personal care assistance, shopping for essentials, medication management, etc.) is one benefit available via this waiver. A person with Alzheimer’s disease who meets the level of care needed (nursing facility) may be functionally eligible, given no one’s safety, health, and welfare are jeopardized. Assisted living facilities with a memory care unit may be enrolled as Medicaid providers, which means eligible waiver recipients can receive dementia specific care. |
| Nevada | HCBS Waiver for the Frail Elderly (HCBS-FE)
The Nevada Home and Community Based Waiver for the Frail Elderly (HCBW-FE), formally called the Waiver for the Frail Elderly, offers an Augmented Personal Care (Assisted Living) benefit with four levels of care. Supportive services may include companionship, medication management, personal care assistance, homemaker services, and 24-hour supervision. Staff providing care for persons with dementia are required to be trained accordingly. |
| New Hampshire | Choices for Independence (CFI) Waiver
The CFI Waiver, previously called the Home and Community-Based Care Program for the Elderly and Chronically Ill (HCBC-ECI), offers residential care facility services, which includes supportive services (personal care assistance and supervision) in assisted living residences. Intended for New Hampshire residents who require a nursing home level of care, dementia care, and services can also be provided in this setting. |
| New Jersey | Managed Long Term Services and Supports (MLTSS)
In the state of New Jersey, the Medicaid program is known as NJ FamilyCare and assisted living services are made available through the Managed Long-Term Services and Supports (MLTSS) program. MLTSS is for people of all ages who meet the eligibility criteria. When determining functional needs, cognitive deficits, which are commonly seen in persons with dementia, are considered. More info. |
| New Mexico | Centennial Care Community Benefit
In New Mexico, Medicaid is called Centennial Care, and long-term Home and Community-Based Services and supports are made available through what is called Community Benefit (CB). While program participants must require a nursing facility level of care (NFLOC), assisted living services are available via CB. Because dementia is a covered condition, determining the need for nursing facility level of care can include patients with Alzheimer’s disease, Lewy Body, and Multi-Infarct. |
| New York | Assisted Living Program
The Assisted Living Program (ALP) is open to adults 21+ years old who have a medical need for nursing home care but can live in an assisted living residence with the appropriate support. This program is unique in that it is open to both Medicaid and non-Medicaid-eligible recipients. The ALP can provide home health aides, personal care assistance, housekeeping services, and personal emergency response systems. While Medicaid will not pay for room and board, SSI can supplement one’s income to cover the cost. ALP is suitable for people in the earlier stages of dementia, but wouldn’t be suitable for persons with advanced stages of dementia, as participants must be somewhat mobile and not present a danger to other assisted living residents. More info. |
| North Carolina | North Carolina Medicaid Community Alternatives Program for Disabled Adults (CAP/DA)
This waiver is designed to offer long-term care to program enrollees. That means that individualized care plans are created depending upon the amount of care someone already has combined with what they need. This Home and Community-Based service offers your loved one the opportunity to stay in their homes for as long as possible and not move into a nursing home until necessary. Benefits can range from help with activities of daily living (ADL) to respite care and adult day care. There is limited availability with this waiver, so once the program is full a waitlist starts. More info. |
| Ohio | Assisted Living Waiver Program
The Assisted Living Waiver Program provides supportive services in assisted living facilities for people who are older than 21 and require a nursing home level of care. In Ohio, assisted living facilities are commonly called residential care facilities. People with Alzheimer’s disease and related dementias that meet the eligibility criteria can receive personal care assistance, housekeeping, non-medical transportation, health assessments and limited nursing care, and 24-hour on-site response in assisted living via this waiver. Some facilities have memory care units. More info. MyCare Ohio |
| Oklahoma | ADvantage Waiver
The ADvantage Waiver offers a variety of Home and Community-Based Services to prevent the premature institutionalization of the disabled and frail elderly. One such benefit is assisted living services, which offer personal care assistance, intermittent nursing services, medication assistance, and housekeeping in assisted living facilities. While persons with Alzheimer’s disease and related dementias are eligible to receive assisted living services, specific memory care services are not provided. |
| Oregon | K Plan
Oregon’s K Plan is also called the Community First Choice (CFC) State Plan Option. This program provides Home and Community-Based Services to promote independent living and prevent unnecessary nursing home admissions for persons who require a nursing home level of care. While not technically a waiver program, CFC will pay for services provided in assisted living facilities. People with dementia, such as Alzheimer’s disease, who meet the eligibility criteria are able to receive these benefits. |
| Pennsylvania | Pennsylvania’s Community HealthChoices Program (CHC)
Pennsylvania’s Medicaid waiver is for residents who need long-term care and meet the financial and medical requirements. This program is for those who need nursing home level care. The benefits include meals, transportation, physical therapy, and help with activities of daily living. Applicants can receive services in their home or community, which may include memory care residences. There is limited space in this waiver, so there can be a waitlist to receive benefits. |
| Rhode Island | Rhode Island Medicaid Long-Term Services and Supports (Medicaid LTSS)
RI operates its Medicaid program which includes this Home and Community Based waiver. This program’s goal is to keep elderly and disabled residents in their homes and living as independently as possible. By focusing on supporting long-term care, patients can prevent going into nursing homes early. Assisted living services (personal care assistance, chore and homemaker services, companionship, and medication management) are an available benefit for qualified applicants of this waiver. Additionally, there can be coverage afforded to medical equipment, adult day care, and more depending on an individual’s need. There is limited space in this waiver, so after meeting the eligibility requirements, there can be a waitlist. |
| South Carolina | Community Choices Waiver
Via Community Choices, a variety of supportive services are provided for persons 18 and over who are not able to complete their activities of daily living without assistance, and therefore, require a level of care consistent with that which is provided in a nursing home. The impairment, resulting in the need for care, can be physical or cognitive in nature, both of which are commonly seen in persons with dementia. Program participants have the option of receiving personal care assistance and supervision in assisted living residences. |
| South Dakota | Home & Community-Based Options and Person Centered Excellence Waiver (HOPE)
For elderly individuals aged 65 and older and disabled adults who require the level of care provided in a nursing home, supportive services can be received in assisted living facilities. These include personal care assistance, homemaker services, 24-hour supervision and response, social and recreational activities, and medication assistance. Cognitive loss, which is common in persons with Alzheimer’s disease, is a consideration of functional needs when determining eligibility for waiver services. |
| Tennessee | CHOICES in Long-Term Services and Supports Program
CHOICES provides supportive services to help the aged and disabled continue to live in their homes or communities rather than require placement in nursing homes. While program participants must cover the cost of room and board in assisted living residences, assistance with personal care, medication administration, and homemaker tasks are available for eligible program participants. Based on the needs of a person with dementia, it is possible to meet the functional requirement for CHOICES. |
| Texas | STAR+PLUS HCBS Medicaid Waiver
A managed care program for the elderly and disabled, service coordination and long-term services and supports are provided via STAR+PLUS HCBS (Home and Community-Based Services). In addition to being able to receive supportive services, such as assistance with daily living tasks at home, program participants can also receive benefits in adult foster care homes and assisted living residences. More info. |
| Utah | Utah’s Aging Waiver
This waiver provides long-term care and support to qualified Medicaid individuals. This program is meant to help residents who are over 65 stay living independently as long as possible and not have to move into a nursing home. Through this Home and Community-Based Services program, benefits are offered to match the needs of your loved one. Support in the form of help with activities of daily living, light housework, and meal prep is available. There can also be coverage for medical equipment and safety home upgrades. Additionally, there can be adult daycare options and respite care. A requirement of the program is that individuals must live on their own or with a loved one. They can not live in adult foster care or an assisted living community. There are caps on how many people can be admitted to this program, so it is possible after being accepted there is a waitlist. |
| Vermont | Choices for Care Program
Vermont’s Medicaid program is called Green Mountain Care and the Choices for Care Program operates under the state’s Vermont Global Commitment to Health Waiver. Via Choices for Care, elderly and disabled state residents who require a nursing home level of care can receive a variety of long-term care services and supports. This includes “enhanced residential care”, which provides services, such as personal care assistance, medication management, housekeeping, and 24-hour supervision, for program participants residing in assisted living. |
| Virginia | Virginia Medicaid’s Commonwealth Coordinated Care Plus Waiver Program (CCC Plus)
This Medicaid waiver helps patients who qualify through their finances and medical needs with long-term care services. By offering in-home support, individuals can stay independent for as long as possible before moving into a nursing home. Support services are tailored for each recipient and are based on what they currently have and need to live safely. Benefits can be given in the form of respite care, adult day care, medical equipment, and help to transition from a nursing home into a residential community. This is a program that is limited by space, so after qualifying, there can be a waitlist. |
| Washington | Community Options Program Entry System Waiver (COPES)
COPES is a Medicaid (Apple Health) Waiver for seniors 65 and over and physically disabled adults who require care consistent with that which is provided in a nursing home. Program applicants can meet the level of care needed if they require supervision and assistance with at least one daily living activity due to an impairment in memory or decision-making, disorientation, or wandering, which are common cognitive impairments seen in persons with dementia. In addition to a variety of supportive services that enable eligible applicants to continue to live in their own homes, eligible persons can also receive services in assisted living. More info. Specialized Dementia Care Program The Specialized Dementia Care Program provides services in assisted living facilities specific to persons with dementia, such as Alzheimer’s disease, Lewy Body Dementia, Creutzfeldt-Jakob disease, Pick’s disease, and vascular dementia. Assisted living staff are awake 24 / hours per day and are trained to work with persons with dementia. Nursing services are available intermittently, as well as personal care assistance, medication management, and other supportive services. |
| West Virginia | West Virginia Medicaid Aged and Disabled Waiver (ADW)
The ADW is a long-term care support service provided by the Home and Community-Based Service. They aim to prevent people from moving into nursing homes early by offering benefits that support them living individually in their own homes. The help can range from helping with activities of daily living, light housework, and chores, to transportation and nursing services. There is limited availability for this waiver, so you can find a waitlist after qualifying. |
| Wisconsin | Family Care
Family Care is an HCBS option under Wisconsin Medicaid which provides services and supports to disabled adults and frail elders in their homes or communities. Benefits are administered through a Managed Care Organization in one’s particular county after a personalized care plan has been made based on unique needs. Benefits including help with activities of daily living are available in Community Based Residential Facilities, which is a legal term in Wisconsin that can include assisted living homes with dementia care. |
| Wyoming | Wyoming Community Choices Waiver (CCW)
The Wyoming Community Choices Waiver offers long-term care through the Home and Community-Based Services program. Built to keep people from having to make a costly move into a nursing home, extra support is offered. There can be benefits in the form of respite care, adult day care, nursing services and help with activities of daily living. Applicants can live in their own homes, in an assisted living community, or adult foster care. After meeting the requirements through finances and medical needs, there is no guarantee of benefits. There is an enrollment cap for this waiver, participants are put on a waitlist. |
How to Apply for an Assisted Living Waiver
The assisted living waiver application process is not the same in all states. The first step towards applying for assistance is to determine if you (or your loved one) are eligible for Medicaid. A non-binding Medicaid eligibility test is available here.
If determined eligible, the next step is to apply for Medicaid. Since the application process varies based on the state in which one resides, it is vital to contact the local Medicaid agency and enquire about the application process. To locate your state Medicaid agency, click here.
If determined ineligible, consider contacting a Medicaid planning professional to seek help becoming eligible.