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. As mentioned above, the medical requirement for almost all of these programs is needing a Nursing Facility Level of Care (NFLOC), although some only require applicants to be “at risk” of needing a NFLOC. It’s also important to note that will these programs will cover long-term care in assisted living, they will not pay for room and board.
| Medicaid Assisted Living Waivers for Alzheimer’s / Dementia (Updated Oct. 2026) | |
| 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. |
| 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. More info. |
| 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 | Elderly and Disabled Waiver Program
Georgia’s Elderly and Disabled Program, formerly known as the Community Care Services Program, provides long-term care services to seniors in personal care homes, also known as assisted living residences. Benefits include adult day care, meal delivery, respite care for family caregivers and personal care assistance. Applicants must need a Nursing Facility Level of Care (NFLOC) to qualify. |
| 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 | Supportive Living Program
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 | Pathways for Aging
Indiana dementia patients age 60+ who qualify for Medicaid can receive long-term care services and supports in assisted living via Pathways for Aging, or Pathways, which is a statewide Medicaid managed long-term services and supports (MLTSS) program. Pathways covers medical care, such as doctor appointments, hospitalization, laboratory work, and x-rays, as well as long-term care like homemaker services, adult day care, home modifications, personal emergency response systems, and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). |
| Iowa | Elderly Waiver
Iowa’s Elderly Waiver is intended for state residents age 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. |
| 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. |
| 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. |
| Massachusetts | Moving Forward Plan
The Moving Forward Plan will provide assistance to qualified seniors (as well as adults with disabilities or mental illnesses) who are currently residing in a nursing home facility or psychiatric, chronic disease, or rehabilitation hospital, but wish to move to assisted living, or memory care, as well as other settings in the community. The program will help with the transition and provide long-term care benefits so the individual can live comfortably in the new location in the community. Benefits are based on the needs of the individual and they might include assistance in finding housing, arranging the move, covering moving costs, personal care assistance, homemaker services, home modifications, transportation, and peer support. |
| 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 Coordinated Health (MICH) is a managed care program available in 22 Michigan counties for residents who are aged or disabled and are enrolled in both Medicaid and Medicare, also known as being “dual eligible.” MICH combines the benefits of both programs into a single managed care plan called a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP). Benefits are based on the needs of the individual and can include adult day care, home delivered meals, personal care assistance, home and vehicle modifications, and personal emergency response systems, as well as medical care, prescription drugs and behavioral health services. More info. |
| Minnesota | Elderly Waiver (EW)
Minnesota’s Elderly Waiver (EW) provides long-term care in the community for qualified dementia patients aged 65+ who are at risk of being placed in a nursing home. Program benefits are based on the needs of the individual and can include adult day health care, homemaker services, skilled nursing visits, and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). Transitional services, to assist in relocation from a nursing home to assisted living/memory care, are also available. |
| 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. |
| Montana | Big Sky Waiver Program
This Home and Community Based Services (HCBS) Waiver is for elderly and disabled Montana residents. The program provides a variety of long-term care services and supports in assisted living residences, including personal care assistance, homemaker services, medication management, 24-hour supervision, and medical escort. These services can be delivered by licensed agency providers, but beneficiaries also have the ability to hire caregivers of their choice, such as friends or family members, including spouses. |
| 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 | Waiver for the Frail Elderly
Nevada’s Waiver for the Frail Elderly (FE), also called the Home and Community Based Services Waiver for the Frail Elderly (HCBS FE Waiver), offers long-term care services and supports to dementia patients in assisted living, including memory care, to promote independent living. The exact services and supports one receives is based on their specific needs and circumstances, but potential benefits include adult day care, in-home respite care, homemaker services, and personal emergency response systems. More info. |
| New Hampshire | Choices for Independence (CFI) Waiver
New Hampshire’s Choices for Independence Waiver (CFI) provides long-term care services and supports to New Hampshire dementia patients who reside in a residential care facility (assisted living residence) but require a Nursing Facility Level of Care (NFLOC). Benefits are based on the needs of the individual and can include skilled nursing, adult day care, meal delivery, housekeeping services and personal care assistance with the Activities of Daily Living. The state will assign a licensed caregiver to provide the benefits, or CFI recipients can self-direct their care by hiring caregivers of their choice, including friends, spouses and family members. More info. |
| New Jersey | Managed Long Term Services and Supports (MLTSS)
New Jersey’s Managed Long Term Services & Supports (MLTSS) program provides long-term care services and supports, as well as healthcare coverage, to qualified New Jersey dementia patients who require a Nursing Facility Level of Care but reside in an assisted living residence (or their own home, the home of a loved one, an adult family care home, or a comprehensive personal care home). MLTSS benefits can include adult day care, housekeeping, home modifications, in-home nursing care, meal delivery and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). MLTSS program participants receive these benefits, as well as their medical care, through a single Medicaid health plan, but they can also go outside the network for some benefits, like personal care assistance and housekeeping, and self-direct their care by hiring caregivers of their choice, including spouses, adult children, siblings and other adult family members. There is no limit on enrollment in the MLTSS program. This means that all eligible applicants will receive benefits without delay. More info. |
| New Mexico | Community Benefit Program
In New Mexico, Medicaid is called Centennial Care, and long-term care in assisted living (as well as other locations in the community) are made available through the Community Benefit (CB) Program. 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. Benefits can include adult day health care, respite care, personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting), as well as transitional services to assist dementia patients currently residing in nursing home facilities in transitioning back into the community. |
| 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. |
| 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. Next Generation 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 include 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. More info. |
| Pennsylvania | Community HealthChoices (CHC)
Pennsylvania’s Community HealthChoices (CHC) program is a is a statewide program through which participants, including dementia patients in assisted living, receive their long-term care benefits via a single Medicaid plan provided by a managed care organization (MCO). Long-term care benefits depend on the needs of the individual, but they can include personal care assistance, meal delivery, home modifications, and personal emergency response systems. More info. |
| Rhode Island | Medicaid Long-Term Services and Supports
Rhode Island seniors with dementia who reside in assisted living can receive long-term care through the state’s Medicaid Long-Term Services and Supports (Medicaid LTSS) program. Benefits depend on the need of the individual, but they can include personal care assistance, chore services, homemaker assistance, medication management, medical equipment and adult day care. More info. |
| South Carolina | Community Choices Waiver
Eligible South Carolina seniors with dementia who reside in assisted living facilities can receive long-term care via the Community Choices Medicaid program. Benefits depend on the needs of the individual, but they can include adult day care, personal care assistance, meal delivery, respite care for unpaid caregivers and personal emergency response systems. More info. |
| South Dakota | Home & Community-Based Options and Person Centered Excellence Waiver (HOPE)
South Dakota’s HOPE Waiver will provide long-term care services for eligible dementia patients age 65 and older who reside in assisted living facilities. Available benefits depend on the needs of the individual, but they can include homemaker services, 24-hour supervision and response, social and recreational activities, medication management and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). 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, including dementia patients. 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
Texas’ STAR+PLUS is a statewide Medicaid managed care program for seniors, including dementia patients in assisted living and memory care, as well as adults with disabilities. Benefits available in assisted living through STAR+PLUS can include Personal Emergency Response Systems, in-home nursing services, respite care, physical therapy and personal care assistance. STAR+PLUS program participants receive their healthcare and long-term care benefits via a single Medicaid plan provided by a managed care organization (MCO). The MCO can provide caregivers, and STAR+PLUS beneficiaries also have the option to hire their own caregiver, which can include family members, but not spouses. |
| Utah | New Choices Waiver
Utah Medicaid’s New Choices Waiver (NCW) helps seniors, including dementia patients, who currently live in an assisted living facility to move back into their own home, the home of a relative, or another residence in the community that will allow them to live more independently. In addition to transitional services, other NCW benefits include durable medical equipment, assistive technology, respite care, personal emergency response systems and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). The state Medicaid office can assign licensed caregivers to provide these benefits, but program participants also have the option to self-direct their care and hire caregivers of their choice to provide some services, such as personal care assistance. |
| Vermont | Choices for Care Program
Elderly Vermont residents, including those with dementia, who reside in assisted living communities can receive long-term care services and supports via the Choices for Care program. Benefits are based on the needs of the individual, but they can include housekeeping services, 24-hour supervision, medication management and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). This program operates under the Vermont Global Commitment to Health Waiver. |
| Washington | Community Options Program Entry System Waiver (COPES)
COPES is a Washington Medicaid (Apple Health) HCBS Waiver for seniors 65 and over, including dementia patients, as well as physically disabled adults. Benefits are based on the needs of the individual, but they can include skilled nursing services, durable medical equipment and supplies, meal delivery, adult day care and transportation. More info. |
| Wisconsin | Family Care and Family Care Partnership
These two programs will provide long-term care for qualified disabled and elderly Wisconsin residents, including those with dementia, who are in assisted living or memory care. Benefits vary based on the needs of the individual, but they can include adult day care, meal delivery, assistive technology, skilled nursing, remote monitoring, mental health services and personal care assistance. Program participants receive these benefits through a single Medicaid health plan provided by a managed care organization (MCO). However, beneficiaries can hire caregivers of their choice to provide some of these benefits, such as personal care assistance. There are some key differences between the two programs, which you can read about by clicking here. |
| Wyoming | Community Choices Waiver
Wyoming’s Community Choices Waiver offers long-term care to elderly state residents with dementia who reside in assisted living. Benefits vary based on the needs of the program participant, but they can include adult day care, nursing services, respite care and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). Licensed caregivers can be assigned to provide these services, but beneficiaries can also self-direct some of their care by hiring caregivers of their choice, including family members and spouses. |
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.