Medicaid may help cover the costs of assisted living, but eligibility and coverage depend on several factors. This article explains how Medicaid works for assisted living, who qualifies for coverage, and what options exist if Medicaid doesn’t fully cover the cost.
What is Medicaid for Assisted Living?
Medicaid is a federal and state program that helps individuals with limited income and resources access healthcare services, including long-term care options such as assisted living. While Medicaid is known for covering nursing home care, it may also help cover assisted living costs, depending on your eligibility and the specific program you qualify for. The National Institute on Aging provides further guidance on how long‑term care facilities, including assisted living and nursing homes, are treated under Medicaid and other programs.
Eligibility for Medicaid‑Assisted Living Coverage
To qualify for Medicaid assistance with assisted living, you generally must meet both financial (income and asset) and functional eligibility criteria, which means you require assistance with daily activities such as bathing, dressing, or eating. Coverage for assisted living is often provided through Home-and-Community-Based Services (HCBS) waivers or state-specific programs designed to help seniors remain in less restrictive settings. For a clear overview of the types of senior care settings and the role they serve, see our page on What Senior Care Is.
How Much Does Medicaid Pay for Assisted Living?
The amount Medicaid will pay toward assisted living depends on your specific program and eligibility. It typically covers room, board, and personal care services for approved residents but it may not fully cover the full cost of a private room or add‑ons. If Medicaid is insufficient, additional funding options may be necessary. A helpful comparison of care settings, including assisted living vs nursing homes, is available from Healthline.
Alternative Payment Options When Medicaid Isn’t Enough
If Medicaid does not fully cover assisted living, there are other routes to cover the expenses:
- Life Settlements: You can sell a life insurance policy for a lump‑sum payment and use that money for assisted living. Learn more about the process on our Life Settlements page.
- Viatical Settlements: If you or your loved one is facing a serious illness and the policy qualifies, a viatical settlement might be an option for larger funds. Learn what a Viatical Settlement is for these specialized solutions.
- Senior Assisted Living Facilities: If Medicaid’s support is limited, selecting the right assisted living facility for your budget and needs becomes even more critical. Explore our guide to Senior Assisted Living.
When Assisted Living Isn’t Enough: Consider Nursing-Level Care
If your care needs extend beyond assisted living and require full-time medical supervision, skilled nursing care may be necessary. This level of care typically includes 24/7 nursing supervision and more intensive support. While this may involve higher costs, it’s important to explore available options for coverage.Â
Bottom Line
Yes, Medicaid can cover assisted living in many cases, but eligibility, financial needs, and the state’s specific program determine coverage. If Medicaid’s coverage is partial or unavailable, other options, such as life or viatical settlements, personal savings, or selecting the appropriate care setting, are essential to consider. If you’re evaluating your options or want to explore how a policy sale could help with assisted living costs, get your free estimate today.
