Medicaid Will Pay for Assisted Living Services in the Majority of States

Last updated: June 16, 2025

Table of Contents

Introduction

Payment Methods

Waivers

State Plan Personal Care

State-Specific Assisted Living Benefits

 

Introduction: State Coverage of Medicaid-Funded Assisted Living

Medicaid-funded Home and Community Based Services (HCBS), which encompasses assisted living services, is an optional Medicaid benefit. In other words, unlike with Nursing Home Medicaid, a state’s Medicaid program is not required to provide it. However, states are increasingly offering assisted living services as a Medicaid-funded benefit. In fact, all states but Alabama, Kentucky, and Louisiana provide assisted living services. This alternative to nursing home care is not only attractive to many seniors and persons with disabilities who require assistance with daily living activities, but it is also more cost-effective (more affordable) for the state in comparison to paying for nursing home care.

 In all states but Alabama, Kentucky, and Louisiana, Medicaid-funded assisted living services are available. No state, however, will pay for assisted living room and board.

While in most states, Medicaid will pay for assisted living services for persons who meet the eligibility criteria, the exact benefits available vary based on the state and the specific Medicaid program. Examples of long-term care assistance that may be provided include personal care assistance, homemaker services, non-emergency transportation, personal emergency response systems, 24/7 supervision and care, and memory care (care specific to persons with Alzheimer’s disease and related dementias). It is extremely importation to mention that Medicaid does not pay for room and board in assisted living. Many states, however, have room and board policies in place to ensure that the cost of room and board is affordable for Medicaid beneficiaries.

 

Avenues Through Which States Pay for Medicaid Assisted Living Services

The avenues through which Medicaid pays for assisted living services / memory care services is based on the state. Most commonly, assistance is provided via 1915(c) HCBS Waivers. These Medicaid waivers target specific populations of persons (i.e., elderly, persons with disabilities, persons with cognitive impairments), are sometimes limited to specific geographic areas within a state, and limit the number of program participants. Therefore, waiting lists for assistance forms when all of the participant slots are filled. States also sometimes authorize assisted living services via 1115 Demonstration Waivers, which also may have waiting lists for Home and Community Based Services.

Additionally, many states provide personal care services via their Medicaid State Plan, or put differently, their Regular Medicaid program. Additionally, some states provide assistance via a Medicaid State Plan Option. This includes attendant care services via a 1915(k) Community First Choice (CFC) program and / or services and supports for independent living via 1915(i) State Plan HCBS. While assistance via these avenues are an entitlement, meaning anyone who meets eligibility criteria will receive benefits without being put on a waiting list, not all states permit personal care services / attendant care in assisted living. This information, unfortunately, is not readily available, and therefore, it is often necessary for one to check with their state’s Medicaid program to see if assisted living services are provided via this avenue(s).

 To be eligible for Medicaid-funded assisted living services (including dementia care), an applicant must meet financial and functional eligibility criteria. This criteria can differ based on the state in which one is applying, as well as the specific Medicaid program for which one is an applicant. Medicaid eligibility criteria for memory care is generally the same as with assisted living, with the exception that one must have a cognitive impairment. For assistance via some programs, one must have a specific dementia(s). See general eligibility requirements for assisted living services. Persons can also find state-specific and program-specific Medicaid eligibility criteria.
States that Provide Medicaid-Funded Assisted Living via Waivers

The states named below offer care services and supports in assisted living residences via HCBS Medicaid Waivers or 1115 Demonstration Waivers. Additionally some states offer memory care specific to persons with Alzheimer’s disease or a related dementia. The name of the coordinating program name(s) are in parenthesis. As mentioned previously, waitlists for assistance may exist.

Seniors interested in Medicaid-funded assisted living services should confirm with their state’s Medicaid agency or AAA office that these benefits are available. A state’s Medicaid policies and benefits can change and / or assisted living services may be limited to a group of persons that do not include seniors.

 

States that Provide Medicaid-Funded State Plan Personal Care Assistance

The following states offer personal care assistance through their Medicaid State Plan or a Medicaid State Plan Option (Community First Choice, 1915(i) HCBS). This does not necessarily mean the state will cover personal care assistance, sometimes called attendant care, in assisted living facilities. Nor does it mean the assisted living residence in which one resides will allow outside assistance (paid for by Medicaid) to enter the residence and provide care. Whether Medicaid State Plan personal care assistance can be provided in assisted living (memory care) is not readily provided. Furthermore, just because a state says they provide Medicaid-funded assisted living services, it does not necessarily mean assisted living facilities accept Medicaid as payment.
That said, per the Kaiser Family Foundation (KFF) Medicaid HCBS Program Survey 2024, the states with an asterisk next to their name provide personal care services via State Plan Medicaid and / or Community First Choice in assisted living residences. Note: Idaho, Indiana, Florida, nor Utah responded to the survey.

  • Alaska
  • Arkansas
  • California
  • Connecticut
  • Delaware (included in Diamond State Health Plan Plus)
  • District of Columbia
  • Florida
  • Idaho
  • Indiana
  • Iowa
  • Kansas
  • Louisiana (does not offer assisted living services)
  • Maine*
  • Maryland
  • Massachusetts
  • Michigan*
  • Minnesota*
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey*
  • New Mexico
  • New York
  • North Carolina*
  • North Dakota*
  • Oklahoma
  • Oregon*
  • Pennsylvania
  • Rhode Island
  • South Dakota
  • Texas
  • Utah
  • Vermont
  • Washington*
  • West Virginia*
  • Wisconsin
 Based on the state, assisted living residences may go by an alternative name. These names include board and care homes, dementia care homes, adult family care, alternative care facilities, residential care facilities for the elderly, and congregate housing.

 

State-Specific Assisted Living Benefits

According to the Kaiser Family Foundation (KFF) Medicaid HCBS Program Survey 2024, 41 states provide Medicaid-funded services and supports in assisted living. The most commonly provided Medicaid assisted living benefit is personal care services. Thirty-four states reported providing this benefit, which includes assistance with Activities of Daily Living (i.e., toileting, bathing, dressing) and Instrumental Activities of Daily Living (i.e., meal preparation, light housecleaning, medication management). The second most commonly available benefit is round-the-clock services. Twenty-nine states reported providing care and supervision 24 hours a day / 7 days a week. Furthermore, 24 states reported providing case management, 22 states reported providing nursing services, 21 states reported providing “equipment, technology, and modifications” (i.e., personal emergency response systems, home / vehicle modifications, supplies), 19 states reported providing non-medical transportation, 18 states reported providing day services (i.e., adult services, adult day health, education services), 18 states reported providing home based services (i.e., home health aide, personal care, homemaker, companion), 7 states reported providing home delivered meals, and 3 states reported providing caregiver support (i.e., respite care, caregiver counseling/training).

State Assisted Living Services Relevant to Seniors and Persons with Disabilities
Alabama N/A
Alaska 1) Case Management 2) Day Services 3) Equipment, Technology, and Modifications 4) Non-Medical Transportation 5) Nursing 6) Round-the-Clock Services
Arizona 1) Round-the-Clock Services
Arkansas 1) Round-the-Clock Services
California 1) Personal Care 2) Case Management 3) Equipment, Technology, and Modifications 4) Nursing 5) Round-the-Clock Services
Colorado 1) Personal Care 2) Round-the-Clock Services
Connecticut 1) Personal Care 2) Equipment, Technology, and Modifications
Delaware 1) Personal Care 2) Round-the-Clock Services
District of Columbia 1) Personal Care 2) Home-Based Services
Florida No response by the state
Georgia 1) Personal Care 2) Case Management 3) Day Services 4) Equipment, Technology, and Modifications 5) Home-Based Services 6) Non-Medical Transportation 7) Nursing 8) Round-the-Clock Services
Hawaii 1) Personal Care 2) Case Management 3) Nursing 4) Round-the-Clock Services
Idaho No response by the state
Illinois 1) Personal Care 2) Nursing 3) Round-the-Clock Services
Indiana No response by the state
Iowa 1) Personal Care 2) Case Management 3) Day Services 4) Equipment, Technology, and Modifications 5) Home-Based Services 6) Home-Delivered Meals 7) Round-the-Clock Services
Kansas 1) Personal Care 2) Day Services 3) Round-the-Clock Services
Kentucky N/A
Louisiana N/A
Maine 1) Personal Care
Maryland 1) Round-the-Clock Services
Massachusetts 1) Personal Care 2) Case Management 3) Home-Based Services 4) Equipment, Technology, and Modifications 5) Home-Based Services 6) Non-Medical Transportation 7) Nursing 8) Round-the-Clock Services
Michigan 1) Personal Care 2) Case Management 3) Equipment, Technology, and Modifications 4) Home-Based Services 5) Home-Delivered Meals 6) Non-Medical Transportation 7) Nursing
Minnesota 1) Personal Care 2) Equipment, Technology, and Modifications 3) Home-Based Services 4) Home-Delivered Meals 5) Non-Medical Transportation 6) Nursing 7) Round-the-Clock Services
Mississippi 1) Personal Care 2) Case Management 3) Non-Medical Transportation 4) Nursing 5) Round-the-Clock Services
Missouri N/A
Montana 1) Personal Care 2) Case Management 3) Equipment, Technology, and Modifications 4) Non-Medical Transportation 5) Nursing 6) Round-the-Clock Services
Nebraska 1) Personal Care 2) Case Management 3) Day Services 4) Home-Based Services 5) Home-Delivered Meals 6) Non-Medical Transportation 7) Round-the-Clock Services
Nevada 1) Personal Care 2) Case Management 3) Home-Based Services 4) Non-Medical Transportation 5) Round-the-Clock Services
New Hampshire 1) Personal Care 2) Equipment, Technology, and Modifications 3) Home-Based Services 4) Non-Medical Transportation 5) Nursing 6) Round-the-Clock Services
New Jersey 1) Personal Care 2) Caregiver Support 3) Case Management 4) Day Services 5) Equipment, Technology, and Modifications 6) Home-Based Services 7) Non-Medical Transportation 8) Nursing 9) Round-the-Clock Services
New Mexico 1) Personal Care 2) Case Management 3) Day Services 4) Equipment, Technology, and Modifications 5) Home-Based Services 6) Nursing
New York N/A
North Carolina 1) Personal Care
North Dakota 1) Personal Care
Ohio 1) Case Management 2) Nursing 3) Round-the-Clock Services
Oklahoma 1) Personal Care 2) Case Management 3) Equipment, Technology, and Modifications
Oregon Reported no Assisted Living Services Relevant to Seniors & Persons with Disabilities
Pennsylvania 1) Personal Care 2) Case Management
Rhode Island 1) Personal Care 2) Day Services 3) Home-Based Services 4) Home-Delivered Meals 5) Round-the-Clock Services
South Carolina 1) Personal Care 3) Case Management 3) Home-Delivered Meals
South Dakota 1) Day Services 2) Equipment, Technology, and Modifications 3) Round-the-Clock Services
Tennessee N/A
Texas 1) Personal Care 2) Case Management 3) Day Services 4) Equipment, Technology, and Modifications 5) Home-Based Services 6) Non-Medical Transportation 7) Nursing 8) Round-the-Clock Services
Utah No response by the state
Vermont 1) Personal Care 2) Case Management 3) Day Services 4) Nursing
Virginia Reported no Assisted Living Services Relevant to Seniors & Persons with Disabilities
Washington 1) Personal Care 2) Caregiver Support 3) Case Management 4) Day Services 5) Equipment, Technology, and Modifications 6) Non-Medical Transportation 7) Nursing 8) Round-the-Clock Services
West Virginia 1) Personal Care
Wisconsin 1) Personal Care 2) Caregiver Support 3) Case Management 4) Day Services 5) Equipment, Technology, and Modifications 6) Home-Based Services 7) Non-Medical Transportation 8) Nursing 9) Round-the-Clock Services
Wyoming 1) Personal Care 2) Case Management 3) Day Services 4) Equipment, Technology, and Modifications 5) Home-Based Services 6) Home-Delivered Meals 7) Non-Medical Transportation 8) Nursing 9) Round-the-Clock Services

 

 Even in a state that provides Medicaid-funded assisted living services, not all assisted living facilities will accept Medicaid beneficiaries. Learn more. Persons can learn how to find an assisted living residence that accepts Medicaid beneficiaries here.

 

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