The Ultimate State-by-State Guide to Assisted Living Waiver Programs

The demand for assisted living  waiver programs services continues to grow, and one of the biggest questions many families have is how they’ll afford to move a loved one into an assisted living or nursing community. Fortunately, some options can make affordable care easier.

For example, Medicaid Waiver Programs are options in many (but not all) states that help keep someone in a residential community or provide personal care services at home instead of requiring a nursing home.

If you have a loved one in an assisted living community or who will need health care services in their home, working with the Medicaid program and a care coordination agency can help them get the support they need. While a nursing facility may be required in some instances, there are many times when other options are available through Medicaid services.

An assisted living waiver (ALW program) is a type of HCBS Medicaid waiver, and the HCBS waiver program may be exactly what you and your loved one need to afford vital, valuable care. Every state handles this issue differently, so here’s what you need to know.

What Is an Assisted Living Waiver Program?

The assisted living waiver program differs from the traditional Medicaid services provided through nursing facilities. These waivers allow Medicaid to cover care in settings other than nursing homes so seniors can stay in less restrictive, more home-like environments.

Those environments typically include assisted living communities and in-home and community-based services provided to seniors who meet the medical criteria. HCBS programs require an application process, often a waitlist request form, and other requirements; however, they can be extremely beneficial for many people.

What Services Do Assisted Living Waivers Typically Cover?

Generally, ALW participants are covered in an assisted living community or their own homes for services such as:

• Personal care assistance (ADLs like bathing and dressing)
• Medication management
• Meals
• Transportation
• Case management
• Housekeeping
• Sometimes room and board (varies by state)

It’s important to note that the waiver program covers daily living activities and basic care, but luxury amenities and private room upgrades are usually not covered or approved. The program’s goal is to meet basic needs in long-term care for eligible elderly people, help reduce costs, and ensure access to resources.

Eligibility Criteria for Assisted Living Waivers

Before you submit a form for coverage under the ALW program, it’s important to ensure your loved one fits the criteria for a waiver. For example, they won’t be Medicaid eligible if they have significant cash or other assets.

Working with a coordinated care agency can help you discover what your loved one qualifies for. To be considered, they must meet:

• Medicaid eligibility (income & asset limits)
• Age and/or disability requirements
• Functional needs assessment (must need a nursing home level of care)
• Waiver waitlists or enrollment caps (in many states)

Beneficiaries of Medicaid services may also have Medicare, which could provide some additional support. However, the waiting list for nursing home care or other support can still be long. It’s generally best to apply as soon as your loved one meets the criteria and needs help with daily living activities, so you can get them the support they need and deserve.

State-by-State Overview of Assisted Living Waiver Programs

Not sure what’s offered in your state? Here’s a comprehensive list of what you can expect. Remember, most states have waivers, but many also have waitlists due to high demand for services. Additionally, many waivers don’t cover room and board for assisted living, but cover several services.

How to Get A Waiver:

1. Confirm your state runs a waiver or equivalent program (use the state list below)
2. heck the three eligibility tests: income and assets, age or disability, and care level.
3. Request a functional-needs assessment through your state Medicaid agency.
4. Submit the application and any waitlist request form.
5. Find a community that accepts the waiver, then confirm the slot. Find a local CarePatrol Senior Care Advisor for personalized help exploring senior living options in your area

Alabama

Alabama has several Medicaid-based programs to help people stay in their homes when they need care, but there’s no waiver program for those in assisted living.

Alaska

Alaska offers two options through the state that can help elderly people get assisted living services: the Alaskans Living Independently Waiver and the Adults With Physical Disabilities Waiver. Both provide residential-supported living services. Qualifying for a waiver is based on the level of care needed and Medicaid eligibility. They have caps, so waitlists may exist.

Arizona

The Arizona Long-Term Care System (ALTCS) is a state program that pays for services provided in assisted living communities if there is available space in the program. Participants can choose their own service providers, but there may be a waitlist depending on current needs throughout the state.

Arkansas

The State of Arkansas offers two options for residents of centers and assisted living communities. The Living Choices Assisted Living Waiver and the Independent Choices Program make it easier for elderly and disabled individuals to afford the costs of needed support from providers they trust. These programs have income-based and health-need requirements.

California

Medi-Cal, which is the State of California’s Medicaid department, offers resources and waivers, but options are limited. As of 2024, the ALW program is only good in 15 counties and is not statewide. Some people who need care may choose to move to an assisted living community in a covered county, which are Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma. Due to the limited number of covered facilities, waitlists are common.

Colorado

The Colorado Department of Health Care Policy & Financing offers an Elderly, Blind, and Disabled waiver for care services in assisted living communities and at home. Participants can hire their own care providers and must meet income—and need-based requirements for services such as long-term care.

Connecticut

In Connecticut, Medicaid has a program called the Home Care Program for the Elderly (CHCPE) that provides care for people in assisted living communities. Persons interested in setting up care for loved ones can access the Connecticut Assisted Living Program to get more information, fill out a waitlist request form, or determine eligibility based on income and care needs.

Delaware

The state offers the Diamond State Health Plan Plus, which provides assisted living community services to Medicaid-eligible persons needing significant care. Participants must meet income and care requirements in order to use the services offered by this plan.

District of Columbia (DC)

Through the DC Medicaid program, interested persons can access an Elderly and Persons With Disabilities Waiver. This has been expanded to cover assisted living services, allowing more people to stay in their homes or other care facilities with their current providers instead of transferring to a nursing home.

Florida

The State of Florida has eliminated its HCBS waiver program. It now uses the Statewide Managed Medicaid Care-Long Term Care program through the Florida Agency for Health Care Administration for assisted living support. This program typically has a waitlist.

Georgia

Georgia has an Elderly and Disabled Waiver Program, formerly called the Community Care Services Program, that provides support for assisted living agency care or increased care in your own home if you qualify for Medicaid. A similar option, the Georgia SOURCE waiver, also includes assisted living benefits. Depending on your location and needs, there can be a waitlist.

Hawaii

Med-QUEST, Hawaii’s Medicaid managed care program, will cover nursing services within an assisted living setting. Adult foster care is another option for some people. It offers services similar to assisted living but in a small, home-like environment rather than a larger community.

Idaho

Idaho Medicaid has three different programs that pay for personal care no matter where the person is located (assisted living or at home). These are the HCBS Aged & Disabled Waiver, Personal Care Services Program, and Idaho Medicare Medicaid Coordinated Plan.

Illinois

In Illinois, the HCBS Waiver for Supportive Living Facilities provides care for people in assisted living. To qualify, you must meet Medicaid income and asset guidelines and need a nursing home level of care. There are nine total HCBS waiver programs, some of which are for adults and some for children.

Indiana

Indiana has an Aged & Disabled Waiver with assisted living support, but you’ll need to live in a Medicaid-approved community. Structured Family Caregiving is also an option under this waiver as an alternative to assisted living.

Iowa

The HCBS Elderly Waiver is Iowa’s Medicaid-friendly option for people needing care to choose assisted living or in-home options, as well as attendant or personal care. For people under 65, there’s also a Health and Disability Waiver program that provides similar care opportunities.

Kansas

KanCare, the Kansas State version of Medicaid, pays for nursing services whether the person is in assisted living or at home. The funding comes through the HCBS / FE Waiver, and you must be Medicaid-eligible to qualify. The waiver includes health services, personal care, and household tasks.

Kentucky

The Supports for Community Living Waiver covers adult foster care for those with developmental or intellectual challenges that developed prior to age 22, but it isn’t available for most seniors. The state doesn’t have an overarching Medicaid waiver provision.

Louisiana

The Community Choices Waiver offers a benefit called Monitored In-Home Caregiving, which is similar to foster care. However, the state doesn’t offer a Medicaid waiver program to help with assisted living costs.

Maine

MaineCare (Maine’s state Medicaid plan) offers long-term care assistance, including residential communities such as assisted living. There are also two different Medicaid programs that can help with the costs for a senior who needs care but wants to stay in their home.

Maryland

The Community Options Waiver will pay for assisted living care under certain conditions, including the results of an assessment of care needs. To qualify for this waiver, a senior needs to require a higher level of care but not need so much care that a nursing home would be less expensive. The Increased Community Services (ICS) Program and Community First Choice waiver are other options to cover assisted living care.

Massachusetts

MassHealth (Massachusetts’ Medicaid program) has a Personal Care Attendant program that pays for assisted living. Another program, Careforth (formerly Caregiver Homes), offers a similar level of care on a 24/7 basis in the caregiver’s home. There’s also Group Adult Foster Care, which covers personal care and support but not rent.

Michigan

Michigan offers the Choice Waiver Program to pay for assisted living, which may refer to homes for the aged or adult foster care. Health Link is another option for assisted living support in the state. Both are offered by the state’s Department of Health and Human Services.

Minnesota

The Elderly Waiver is Minnesota’s Medicaid waiver, and it can be used to pay for assisted living. Participation is limited, and there may be a waitlist to get into a community setting or other type of public, subsidized housing that will provide care. There are two other options in the state: the MSC+ & MSHO (Medicaid managed care program) and the Community Access for Disability Inclusion (CADI) Waiver.

Mississippi

The Mississippi Division of Medicaid offers an Assisted Living Waiver specifically designed to help people in assisted living communities. Income and need-based requirements must be met, and the waiver covers services like case management, personal care, medication oversight, and homemaker services.

Missouri

In Missouri, the cost of assisted living care is covered by the Medicaid Aged and Disabled Waiver. The senior’s location isn’t mandated other than to say they cannot reside in a nursing home. The State Plan Personal Option has the same regulations. There are also Medicaid Care Options for long-term care services in assisted living, and the Supplemental Nursing Care Assistance Program to help with costs.

Montana

Montana uses the term Adult Residential Living for assisted living communities, and the Home and Community Based Services Medicaid Waiver covers the cost of care services for seniors who qualify based on income and care needs. Like many states’ programs, the need is typically greater than the availability, and there may be a waitlist.

Nebraska

The Aged and Disabled Medicaid Waiver is offered by the State of Nebraska, and one of the benefits of this waiver is assisted living care. Covered services include personal care, activities of daily living, and health maintenance.

Nevada

Nevada has an HCBS Waiver that covers what the state calls “augmented personal care,” which means personal care within an assisted living residence. The state also has the WIN Waiver, which is a similar program designed for disabled adults in any age group, including seniors.

New Hampshire

New Hampshire offers the Choices for Independence waiver program through the New Hampshire Care Collaborative, which pays for care in assisted living. You can find this listed as adult family care under the program’s benefits.

New Jersey

The Managed Long Term Services and Supports (MLTSS) is the Medicaid managed care program offered by the New Jersey Department of Human Services. Assisted living is one of the options, and the program will provide support for basic care activities, daily living, health management, upkeep of the residence, and more.

New Mexico

The New Mexico Health Care Authority offers a program for long-term care in assisted living, called the Centennial Care Community Benefit. Seniors will need to qualify for full-coverage Medicaid and also need the required level of care before they can receive services.

New York

New York’s Assisted Living Program (ALP) provides more than 4,000 units in assisted living communities, but it is not strictly for Medicaid recipients, so waitlists are often long. Managed Long Term Care also offers the opportunity for personal care in assisted living, and the Consumer Directed Personal Assistance Program also provides personal care options.

North Carolina

Seniors who need help with assisted living care in North Carolina can apply for support through the Medicaid State Plan Personal Care (PCS) option. This is designed to cover assistance with activities of daily living, residential upkeep, medication management, basic health support, and more.

North Dakota

The State of North Dakota has a State Plan Personal Care option that covers care regardless of the community and can be used for assisted living. It covers services like activities of daily living, laundry, housework, and preparing meals.

Ohio

Ohio has a Medicaid waiver called the Assisted Living Waiver Program that’s designed specifically for people in assisted living communities. It pays for services but not room and board, requires an approved provider and has a limited number of available spots. For seniors who have both Medicare and Medicaid, this waiver is replaced by the MyCare-Ohio Managed Medicaid program.

Oklahoma

Oklahoma Human Services offers a Medicaid ADvantage Program waiver that covers services in assisted living communities. The Medicaid State Plan Personal Care is another option to cover these services, and seniors should use whichever program they qualify for that gives them the most comprehensive benefits.

Oregon

Oregon offers the K Plan, which is part of the Community First Choice state plan option. It offers attendant care benefits for seniors who aren’t in nursing homes, which include assisted living, adult foster care, independent living, and in-home care.

Pennsylvania

The State of Pennsylvania doesn’t have a Medicaid-assisted living waiver program. For seniors needing assistance, there is the Community HealthChoices Program that offers support for personal care assistance in seniors’ own homes. There’s also additional Supplemental Security Income (SSI) for people living in residential care that’s not nursing-based.

Rhode Island

Rhode Island’s support program is called SSI Enhanced Assisted Living and provides up to $1,500 a month toward the costs of assisted living care. However, this program is not attached to Medicaid. Additionally, there’s a Medicaid program called RIte @ Home that provides 24/7 personal care, but it must be in the caregiver’s home and not a facility. For additional support in assisted living, the state also has the Global Consumer Choice Compact Waiver.

South Carolina

South Carolina Medicaid has a Community Choices Waiver that includes assisted living and in-home options. This provides an alternative to nursing home care and helps ensure that seniors get the support they need to live as comfortably as possible in a setting they prefer.

South Dakota

South Dakota offers an HCBS Waiver for the Elderly, which is also called the HOPE Waiver. It covers standard services within assisted living communities, allowing seniors to stay where they’re comfortable instead of being required to move to nursing homes.

Tennessee

In Tennessee, seniors needing supportive care in assisted living communities have the CHOICES in Long Term Care Program, which pays for nursing and personal care. Room and board aren’t covered, as is the case with the Medicaid waiver programs in most states. Participants in the program also have the option to receive care in their homes.

Texas

Texas Medicaid covers the cost of services in an assisted living community through the state’s STAR+PLUS Program. Room and board are not included, and high demand often creates a waitlist. The program is designed for adults with complex medical needs who want to stay in their own homes or assisted living communities instead of transferring to nursing homes.

Utah

In Utah, the New Choices Waiver is used to pay for services at assisted living communities. The Utah Department of Health & Human Services offers the waiver, which helps with community-based living and allows a participant to stay in their home or an assisted living community if they would prefer not to move to a nursing home.

Vermont

Vermont has the Choices for Care Medicaid Waiver, which operates under the umbrella of the Global Commitment to Health Waiver. This program pays for services in residential care communities that are not nursing homes. The Attendant Services Program and Assistive Community Care Services are also options for support.

Virginia

Virginia doesn’t offer a Medicaid waiver program or other programs for assisted living. There is a VA Adult Services program that provides assisted living assessments, but costs aren’t covered.

Washington

Washington has several programs to help with the costs of assisted living or in-home care. These include the Medicaid Personal Care program and the Community First Choice Program. Additionally, the COPES Program has an option for assisted living support, as does the New Freedom Program. Another option is the Nurse Delegation Program, which trains caregivers to assist with some types of medical tasks.

West Virginia

The Medicaid Personal Care option in West Virginia covers personal care for residents of the state if they’re in an assisted living community or need in-home care and support. The West Virginia Department of Human Services handles this Medicaid program.

Wisconsin

The Family Care program offers some limited options for care in assisted living communities to residents of the state. There is also a Personal Care option under the state’s general Medicaid program, and seniors can receive support through IRIS (Include, Respect, I Self-Direct), which is available to provide care options to people in assisted living communities.

Wyoming

Wyoming Medicaid has a Community Choices Waiver that will pay for a number of nursing and personal health care services for people in assisted living communities. As is the case with most other states’ programs, room and board are not covered by this waiver, and waitlists are common.

Common Myths and Misunderstandings

Many common myths surround Medicare and Medicaid waiver programs, including those that offer support for residents of assisted living communities. Whether your loved one has income requirements, is seeking other providers, or has been approved and is ready to start receiving care, it’s essential that they have accurate information and complete details. Here are a few of the biggest myths.

Myth 1: The waiver covers rent in assisted living.

Truth: In most states, Medicaid can’t directly pay for room and board. The waiver often covers care services (help with bathing, meals, meds), but families may still have to pay some rent.

Myth 2: Every state offers an assisted living waiver.

Truth: Not all states have a waiver program specifically for assisted living. Some offer it through broader HCBS waivers, while others only fund care in nursing homes.

Myth 3: If my loved one qualifies, they can move in right away.

Truth: Many states have waitlists or enrollment caps for waiver programs. Even if someone qualifies, they may have to wait weeks or months for a slot to open.

Myth 4: Medicaid only pays for nursing homes.

Truth: That used to be true, but HCBS waivers were created to give people the option to live in more home-like settings, such as assisted living, instead of being institutionalized.

Myth 5: It’s easy to find a community that accepts waivers.

Truth: Not all assisted living communities accept Medicaid or waivers. That’s why families often need help finding the right place, which is where CarePatrol comes in!

How CarePatrol Helps Families Navigate Care Options

As we age, care needs change and even increase, requiring additional support to help us live the best life possible. At CarePatrol, we help you navigate care options to ensure you or your loved one is in a place where you can thrive.

With so much information available about care options for older adults, it may be challenging to find clear answers to your questions about care support. Our Local Senior Care Advisors take away the burden by providing you with expert knowledge and support about the various care options available, arranging community tours, and even following up after your move to ensure your care needs are being met, even when health conditions change. Our goal is to assist you and your family to find the most up to date information with our assisted living waiver programs guide.

Next Steps for Families

Whether you are being discharged from a hospital or care setting or need extra support due to a change in health condition, CarePatrol is here to help. Our senior living advisory services are at no cost to you, as we are paid for by over 20,000 preferred senior care providers across the nation.

Contact your Local Senior Care Advisor to learn more about how we can help you navigate care options.

Frequently Asked Questions About Assisted Living Waivers

Does Medicaid pay for assisted living?

In many states, yes, but not for everything. Medicaid does not pay assisted living rent in most states. What it can cover, through a Home and Community Based Services (HCBS) waiver, is the care delivered inside an assisted living community: personal care, medication management, and similar services. Whether a waiver exists, and what it pays for, depends entirely on your state.

What is an assisted living waiver (ALW)?

An assisted living waiver is a type of Medicaid HCBS waiver that lets Medicaid fund care in an assisted living community instead of a nursing home. The point is to let seniors receive care in a less restrictive, more home-like setting while Medicaid covers the qualifying services.

Does every state have an assisted living waiver?

No. Some states run a dedicated assisted living waiver, some fold the benefit into a broader HCBS or managed-care program, and a handful cover this level of care only in nursing homes. States without a dedicated waiver often still offer personal-care or in-home options. Check your state’s entry in the guide above for the specific program name.

What does an assisted living waiver cover?

Waivers typically cover care services rather than housing. Common covered services include personal care with daily activities such as bathing and dressing, medication management, meals, transportation, case management, and housekeeping. Luxury amenities and private-room upgrades are generally not covered.

Does the waiver cover room and board or rent?

In most states, no. Medicaid generally cannot pay assisted living room and board directly, so families often still cover rent out of pocket or through other income sources. A few states offer separate supplements toward housing costs, but these are the exception, not the rule.

Who qualifies for an assisted living waiver?

Qualifying usually means meeting three tests at once: financial eligibility for Medicaid within your state’s income and asset limits, an age or disability requirement, and a functional-need assessment showing you require a nursing-home level of care. Someone with significant cash or other assets will generally not qualify until those tests are met.

How do I apply for an assisted living waiver?

Start by confirming your state has a program and that you meet its criteria, then apply through your state Medicaid agency, which often involves a waitlist request form and a functional-needs assessment. Because the steps and waitlists vary widely, working with a care coordination agency shortens the process. A CarePatrol Local Senior Care Advisor can walk you through it at no cost.

How long is the waitlist for a waiver?

It varies from none to many months. Most states cap enrollment, so even people who qualify may wait for a slot. The practical takeaway is to apply as soon as your loved one meets the criteria rather than waiting until care is urgent.

What is the difference between a waiver and regular Medicaid?

Traditional Medicaid long-term care is delivered through nursing facilities. An HCBS waiver “waives” that institutional requirement so the same funding can support care in assisted living or at home. The care can be similar. The setting is the difference.

Does Medicare pay for assisted living?

No. Medicare does not pay for long-term assisted living care. It covers short-term skilled needs such as limited rehabilitation, not ongoing custodial care. For ongoing assisted living costs, Medicaid waivers and private pay are the usual routes.

What if my state does not have an assisted living waiver?

You still have options. Many states without a dedicated waiver offer personal-care or in-home support programs, state supplements, or managed-care benefits that reach some of the same needs. A Local Senior Care Advisor can identify what your state offers and which communities accept it.