Medicaid and Medicare Assisted Living Programs: What Is Covered in 2027
Reviewed October 17, 2026. Medicare doesn’t pay for assisted living. Medicaid can help, but only through state programs, usually home and community-based services (HCBS) waivers, that pay for care services such as personal care, medication help and nursing in an assisted living residence. Federal rules generally don’t let these waivers pay room and board, so residents still pay rent and meals, often from their own income.
Quick answer: To get help paying for assisted living, ask your state Medicaid agency or local Area Agency on Aging which assisted living waiver or program your state runs, whether there’s a waitlist, and which residences accept it. Most programs require that you need a nursing home level of care and meet Medicaid’s income and asset limits. Call the Eldercare Locator at 1-800-677-1116 to find local help.
Does Medicare cover assisted living?
No. Medicare.gov says Medicare doesn’t pay for long-term care or custodial care, such as help with bathing, dressing and eating, when that’s the only care you need. (Medicare.gov: Long-term care) Medicare still pays for your doctor visits, hospital care, drugs (Part D) and short-term skilled nursing after a qualifying hospital stay while you live in assisted living. In 2026, skilled nursing days 21-100 cost $217 a day; 2027 amounts aren’t published yet. (Medicare.gov: SNF care)
How Medicaid assisted living programs work
- HCBS waivers. Section 1915(c) waivers, available in 47 states and D.C., let states pay for services like personal care, case management and adult day health outside a nursing home. States cap enrollment, so waitlists are common. (Medicaid.gov: HCBS authorities)
- Room and board isn’t covered. Waivers pay for services “other than room and board.” (CMS)
- Nursing homes are different. Nursing facility care is a mandatory Medicaid benefit that covers room and board; see Medicaid for nursing home care.
State examples
| State | Program | Notes |
|---|---|---|
| Florida | SMMC Long-Term Care program | Covers assisted living services; waitlist released by priority (AHCA) |
| Texas | STAR+PLUS HCBS | Assisted living for adults 21+; members pay room and board; interest list (Texas HHS) |
| California | Assisted Living Waiver | 15 counties; resident pays room and board; waitlist (DHCS) |
| New York | Assisted Living Program | For people medically eligible for nursing home care (NY DOH) |
Medicaid eligibility for assisted living
Most programs require a nursing facility level of care plus financial eligibility. Many states use the special income level of 300% of the SSI rate ($2,982 a month in 2026) and an asset limit that is commonly $2,000 for an individual. Spousal impoverishment protections, such as a 2026 community spouse resource allowance of up to $162,660, can apply to waiver recipients. (CMS 2026 standards) Medicaid also reviews asset transfers made in the 60 months before you apply. If you’re over the limits, ask about a Medicaid spend-down, or start with our Medicaid eligibility tool guide. People with both Medicare and Medicaid should also read dual eligibility for Medicare and Medicaid.
Memory care in assisted living
Assisted living communities with secured memory care units follow the same Medicaid rules: a waiver may cover care, and the resident pays room and board. Read memory care facilities that accept Medicaid for how to find one.
Other ways to pay for assisted living
- Veterans benefits. Eligible veterans and surviving spouses may qualify for a VA pension with an added Aid and Attendance amount that can help with assisted living costs. Check eligibility on VA.gov.
- Long-term care insurance. Many policies pay for assisted living once you need help with activities of daily living; check your policy’s elimination period and daily benefit.
- Personal savings and home equity, including the sale of a home or a reverse mortgage. Talk to a HUD-approved counselor before taking a reverse mortgage.
For a broader look at facility types, see our guide to assisted living facilities.
Frequently asked questions
Does Medicaid pay for assisted living?
In most states, Medicaid pays for care services in assisted living through a waiver or state program, but not room and board.
Does Medicare pay for assisted living?
No. Medicare doesn’t cover custodial or long-term care. It continues to cover medical care while you live in assisted living.
Is there a waiting list for Medicaid assisted living?
Often. Florida, Texas and California all report waitlists or interest lists for their programs. Apply early.
Who do I call about Medicaid assisted living?
Your state Medicaid agency or Area Agency on Aging. The Eldercare Locator (1-800-677-1116) can connect you.
This article is general information, not legal or financial advice. Medicare365 is an independent website and is not affiliated with any government agency. Rules vary by state.