Assisted Living Waiver Program: An Essential Guide for Eligibility and Benefits

The Assisted Living Waiver Program is a specialized initiative designed to support seniors and individuals with disabilities who require assistance with daily living activities but wish to avoid institutionalized care. This program is a part of Medicaid, a joint federal and state program that provides health coverage to people with low income, including some low-income adults, children, pregnant women, elderly adults, and people with disabilities.

The waiver program specifically targets those who are eligible for nursing home care but prefer to reside in an assisted living facility. By doing so, it offers a more home-like environment and promotes independence, dignity, and choice for its beneficiaries.

Through the Assisted Living Waiver Program, eligible individuals can receive financial assistance to cover the costs of services in assisted living facilities. These services can range from personal care to medication management, recreational activities, and more. It’s important to note that while the program covers the cost of services provided within the facility, it does not typically cover the room and board expenses.

Each state has its own set of guidelines and eligibility criteria for the program, and the availability of waivers can vary. As such, it’s crucial for individuals and families to research and understand the specific requirements and offerings in their respective states.

Services Covered by the Assisted Living Waiver Program

The Assisted Living Waiver Program is designed to provide a comprehensive range of services to ensure that seniors and individuals with disabilities receive the care and support they need while residing in an assisted living facility. While the exact services covered can vary by state, the following is a list of services that are typically covered under the program:

Personal Care Services: Assistance with daily living activities such as bathing, dressing, grooming, and toileting.
Medication Management: Ensuring that residents take their medications as prescribed, including assistance with administering medications and monitoring for any side effects.
Recreational and Social Activities: Organized events and activities to promote social interaction, mental stimulation, and overall well-being.
Meal Preparation and Dietary Services: Providing nutritious meals tailored to the dietary needs and preferences of residents.
Health Monitoring: Regular check-ups and monitoring of residents’ health conditions, including vital signs and other health metrics.
Transportation Services: Assistance with transportation for medical appointments, shopping, and other essential outings.
Housekeeping and Laundry Services: Regular cleaning of residents’ living spaces and laundry services for their personal clothing.
Therapeutic Services: Physical, occupational, and speech therapy services to address specific health and mobility challenges.
Emergency Response Systems: Installation and monitoring of emergency call systems to ensure residents can quickly get help in case of emergencies.
Case Management: Coordination of care and services to ensure that residents receive the appropriate level of care based on their individual needs.

It’s essential to note that while these services are typically covered by the waiver program, the room and board expenses at the assisted living facility are usually not included. Additionally, each state may have its own specific list of covered services, so it’s crucial to consult with local Medicaid offices or related agencies to get a detailed understanding of what’s covered in a particular state.

Eligibility Requirements for the Assisted Living Waiver Program

To benefit from the Assisted Living Waiver Program, individuals must meet specific eligibility criteria. These requirements ensure that the program caters to those who genuinely need assistance and support in an assisted living setting. While the exact criteria can vary by state, the following are general eligibility requirements commonly found across the U.S.:

Age and Disability: The program is primarily designed for seniors, typically those aged 65 and older. However, younger individuals with certain disabilities may also qualify.
Medical Eligibility: Applicants must require a level of care equivalent to that provided in a nursing home. This means they need assistance with multiple daily living activities or have medical conditions that necessitate regular monitoring and care.
Financial Eligibility: Since the program is a part of Medicaid, applicants must meet the financial criteria set by Medicaid. This typically involves having an income and asset level below a certain threshold. The exact figures can vary by state and are adjusted annually.
Residency: Applicants must be residents of the state in which they are applying for the waiver program. Additionally, they must be U.S. citizens or qualified non-citizens.
Preference for Community Living: The program is designed for individuals who prefer to live in a community setting rather than an institutional one. As such, applicants must express a desire to reside in an assisted living facility as opposed to a nursing home.
Availability of Waivers: The number of waivers available can be limited. As a result, even if an individual meets all eligibility criteria, they might be placed on a waiting list until a waiver becomes available.

It’s important to note that each state may have additional or slightly different eligibility criteria. Therefore, individuals interested in the program should consult with their local Medicaid office or related state agency to get a comprehensive understanding of the eligibility requirements in their specific state.

Assisted Living Waiver Program by State

Alabama

The Alabama Community Transition (ACT) Waiver is the state’s program designed to assist seniors and individuals with disabilities.

Services Covered: Personal care, case management, respite care, and environmental accessibility adaptations.
Eligibility Requirements: Must be 65 and older or 21 and older with a disability, require a nursing facility level of care, and meet financial criteria set by Medicaid.
Link to Alabama Medicaid Agency

Alaska

Alaska’s Alaskans Living Independently (ALI) Waiver aims to support those who prefer community-based care over institutional settings.

Services Covered: Respite care, specialized medical equipment, environmental modifications, and chore services.
Eligibility Requirements: Must be 65 and older or 21 and older with physical or developmental disabilities and meet the financial criteria set by Medicaid.
Link to Alaska Department of Health and Social Services

Arizona

The Arizona Long-Term Care System (ALTCS) is the state’s program for seniors and individuals with disabilities requiring long-term care.

Services Covered: Personal care, respite care, adult day health care, and home health services.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Arizona Health Care Cost Containment System

Arkansas

The Arkansas Living Choices Assisted Living Waiver supports seniors and individuals with disabilities in community-based settings.

Services Covered: Personal care, case management, respite care, and environmental modifications.
Eligibility Requirements: Must be 65 and older or have a physical disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Arkansas Department of Human Services

California

California’s Assisted Living Waiver (ALW) Program aims to facilitate the provision of assisted living services to eligible Medicaid beneficiaries.

Services Covered: Personal care services, nursing services, social recreational activities, and transportation.
Eligibility Requirements: Must be 21 and older, require a nursing facility level of care, and meet the financial criteria set by Medicaid.
Link to California Department of Health Care Services

Colorado

The Colorado Elderly, Blind, and Disabled (EBD) Waiver is designed to assist seniors and individuals with disabilities in accessing community-based services.

Services Covered: Personal care, respite care, adult day services, and home modifications.
Eligibility Requirements: Must be 65 and older or blind or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Colorado Department of Health Care Policy & Financing

Connecticut

Connecticut’s Home Care Program for Elders (CHCPE) supports seniors in accessing services that allow them to remain in their homes or communities.

Services Covered: Personal care assistance, adult day care, home-delivered meals, and emergency response systems.
Eligibility Requirements: Must be 65 and older, at risk of nursing home placement, and meet the financial criteria set by Medicaid.
Link to Connecticut State Department of Social Services

Delaware

The Delaware Diamond State Health Plan Plus (DSHP Plus) offers long-term services and supports to eligible individuals.

Services Covered: Personal care, case management, respite care, and adult day services.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Delaware Department of Health and Social Services

Florida

Florida’s Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program provides long-term care services to eligible individuals.

Services Covered: Personal care, case management, adult day care, and home accessibility adaptations.
Eligibility Requirements: Must be 65 and older or 18 and older with a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Florida Agency for Health Care Administration

Georgia

The Georgia Community Care Services Program (CCSP) offers services to seniors and individuals with disabilities to prevent institutionalization.

Services Covered: Personal support services, emergency response services, and alternative living services.
Eligibility Requirements: Must be 60 and older or have a disability, require an intermediate level of care, and meet Medicaid’s financial criteria.
Link to Georgia Department of Community Health

Hawaii

Hawaii’s Med-QUEST Integration (MQD) program provides integrated health services to eligible beneficiaries.

Services Covered: Personal assistance, respite care, skilled nursing, and environmental accessibility adaptations.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Hawaii Department of Human Services

Idaho

The Idaho Aged and Disabled (A&D) Waiver program supports seniors and individuals with disabilities in accessing community-based services.

Services Covered: Personal care services, respite care, adult day care, and specialized medical equipment.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Idaho Department of Health and Welfare

Illinois

Illinois’ Supportive Living Program (SLP) offers an alternative to nursing home care for low-income seniors and persons with disabilities.

Services Covered: Personal care, medication management, social and recreational activities, and laundry services.
Eligibility Requirements: Must be 65 and older or 22 and older with a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Illinois Department of Healthcare and Family Services

Indiana

Indiana’s Aged and Disabled (A&D) Waiver provides services to seniors and individuals with disabilities to allow them to remain in their homes or communities.

Services Covered: Personal care, respite care, home modifications, and transportation services.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Indiana Family and Social Services Administration

Iowa

Iowa’s Elderly Waiver (EW) program provides home and community-based services to seniors as an alternative to institutional care.

Services Covered: Personal care, home health aide, respite care, and adult day care.
Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Iowa Department of Human Services

Kansas

The Kansas Frail Elderly (FE) Waiver offers services to seniors to support them in community settings.

Services Covered: Personal care, nursing evaluation visits, sleep cycle support, and assistive services.
Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Kansas Department for Aging and Disability Services

Kentucky

Kentucky’s Home and Community Based (HCB) Waiver program provides services to seniors and individuals with disabilities to prevent institutionalization.

Services Covered: Personal care, respite care, home adaptations, and adult day health care.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Kentucky Cabinet for Health and Family Services

Louisiana

Louisiana’s Community Choices Waiver (CCW) supports seniors and individuals with disabilities in accessing community-based services.

Services Covered: Personal care, respite care, assistive devices, and environmental accessibility adaptations.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Louisiana Department of Health

Maine

Maine’s Elderly and Adults with Disabilities (EAD) Waiver program offers services to seniors and individuals with disabilities to allow them to remain in their homes or communities.

Services Covered: Personal care, respite care, adult day services, and home modifications.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Maine Department of Health and Human Services

Maryland

Maryland’s Home and Community-Based Options (CO) Waiver provides services to seniors and individuals with disabilities as an alternative to nursing home care.

Services Covered: Personal assistance, nurse monitoring, assisted living, and environmental assessments.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Maryland Department of Health

Massachusetts

Massachusetts’ Frail Elder Home and Community-Based Services (HCBS) Waiver program supports seniors in accessing community-based services.

Services Covered: Personal care, adult foster care, respite care, and home modifications.
Eligibility Requirements: Must be 60 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Massachusetts Executive Office of Elder Affairs

Michigan

Michigan’s MI Choice Waiver program offers services to seniors and individuals with disabilities to prevent institutionalization.

Services Covered: Personal care, respite care, environmental modifications, and counseling.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Michigan Department of Health and Human Services

Minnesota

Minnesota’s Elderly Waiver (EW) program provides home and community-based services to seniors.

Services Covered: Personal care assistance, adult day care, respite care, and home modifications.
Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Minnesota Department of Human Services

Mississippi

Mississippi’s Assisted Living (AL) Waiver program supports seniors in accessing services in licensed personal care home settings.

Services Covered: Personal care services, nursing services, therapeutic services, and medication administration.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Mississippi Division of Medicaid

Missouri

Missouri’s Aged and Disabled Waiver program offers services to seniors and individuals with disabilities to allow them to remain in their homes or communities.

Services Covered: Personal care, respite care, advanced respite care, and environmental accessibility adaptations.
Eligibility Requirements: Must be 63 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Missouri Department of Social Services

Montana

Montana’s Big Sky Home and Community-Based Services (HCBS) Waiver program provides services to seniors and individuals with physical disabilities.

Services Covered: Personal assistance, respite care, environmental modifications, and specialized medical equipment.
Eligibility Requirements: Must be 65 and older or have a physical disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Montana Department of Public Health and Human Services

Nebraska

Nebraska’s Aged and Disabled (A&D) Waiver program offers services to seniors and individuals with disabilities to support them in community settings.

Services Covered: Personal emergency response systems, home modifications, personal care, and respite care.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Nebraska Department of Health and Human Services

Nevada

Nevada’s Home and Community-Based Waiver for the Frail Elderly (HCBW-FE) supports seniors in accessing community-based services.

Services Covered: Personal care, respite care, adult day health care, and home modifications.
Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Nevada Division of Health Care Financing and Policy

New Hampshire

New Hampshire’s Choices for Independence (CFI) Medicaid Waiver program provides services to seniors and individuals with chronic illnesses.

Services Covered: Personal care services, respite care, environmental modifications, and specialized medical equipment.
Eligibility Requirements: Must be 65 and older or have a chronic illness, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to New Hampshire Department of Health and Human Services

New Jersey

New Jersey’s Managed Long-Term Services and Supports (MLTSS) program offers comprehensive services to seniors and individuals with disabilities.

Services Covered: Personal care, respite care, home modifications, and adult day services.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to New Jersey Division of Medical Assistance and Health Services

New Mexico

New Mexico’s Centennial Care program provides a wide range of services to seniors, individuals with disabilities, and other eligible groups.

Services Covered: Personal care services, respite care, adult day services, and environmental modifications.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to New Mexico Human Services Department

New York

New York’s Managed Long-Term Care (MLTC) program offers services to seniors and individuals with disabilities to support them in community settings.

Services Covered: Personal care, adult day health care, home health services, and non-emergency transportation.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to New York State Department of Health

North Carolina

North Carolina’s Personal Care Services (PCS) program provides assistance to seniors and individuals with disabilities in their homes.

Services Covered: Personal care services, home modifications, meal delivery, and case management.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to North Carolina Department of Health and Human Services

North Dakota

North Dakota’s Home and Community-Based Services (HCBS) program offers services to seniors and individuals with disabilities to support them in community settings.

Services Covered: Personal care, adult day care, respite care, and environmental modifications.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to North Dakota Department of Human Services

Ohio

Ohio’s Assisted Living (AL) Waiver program provides services to seniors in licensed residential care settings.

Services Covered: Personal care, nursing services, emergency response systems, and medication administration.
Eligibility Requirements: Must be 60 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Ohio Department of Medicaid

Oklahoma

Oklahoma’s Advantage Waiver program offers services to seniors and individuals with disabilities to prevent institutionalization.

Services Covered: Personal care, adult day health services, case management, and specialized medical equipment.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Oklahoma Health Care Authority

Oregon

Oregon’s Aged and Physically Disabled (APD) Waiver program provides home and community-based services to seniors and individuals with physical disabilities.

Services Covered: Personal care, respite care, home-delivered meals, and assistive technology.
Eligibility Requirements: Must be 65 and older or have a physical disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Oregon Department of Human Services

Pennsylvania

Pennsylvania’s Community HealthChoices (CHC) program offers long-term services and supports to seniors and individuals with physical disabilities.

Services Covered: Personal care, respite care, home health services, and adult day services.
Eligibility Requirements: Must be 21 and older with a physical disability or be 60 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Pennsylvania Department of Human Services

Rhode Island

Rhode Island’s Global Consumer Choice Compact Waiver program provides comprehensive services to seniors and individuals with disabilities.

Services Covered: Personal care assistance, adult day services, shared living, and assistive technology.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Rhode Island Executive Office of Health and Human Services

South Carolina

South Carolina’s Community Choices Waiver program offers services to seniors and individuals with disabilities to support them in community settings.

Services Covered: Personal care, respite care, adult day health services, and meal delivery.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to South Carolina Department of Health and Human Services

South Dakota

South Dakota’s HOPE Waiver program provides home and community-based services to seniors and individuals with disabilities.

Services Covered: Personal care, adult day services, respite care, and emergency response systems.
Eligibility Requirements: Must be 60 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to South Dakota Department of Social Services

Tennessee

Tennessee’s CHOICES in Long-Term Services and Supports program offers comprehensive services to seniors and individuals with disabilities.

Services Covered: Personal care, adult day care, in-home respite, and assistive technology.
Eligibility Requirements: Must be 65 and older or have a physical disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Tennessee Bureau of TennCare

Texas

Texas’ STAR+PLUS program provides long-term services and supports to seniors and individuals with disabilities as part of the state’s Medicaid managed care system.

Services Covered: Personal care, nursing services, respite care, and emergency response services.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Texas Health and Human Services

Utah

Utah’s Aging Waiver for Individuals Age 65 or Older program offers services to seniors to support them in community settings.

Services Covered: Personal care, respite care, adult day services, and home modifications.
Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Utah Department of Health

Vermont

Vermont’s Choices for Care program provides long-term services and supports to seniors and individuals with disabilities.

Services Covered: Personal care, respite care, home modifications, and assistive devices.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Vermont Department of Disabilities, Aging and Independent Living

Virginia

Virginia’s Commonwealth Coordinated Care Plus (CCC Plus) program offers comprehensive services to seniors and individuals with disabilities.

Services Covered: Personal care, adult day health care, respite care, and private duty nursing.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Virginia Department of Medical Assistance Services

Washington

Washington’s Community First Choice (CFC) program provides home and community-based services to seniors and individuals with disabilities.

Services Covered: Personal care, relief care, skills acquisition training, and assistive technology.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Washington State Department of Social and Health Services

West Virginia

West Virginia’s Aged and Disabled (A/D) Waiver program offers services to seniors and individuals with disabilities to support them in community settings.

Services Covered: Personal care, respite care, case management, and environmental modifications.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to West Virginia Department of Health and Human Resources

Wisconsin

Wisconsin’s Family Care program provides long-term care services to seniors and individuals with disabilities.

Services Covered: Personal care, adult day care, home modifications, and supportive home care.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Wisconsin Department of Health Services

Wyoming

Wyoming’s Community Choices Waiver (CCW) program offers services to seniors and individuals with disabilities to prevent institutionalization.

Services Covered: Personal care, respite care, home modifications, and specialized medical equipment.
Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
Link to Wyoming Department of Health

About The Author

Geoff

Geoff has had several family members graduate through different levels and different types of senior care. He writes on Senior Care Advisor to help other families as they go through the senior care journey with a loved one.

Top Resources

Guide to Assisted Living
Assisted Living Costs
Paying for Assisted Living
Assisted Living & Medicare
Guide to Custodial Care
Guide to Aging in Place
Guide to Home Health Aides
Guide to Respite Care
Guide to Medigap
Guide to LTCI
LTCI Costs
Home Healthcare & Medicare

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