Almost 1 in 6 residents relies on Medicaid to pay for daily services (15.0%).
State Medicaid programs can cover home and community-based services (HCBS) such as personal care and supportive services provided in assisted living communities. Medicaid does not pay for room and board costs.
States can use several different Medicaid authorities to cover such services in assisted living:
- Medicaid state plan authorities,
- § 1915(c) HCBS waiver,
- concurrent § 1915(b) managed care waiver, or
- §1115 research or demonstration programs.
Note, a small minority of state Medicaid programs do not cover services in assisted living.
Over time, spending on Medicaid long-term services and supports (LTSS) has shifted from traditional settings of care towards HCBS settings.
- 53.1% ($80.6 billion) of Medicaid long term care services and supports spending was on HCBS in FY 2014
- HCBS spending increased 7.7% from FY 2013 to FY 2014
- Of the total Medicaid HCBS spending, 51.5% ($41.5 billion) was through 1915(c) waiver programs.