How to Afford Assisted Living

How to Afford Assisted Living on a Low Income in 2025: Government Programs That Actually Work

Emergency Help & Key Facts

If you need immediate assistance:

• Call your local Area Agency on Aging: 1-800-677-1116 (Eldercare Locator)
• For housing crisis: Call 211 for emergency resources
• If you’re at risk of eviction: File a hardship waiver with your state’s Department of Health and Human Services

Critical 2025 Numbers You Need:

• National median assisted living cost: $5,900/month ($70,800 annually per Genworth 2024 survey)
• Medicaid waiver income limit: Up to $2,901/month for individuals (300% of Federal Benefit Rate)
• VA Aid & Attendance maximum: $2,795/month for married veterans, $2,358/month for single veterans (VA.gov 2025 rates)
• VA net worth limit: $159,240 (2025 adjustment)
• Americans age 65+ with income under $2,608/month: Over 17 million people

Bottom Line Up Front: Three government programs can help you afford assisted living: Medicaid waivers (cover care services), VA Aid & Attendance (covers full costs), and HUD Section 202 housing (affordable senior housing). Start applications immediately—waiting lists are 6-24 months.

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What Is Assisted Living? (And Why It Costs Less Than You Think)

Assisted living provides a middle ground between living independently at home and moving to a nursing home. You get your own apartment or room plus help with daily activities like bathing, dressing, and medication management.

What You Actually Get:

• Private or semi-private room with bathroom
• Three meals daily in common dining room
• Help with Activities of Daily Living (ADLs): bathing, dressing, eating, toileting, mobility
• Medication management and reminders
• Housekeeping and laundry services
• 24/7 staff availability
• Social activities and transportation
• Emergency call systems

Key Statistics:

• Residents: About 800,000 Americans live in assisted living (0.7% of seniors 65+)
• Average age: 84 years old
• Gender split: 73% women, 27% men
• Average stay: 22 months
• Dementia prevalence: 42% of residents have Alzheimer’s or dementia

Cost Reality Check: Assisted Living vs. Alternatives

According to Genworth’s 2024 Cost of Care Survey:

Reality Check: Assisted living can actually save money compared to extensive home care or nursing homes, especially when government programs help cover costs.

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The True Cost Breakdown: What You’re Really Paying For

2025 National Costs

Based on the latest data from multiple industry sources:

Monthly Base Costs by State (Most vs. Least Expensive):

What Drives These Costs Higher:

• Labor costs (biggest factor in 2024 increases)
• Occupancy rates (increased from 77% to 84% in 2024, pressuring supply)
• Inflation (costs rose 10% in 2024 alone)
• Location (urban vs. rural can differ by $3,000+/month)

Hidden Costs to Watch For:

• Move-in fees: $1,000-$5,000
• Care level increases: $500-$2,000/month additional
• Memory care upgrades: $1,000-$3,000/month additional
• Second person fees: $500-$1,500/month for couples

Reality Check: These rising costs mean that by 2029, over half of U.S. middle-income seniors won’t be able to afford assisted living without help.

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Government Programs That Pay for Assisted Living: Your Three Main Options

1. Medicaid Home & Community Based Services (HCBS) Waivers

What It Covers:

• Personal care services (bathing, dressing, medication help)
• Health aide services
• Care coordination
• DOES NOT cover room and board in most states

Who Qualifies (2025 Limits):

• Income: Cannot exceed $2,901/month (300% of Federal Benefit Rate) in most states
• Assets: Cannot exceed $2,000 ($3,000 for married couples in some states)
• Functional need: Must require “nursing home level of care”
• Age: Must be 65+ or have qualifying disability

States with More Generous Coverage: Some states DO help with room and board through additional programs:

• California: SSI recipients get $1,599/month total, with $1,420 going to facility
• Connecticut: Asset limit $1,600, income limit $2,901/month
• Georgia: Standard $2,901 income, $2,000 asset limits

The Application Reality:

1. Apply for regular Medicaid first (1-2 months processing)
2. Request waiver services (additional 2-4 months)
3. Complete functional assessment to prove nursing home level need
4. Find participating facility (only 50% of facilities accept Medicaid)
5. Join waiting list (can be 6+ months to several years)

Current Waiting List Examples:

• California: 11,973 people as of April 2025
• Most states: 6-24 month waits typical
• Emergency placement available in crisis situations

How to Apply:

• Start at Healthcare.gov or your state Medicaid office
• Contact your local Area Agency on Aging for waiver information
• Use the Eldercare Locator to find local help

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2. VA Aid and Attendance Benefits

Who Qualifies:

• Veterans who served 90+ consecutive days with at least one day during wartime
• Must have honorable discharge
• Need help with at least 2 Activities of Daily Living
• Surviving spouses of eligible veterans

2025 Benefit Amounts (December 2024 – November 2025):

Income and Asset Limits:

• Net worth limit: $159,240 total (income + assets)
• Medical expenses: Can be deducted from countable income
• Look-back period: 36 months for asset transfers
• Home ownership: Primary residence usually exempt

Application Process:

1. Complete VA Form 21-2680
2. Gather military service records (DD-214)
3. Get medical documentation of care needs from doctor
4. Submit financial statements for past 3 years
5. Processing time: 3-6 months typically

What It Actually Covers:

• Full assisted living costs (room, board, and care)
• In-home care services
• Adult day care
• Memory care facilities

Reality Check: This benefit is tax-free cash you can use for any care expenses. Many veterans don’t know about it—only about 2% of eligible veterans receive it.

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3. HUD Section 202 Supportive Housing for the Elderly

Important Clarification: Section 202 is NOT assisted living—it’s independent senior housing with support services. However, it can be a stepping stone or alternative.

What You Get:

• Affordable apartment (rent = 30% of your income)
• Support services like care coordination
• Some properties allow outside home care providers
• Transportation and social activities

Who Qualifies:

• Age: 62 years or older
• Income: Must be below 50% of Area Median Income (check limits by location)
• Must demonstrate housing need

The Reality:

• No new construction funding since 2012, but existing properties continue operating
• Waiting lists: Often 1-3 years
• Limited availability: Approximately 400,000 units nationwide

How to Find Properties:

• Contact your local housing authority
• Search HUD’s database
• Ask your Area Agency on Aging about local options

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State-by-State Program Differences: Where You Live Matters

States with Strong Medicaid Assisted Living Programs

California – Assisted Living Waiver Program:

• Income limit: $2,901/month
• Asset limit: No limit as of 2024 (previously $2,000)
• SSI supplement: $1,599.07/month total for AL residents
• Waiting list: 11,973 people (April 2025)

Connecticut – Home Care Program for Elders:

• Income limit: $2,901/month
• Asset limit: $1,600
• Four-tier service levels available

Georgia – Assisted Living Waiver:

• Income limit: $2,901/month
• Asset limit: $2,000
• Must be 65+ or meet disability requirements

Ohio – PASSPORT Waiver:

• Covers assisted living services
• Income limit: $2,901/month
• Asset limit: $2,000

Texas – STAR+PLUS Program:

• Available in major metropolitan areas
• Covers assisted living services through managed care

States with Limited Options

Alabama:

• No specific assisted living Medicaid waiver
• Must use nursing home waiver or age in place programs
• Alternative: Some PACE programs cover assisted living services

Alaska:

• Alaskans Living Independently (ALI) waiver available
• Income limit: $2,901/month, asset limit: $2,000
• Covers assisted living plus other services

Finding Your State’s Programs

Step 1: Visit Medicaid.gov and select your state Step 2: Contact your state’s Medicaid office directly Step 3: Use the Eldercare Locator for local programs

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Real Application Timelines and What to Expect

Medicaid Waiver Timeline

Month 1-2: Initial Medicaid Application

• Submit application through Healthcare.gov or state office
• Documents needed: Tax returns, bank statements, Social Security cards, proof of residence
• Common delays: Missing income verification, medical records

Month 3-5: Waiver Application

• Contact state waiver coordinator
• Schedule functional assessment
• What assessors look for: Need help with 2+ Activities of Daily Living
• Tip: Have family/caregivers present during assessment to document current care

Month 6+: Facility Search and Placement

• Reality check: Only about 50% of facilities accept Medicaid
• Many have limited Medicaid beds (5-20% of total capacity)
• Strategy: Apply to multiple facilities, join multiple waiting lists

VA Aid & Attendance Timeline

Month 1: Application Submission

• Submit Form 21-2680 with all supporting documents
• Processing location: Regional VA Pension Management Centers
• Tip: Use certified mail with return receipt

Month 2-3: Development Phase

• VA may request additional medical evidence
• Common requests: More detailed doctor statements about care needs
• Tip: Have doctor specifically state patient needs help with 2+ ADLs

Month 3-6: Decision

• Approval rate: About 60% for first-time applications
• If denied: Can appeal within one year
• First payment: Usually within 2-3 months of approval

Section 202 Housing Timeline

Reality Check: Most properties have multi-year waiting lists

Application Process:

• Apply directly to individual properties
• Strategy: Apply to 5-10 properties to increase chances
• Some use lottery system, others first-come-first-served
• Update contact info regularly or lose your place

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How to Find and Evaluate Assisted Living Options

Questions to Ask Every Facility

Financial Questions:

1. “Do you accept Medicaid waiver payments?”
2. “How many Medicaid beds do you have available?”
3. “What’s your current waiting list for Medicaid residents?”
4. “Do you have sliding fee scales based on income?”
5. “Are there additional fees I should know about?”

Care Questions:

1. “What happens if my care needs increase?”
2. “Do you provide memory care services?”
3. “What’s your staff-to-resident ratio?”
4. “Can I bring in outside care providers if needed?”

Practical Questions:

1. “What’s your typical move-in timeline?”
2. “Can I tour during meals and activities?”
3. “What happens if I run out of money?”

Red Flags to Avoid

• Facilities that illegally reject Medicaid (violation of civil rights)
• No clear pricing information or unwillingness to discuss costs
• High staff turnover (ask about retention rates)
• Limited activities or social interaction opportunities
• Poor maintenance or cleanliness issues

Using Official Resources

Eldercare Locator: eldercare.acl.gov

• Enter your ZIP code
• Filter by “accepts Medicaid”
• Get contact info for local Area Agency on Aging

State Ombudsman Programs: Every state has advocates for assisted living residents

• Can help with complaints or disputes
• Provide guidance on resident rights
• Investigate quality concerns

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Emergency Situations: What to Do When You Need Help Now

If You’re Facing Immediate Housing Crisis

Call 211: Provides immediate local resources

• Rural areas: If 211 doesn’t work, try 1-888-866-9880
• TDD/TTY line: 1-800-677-1116 for hearing impaired

Adult Protective Services: Each state has emergency placement options

• Search “[your state] Adult Protective Services” online
• Can provide emergency respite care
• May help with immediate housing needs

Hardship Waivers: Federal law allows you to request emergency Medicaid consideration

• Must document how delays would endanger health or shelter
• File with your state’s Department of Health and Human Services
• Usually processed within 30 days

Emergency Funding Options

Local Community Foundations: Many offer emergency assistance for elder care

• Search “[your city] community foundation senior assistance”
• Grant amounts typically $500-$5,000
• Usually one-time assistance

Faith-Based Organizations: Even if you’re not a member

• Many have emergency assistance funds
• Contact local United Way for referrals

Area Agency on Aging Emergency Services:

• Emergency home care while waiting for placement
• Short-term financial assistance
• Crisis intervention services

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Alternative Housing Options When Assisted Living Isn’t Affordable

Adult Family Homes / Board and Care Homes

• Cost: $2,500-$5,000/month
• Setting: Home-like environment with 2-6 residents
• Who accepts: Many accept VA benefits, some Medicaid waivers
• How to find: Contact your local Area Agency on Aging

Senior Housing with Services

• Cost: $1,500-$4,000/month base rent + care services
• Model: Independent living community + outside home care
• Advantage: Can bring in Medicaid-funded home care services
• Examples: Some Section 202 properties allow this arrangement

Continuing Care Retirement Communities (CCRCs)

• Cost: $100,000-$500,000 entrance fee + $3,000-$6,000/month
• Model: All levels of care on one campus
• Financial aid: Some offer financial assistance or reduced entrance fees
• Advantage: Never have to move as care needs change

PACE Programs (Program of All-Inclusive Care for the Elderly)

• Who qualifies: Age 55+, eligible for nursing home care, can safely live in community
• Coverage: Includes assisted living services in some locations
• Cost: Covered by Medicare/Medicaid combination
• Availability: Limited to certain geographic areas

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Making Multiple Funding Sources Work Together

Example Budget Scenario

Meet Dorothy, 78, in Ohio:

• Monthly income: Social Security $1,800
• VA Aid & Attendance: $2,358 (she’s a widow of WWII veteran)
• Total monthly income: $4,158
• Assisted living cost in Ohio: $4,500/month
• Gap: $342/month (manageable with family help or finding lower-cost facility)

Combining Programs Effectively

VA + Medicaid Considerations:

• VA Aid & Attendance doesn’t count against Medicaid income limits in most states
• Can receive both, but nursing home Medicaid reduces VA pension to $90/month
• Strategy: Use VA for assisted living, save Medicaid for nursing home if needed later

Family Financial Support:

• Can supplement government benefits
• Caution: Large gifts may affect Medicaid look-back periods
• Better approach: Pay facility directly rather than giving cash gifts

Asset Protection Strategies

For Medicaid Planning:

• Exempt assets: Primary home (up to $713,000-$1,071,000 equity), one car, personal belongings
• Look-back period: 5 years for Medicaid, 36 months for VA
• Legal transfers: Consult elder law attorney for complex situations

For VA Benefits:

• Exempt assets: Primary home on up to 2 acres, one vehicle
• Medical expenses: Can reduce countable income dollar-for-dollar
• Planning tip: Pre-pay for care services or equipment

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What Happens When Money Runs Out

Medicaid Spend-Down Process

If your income is slightly too high for Medicaid, you can “spend down”:

• Medical expenses above 5% of income are deductible
• Care services count as medical expenses
• Equipment: Wheelchairs, hospital beds, modifications count
• Insurance premiums: Long-term care insurance premiums count

Hardship Protections

Federal law requires states to have hardship waiver processes:

• Must show that loss of services would endanger health/safety
• Process typically takes 30-60 days
• Documentation needed: Doctor statements about care needs

State-Specific Emergency Programs:

• Some states have emergency placement funds
• Waiting list priorities: Medical emergencies often get priority
• Temporary assistance: Many states offer 30-90 day bridge funding

Facility Obligations

What facilities CANNOT do:

• Discriminate against Medicaid recipients (violation of civil rights)
• Evict solely for inability to pay (must follow legal eviction process)
• Refuse emergency medical care

What facilities CAN do:

• Require 30-day notice before stopping payment
• Transfer to more affordable care level if available
• Work with families on payment plans

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Frequently Asked Questions

Q: How long are the waiting lists really?

A: Varies dramatically by state and program. California’s assisted living waiver has nearly 12,000 people waiting. Ohio and Texas move faster (6-12 months typical). VA benefits average 3-6 months. Section 202 housing often 1-3 years.

Q: Can I apply for multiple programs at once?

A: Absolutely, and this is recommended. Apply for Medicaid waivers, VA benefits, and housing assistance simultaneously. Having multiple applications increases your options.

Q: What if my income is $100 over the Medicaid limit?

A: You may still qualify through “spend-down” – paying medical expenses to meet the limit. Unreimbursed medical expenses above 5% of your income can be deducted. Work with a Medicaid planner to calculate this.

Q: Do all assisted living facilities accept government programs?

A: No. Only about 50% accept Medicaid, and those that do often limit Medicaid residents to 10-20% of their beds. Most accept VA Aid & Attendance because it comes as cash payment.

Q: What happens if I need more care than assisted living provides?

A: Most residents transition to nursing homes after 22 months average. If you’re on Medicaid waiver, you can transition to nursing home Medicaid. VA benefits continue in nursing homes.

Q: Can I keep my home while in assisted living?

A: For Medicaid: Primary residence is usually exempt. For VA: Home on up to 2 acres is exempt. However, you’ll need to consider maintenance costs and whether to rent it out (rental income counts toward income limits).

Q: What if my application is denied?

A: You can appeal all program denials. Medicaid: Request hearing within 60 days. VA: File Notice of Disagreement within one year. Section 202: Reapply after updating circumstances. Always ask for the specific reason for denial.

Q: How do I avoid scams?

A: Never pay upfront fees for benefit applications. Legitimate help is available free through Area Agencies on Aging. Be wary of companies promising “guaranteed approval” for VA benefits. All government applications are free.

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Step-by-Step Action Plan: What to Do Right Now

Week 1: Assessment and Initial Contact

Day 1-2:

• Calculate your exact monthly income and assets
• List all medical expenses from past 12 months
• Gather important documents: Social Security card, tax returns, bank statements

Day 3-5:

• Call Eldercare Locator: 1-800-677-1116
• Contact your local Area Agency on Aging
• If veteran: Gather military service records (DD-214)

Day 6-7:

• Research assisted living facilities in your area
• Call 3-5 facilities to ask about costs and Medicaid acceptance

Week 2: Applications

Medicaid:

• Apply at Healthcare.gov or local Medicaid office
• Request waiver program information

VA (if applicable):

• Download Form 21-2680 from VA.gov
• Schedule appointment with doctor for care needs documentation

Section 202:

• Apply to 3-5 properties in your area
• Join waiting lists even if long

Month 2: Follow-up and Planning

• Check application status monthly
• Tour assisted living facilities
• Create backup plans for waiting list delays
• Consider alternatives like adult family homes

Ongoing: Stay Organized

• Keep copies of all applications and correspondence
• Update contact information with all programs
• Document all care needs and expenses
• Build relationships with facility staff and social workers

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Resources and Contact Information

National Resources

Eldercare Locator

• Phone: 1-800-677-1116
• Website: eldercare.acl.gov
• TTY: 1-800-677-1116 (press 1)
• Online chat available 24/7

National Council on Aging (NCOA)

• Website: ncoa.org
• BenefitsCheckUp: Free tool to find programs you qualify for
• Phone: 571-527-3900

211 (Emergency Resources)

• Phone: 211 or 1-888-866-9880
• Available 24/7 in most areas
• Text your ZIP code to 898211

Government Agencies

U.S. Department of Veterans Affairs

• Website: va.gov/pension/aid-attendance-housebound
• Phone: 1-800-827-1000
• Pension Management Centers: Process Aid & Attendance applications

U.S. Department of Housing and Urban Development

• Website: hud.gov/helping-americans/seniors
• Phone: 202-708-1112
• Local housing authorities: Find yours here

Centers for Medicare & Medicaid Services

• Website: medicaid.gov
• State Medicaid contacts: Directory by state

Professional Assistance

National Academy of Elder Law Attorneys

• Website: naela.org
• Directory of specialized attorneys
• Many offer free consultations

Aging Life Care Association

• Website: aginglifecare.org
• Professional care managers
• Help navigate complex care systems

Veterans Service Organizations (Free Help)

• VFW: vfw.org
• American Legion: legion.org
• DAV: dav.org

Financial Planning Resources

AARP Foundation

• Various assistance programs for seniors
• Tax preparation help during tax season
• Benefits enrollment assistance

State Benefits Assistance

• Most states have SHIP (State Health Insurance Assistance Program)
• Free help with Medicare, Medicaid, and other benefits
• Find yours: shiphelp.org

Community Foundations

• Search “[your city] community foundation”
• Many offer emergency grants for seniors
• Typically provide one-time assistance $500-$5,000

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Final Thoughts: You Can Make This Work

Affording assisted living on a limited income isn’t easy, but it’s absolutely possible with the right combination of programs and persistence. The key is starting early, understanding your options, and being prepared for the application processes.

Remember:

• Over 800,000 Americans currently live in assisted living—many with limited incomes
• Government programs exist specifically to help seniors like you
• You’ve earned these benefits through your lifetime of work and contributions
• Help is available from local agencies and advocates

Your next steps are clear:

1. Call the Eldercare Locator today: 1-800-677-1116
2. Apply for programs simultaneously rather than waiting
3. Build relationships with local agencies and facility staff
4. Don’t give up if initially denied—appeals often succeed

The landscape of senior housing continues evolving, with more programs and options becoming available. While the system can be complex, thousands of seniors navigate it successfully every year. With this guide and the right support, you can secure the dignified, affordable care you deserve.

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Important Disclaimer

Program details, income limits, and eligibility requirements change frequently. The information in this guide reflects 2025 data and policies but may not represent the most current requirements in your specific state. Always verify information directly with program administrators before making financial or housing decisions.

Before applying:

• Contact programs directly to confirm current eligibility requirements
• Verify income and asset limits for your specific state
• Check waiting list status for programs in your area
• Consult with qualified professionals for advice specific to your situation

Sources for current information:

• Your state Medicaid office for waiver programs
• VA.gov for current pension rates and requirements
• Local housing authorities for Section 202 availability
• Your Area Agency on Aging for local program updates

Last updated: August 2025. For the most current program information, always consult official government websites and local program administrators.