When a loved one begins showing signs of Alzheimer’s disease or another form of dementia, families face not only the emotional weight of this diagnosis but also pressing practical questions about how to provide appropriate care. Memory care, specialized support designed for individuals with cognitive impairment, can be essential for safety and quality of life, but it often comes with significant costs. Naturally, many families wonder whether Medicaid might help cover these expenses.
The answer isn’t straightforward. Whether Medicaid will pay for memory care depends on several factors: where the care is provided, what services are needed, which state you live in, and whether the individual meets specific eligibility requirements. Understanding these variables can help you navigate your options during an already challenging time.
What memory care is and where it is provided
Memory care isn’t a single place or program; it’s a specialized set of services designed to support people living with dementia, Alzheimer’s disease, or other cognitive impairments. These services typically include 24-hour supervision, assistance with daily activities, medication management, structured routines and activities designed for cognitive stimulation, secure environments to prevent wandering, and staff trained specifically in dementia care techniques.
Memory care can be delivered in various settings, each offering different levels of structure and medical support:
- Memory care services through a home care provider bring specialized dementia support into the person’s own home, allowing them to remain in familiar surroundings while receiving professional assistance.
- Assisted living communities with memory care wings or programs offer residential settings with specialized sections designed specifically for residents with dementia, typically featuring secure layouts and memory-focused activities.
- Stand-alone memory care facilities are entire communities dedicated exclusively to serving individuals with cognitive impairment, often with higher staff-to-resident ratios and more intensive programming than general assisted living.
- Continuing care retirement communities (CCRCs) with dementia support provide a continuum of care on one campus, allowing residents to transition from independent living to assisted living, nursing home care, and memory care as their needs change.
- Nursing homes that offer specialized memory care units combine the medical and skilled nursing capabilities of a nursing facility with specialized dementia care programming for residents who need both.
The setting that’s appropriate depends on the individual’s level of cognitive impairment, medical needs, and behavioral symptoms.
Does Medicaid cover memory care?
Medicaid can help pay for memory care, but coverage depends heavily on where care is delivered and what services are provided. Unlike Medicare, which generally doesn’t cover long-term memory care, Medicaid is designed to help with extended care needs for those who qualify financially and medically. However, because Medicaid programs are administered by individual states, the availability and scope of coverage vary significantly across the country.
In-home memory care services
Home care for individuals with cognitive impairment involves professional caregivers coming to the person’s residence to provide assistance with daily activities, supervision, and specialized dementia support. For families hoping to keep a loved one at home, Medicaid may offer help through home- and community-based services (HCBS) waivers. These waivers allow states to use Medicaid funds to pay for care delivered at home or in community settings rather than limiting coverage to institutional care like nursing homes.
Not all states offer robust HCBS waiver programs for dementia care, and those that do structure them differently. For example, Oregon’s Medicaid program provides comprehensive home- and community-based care through its Office of Aging and People with Disabilities, covering in-home services including specialized dementia care for eligible individuals. Alabama also offers HCBS waiver programs, but coverage may have lengthy waiting lists.
Another option in some areas is the Program of All-Inclusive Care for the Elderly (PACE). PACE programs coordinate all medical and long-term care services for participants, including memory care services when appropriate. However, PACE is only available in certain communities, and eligibility requires needing a nursing home level of care while still being able to live safely in the community with support.
Memory care in assisted living or stand-alone memory care communities
Assisted living communities provide residential care with support for daily activities in a homelike setting, while stand-alone memory care facilities offer the same residential model with enhanced security and dementia-specific programming. Whether Medicaid helps pay for memory care in these settings depends entirely on your state and the individual’s eligibility.
Many states operate Medicaid waiver programs that can cover services provided in assisted living or memory care communities, though coverage applies to care services rather than room and board.
Not all assisted living or memory care communities accept Medicaid, even in states where waiver programs exist, so it’s important to ask each community directly about their participation.
Memory care in CCRCs
Continuing care retirement communities (CCRCs) offer multiple levels of care on one campus, allowing residents to remain in one community as their needs change. When memory care is needed in a CCRC setting, Medicaid coverage depends on the specific level of care and how the community structures its services.
Medicaid typically doesn’t cover the independent or assisted living portions of CCRCs, but it may apply if and when a resident transitions to the nursing home level of care within the CCRC. If a CCRC offers specialized memory care within its skilled nursing facility, Medicaid could cover that care for eligible residents. However, memory care provided in the assisted living or residential portions of a CCRC would generally not be covered by Medicaid unless the state has specific waiver programs that the community participates in.
Memory care in nursing homes
Nursing homes provide the highest level of institutional long-term care, with 24-hour nursing staff and comprehensive medical support. Many nursing homes operate specialized memory care units designed specifically for residents with dementia.
This is where Medicaid coverage is most comprehensive and consistent across states. Medicaid can fully cover nursing home care, including specialized memory care services provided there, if the resident meets both health and financial eligibility requirements. Federal law requires Medicaid to cover nursing home care, making this the most reliable form of Medicaid coverage for memory care needs, though it requires that the individual needs the intensive level of support that a nursing home provides.
Eligibility and requirements
Qualifying for Medicaid assistance with memory care involves meeting strict financial and medical criteria, both of which vary by state.
Financial eligibility examines both income and assets. For 2025, most states set monthly income limits to around $2,900, though some states have higher limits or different rules. Asset limits typically hover around $2,000 for an individual, excluding exempt assets like a primary residence (up to certain equity limits), one vehicle, and personal belongings.
Medical eligibility requires demonstrating a need for the level of care being sought. For nursing home coverage, applicants must show they need nursing home-level care, typically requiring assistance with multiple activities of daily living or having significant cognitive impairment that necessitates supervision and support. For memory care specifically, a dementia diagnosis alone doesn’t automatically qualify someone; they must also demonstrate functional impairment requiring the level of care provided in that setting.
It’s also important to know that if applying for a state Medicaid waiver program to access memory care in assisted living or at home, many states maintain waiting lists due to enrollment caps. These waits can range from weeks to years, depending on the state and specific waiver program, so early planning is essential.
What Medicaid typically covers in memory care
When Medicaid does help pay for memory care, coverage generally includes personal care assistance with activities like bathing, dressing, eating, and toileting; supervision and monitoring to ensure safety (especially important for individuals prone to wandering); medication management and administration; nursing services for medical needs; and therapeutic activities designed for cognitive stimulation and engagement.
In nursing home settings, Medicaid covers room and board along with all care services. In other settings like assisted living or home care, Medicaid covers only the services, not housing costs.
What Medicaid usually does not cover
Understanding coverage limitations is crucial for realistic planning. Since Medicaid doesn’t cover room and board in assisted living or memory care communities, residents must pay for rent, meals, and utilities themselves, typically using Social Security or other income. It also doesn’t cover private rooms or upgraded accommodations beyond basic shared rooms in nursing homes, optional amenities and enhanced activities, application fees, deposits, community fees, and transportation for nonmedical purposes.
How to find Medicaid-eligible memory care options
Navigating Medicaid coverage for memory care requires research and often professional guidance. Start by asking each community or home care agency directly whether they participate in Medicaid waiver programs and, if so, whether they currently have availability for Medicaid-funded residents.
Contact your local Area Agency on Aging, which can explain what Medicaid programs exist in your state, help determine eligibility, and provide lists of participating providers. Your state Medicaid office can also provide detailed information about waiver programs, application processes, and current waiting list status.
Senior care advisors who specialize in helping families navigate the care landscape can be invaluable during this process. They understand which local communities work with Medicaid programs, can help you identify options that match your loved one’s needs and financial situation, and guide you through what can feel like an overwhelming decision. Find your local Oasis advisor to get personalized support as you explore memory care options and work toward securing the right care in a way that’s financially sustainable for your family.
