Memory care is specialized long-term care for individuals living with Alzheimer’s disease or other forms of dementia. These environments provide structured programming, enhanced supervision, and staff trained to manage unique behavioral and cognitive challenges. Because the cost of this specialized care is high, many individuals eventually turn to Medicaid, the joint federal and state program for low-income Americans, to cover expenses. The question of which memory care facilities accept Medicaid is complex, as the answer depends heavily on the facility’s license type and the specific funding mechanisms available in that state.
Understanding Medicaid Coverage for Long-Term Care
Medicaid is not a single, uniform program but is administered individually by each state under federal guidelines, meaning that eligibility criteria and coverage details vary significantly across the country. The program covers medical care for low-income individuals, but it also becomes the largest single payer for long-term care services once a person has spent down their own financial resources.
The critical distinction in Medicaid long-term care funding is between coverage for institutional settings and coverage for community-based settings. The most comprehensive coverage is provided through Institutional Medicaid, which covers care in a Skilled Nursing Facility (SNF) or nursing home. For eligible beneficiaries, this typically covers the entire cost of care, including the medical services, personal care, and the room and board component. This full coverage is considered an entitlement, meaning that any Medicaid-certified nursing home must accept all eligible applicants up to their capacity.
For care in non-institutional settings, such as assisted living or dedicated memory care units, coverage is accessed through Home and Community-Based Services (HCBS) Waivers. These waivers allow states to use Medicaid funds to provide services outside of a nursing home, helping individuals remain in a less restrictive setting. However, HCBS Waivers typically only cover the care services—such as specialized programming, assistance with daily living activities, and medication management—and generally exclude the cost of room and board. This means the resident or their family must find a way to pay for the housing component.
Facility Settings That Provide Medicaid-Funded Memory Care
The type of facility license determines the scope of Medicaid coverage and the reliability of finding an accepting provider. Memory care is a service level, not a licensed facility type, and is provided primarily in Skilled Nursing Facilities (SNFs) and Assisted Living Facilities (ALFs). These two settings offer very different financial structures for the Medicaid recipient.
SNFs are the most reliable option for full Medicaid coverage of memory care. These facilities provide 24-hour skilled medical and personal care, and they frequently feature dedicated, secured dementia units. Once an individual meets both the financial eligibility criteria and the state’s functional requirement for a “nursing home level of care,” Medicaid covers 100% of the cost, including room and board. The facility must be licensed and certified as a Medicaid Nursing Facility to accept these payments.
ALFs and specialized memory care communities present a more conditional scenario for Medicaid funding. The facility must participate in the state’s HCBS Waiver program, which is not an entitlement and often has enrollment caps or waiting lists. Even when an ALF accepts a waiver, the Medicaid funds are typically directed only toward the care services provided, such as supervision and activities. The resident remains responsible for paying the substantial cost of rent, utilities, and meals, which the waiver does not cover.
Financial Requirements and Maintaining Medicaid Eligibility
Qualifying for Medicaid long-term care requires meeting strict financial thresholds that are significantly lower than those for other public assistance programs. In most states, the asset limit for an individual is extremely low, generally around \$2,000 in countable resources. Countable assets include bank accounts, stocks, bonds, and secondary properties. Exempt assets typically include the primary residence (up to a certain equity limit), one vehicle, and personal belongings.
Income limits are also in place, though rules vary by state. For Nursing Home Medicaid and HCBS Waivers, the monthly income limit in most states is approximately \$2,901 for an individual in 2025. If an applicant’s income exceeds this limit, they may still qualify under a “medically needy” pathway. They must “spend down” their excess income on medical and care expenses before Medicaid begins coverage. In a nursing home setting, nearly all of the individual’s income, minus a small personal needs allowance, is paid directly to the facility as their share of the cost.
A crucial component of the financial review is the “look-back” period, which is 60 months (five years) in almost every state. This period begins on the date of the Medicaid application. The state reviews all financial transactions during this time, particularly gifts or transfers of assets for less than fair value. Any uncompensated transfers trigger a penalty period of ineligibility for Medicaid long-term care benefits. Once approved, the recipient must undergo an annual redetermination process, reporting any changes in income or assets to maintain continuous eligibility.
Practical Steps for Locating and Applying to Facilities
Finding a memory care facility that accepts Medicaid begins with determining which state program an individual is eligible for—Institutional Medicaid for a nursing home or an HCBS Waiver for an assisted living setting. Since Medicaid is state-administered, the most direct resource for finding accepting providers is the local Area Agency on Aging (AAA) or the State Medicaid Agency website. These resources often maintain lists of certified facilities and current HCBS Waiver providers.
Families should directly contact facilities and ask specific questions about their participation, such as whether they have available Medicaid beds or if they accept the state’s specific HCBS waiver for memory care services. Not all certified nursing homes accept Medicaid, and even fewer assisted living facilities participate in waiver programs due to lower reimbursement rates. Facilities with Medicaid beds often have waiting lists, requiring families to plan well in advance.
The application for Medicaid and the application for facility admission must be closely coordinated. The individual must be approved for Medicaid benefits before the facility admission can be finalized, or at least be in the final stages of the process. Working with an elder law attorney or a certified Medicaid planner can help navigate the complex application logistics and ensure eligibility requirements are correctly managed to prevent a penalty period.