Assisted Living Waiver
What ALW pays for, and what you'll still pay each month
ALW pays the assisted-living home for care, not room and meals. What an SSI/SSP resident pays the home in 2026, what you keep, what to ask a home.
The Assisted Living Waiver (ALW) pays the assisted-living home for your care. Care means help with bathing, eating and medications, and supervision. ALW also pays for your care coordination. It does not pay for the room or for food. You pay for those from your own income. On SSI/SSP alone (Supplemental Security Income and the State Supplementary Payment), you pay the home $1,444.07 a month in 2026 and keep at least $182.00.
Read the transcript
Can Medi-Cal help with assisted living? For some people, yes. California's Assisted Living Waiver, called ALW, lets some Medi-Cal members get care in assisted living instead of a nursing home. ALW pays for care, not rent. The state decides who's eligible. Room and meals come out of the resident's own income. Check whether ALW may fit on alwbeta.com.
Who pays for what
There are three kinds of cost.
| Cost | Who pays | Good to know |
|---|---|---|
| Care and care coordination (the ALW services) | Medi-Cal, through ALW, to the home and your Care Coordination Agency | Based on the nurse assessment, your care tier and your care plan. |
| Room and meals ("room and board") | You, from your own income or benefits | ALW itself does not pay room and board. |
| Personal or optional extras | You, if you choose them | Depends on the home's admission agreement. |
Important: ALW does not pay room and board. Every dollar figure here comes from one of the state documents in the sources below and carries that document's date, because figures change. Beta's ALW team can explain the components; Beta cannot guarantee SSI/SSP eligibility, waive a legitimate room-and-board obligation, or tell you every charge a particular home will make.
If you get SSI/SSP: the 2026 numbers
Most ALW residents pay room and board from SSI/SSP, the Department of Health Care Services (DHCS) reports. The California Department of Social Services (CDSS) sets the SSI/SSP amount for someone living in a licensed care home. The state calls it the Non-Medical Out-of-Home Care (NMOHC) payment standard. The 2026 figures, effective January 1, 2026, are from CDSS notice PIN 25-19-CCLD:
| Component | 2026 amount |
|---|---|
| Federal SSI | $994.00 |
| State SSP | $632.07 |
| Total NMOHC | $1,626.07 |
| Room-and-board component | $706.07 |
| Care-and-supervision component | up to $738.00 |
| Maximum amount payable for basic services | $1,444.07 |
| Minimum personal and incidental needs allowance | $182.00 |
If SSI/SSP is your only income, you pay the home $1,444.07 a month for basic services. That sum is $706.07 for room and board plus up to $738.00 for care and supervision. ALW pays the home separately, by care level, for the waiver care services; that part never comes from you. You keep at least $182.00 a month for personal needs. The full $1,444.07 should not be called "room and board", because CDSS separates the two components.
If you have income besides SSI/SSP, the home may charge $20 more a month if your admission agreement says so. An SSI/SSP resident may also be charged for a private room, at up to 10% of the room-and-board portion, or for special food services by agreement. No other charge for basic services is allowed.
Work out what you pay: pick the income and see the 2026 limits.
Don't have SSI?
No ALW rule requires SSI. ALW does require full-scope Medi-Cal with no monthly share of cost, and enough money for room and board with some left for personal needs. If your income comes from Social Security or elsewhere, ask the home for its room-and-board rate in writing, because DHCS does not cap those rates. A benefits specialist or your county Medi-Cal office can look at your income and any spousal protections. For other ways to pay, see how to pay for assisted living in California. For smaller homes, see board and care homes that take Medi-Cal.
Medi-Cal asset rules changed in 2026
Since January 1, 2026, Medi-Cal counts assets again for people who are 65 or older, have a disability or need long-term care. Through June 30, 2027, the limit is $130,000 for one person, plus $65,000 for each extra person in the household, up to 10 people. From July 1, 2027, under SB 164, the limit is $21,000 for one person and $31,000 for two, plus $1,550 for each extra person. If you already have Medi-Cal, you report your assets when you renew.
This is not a universal "ALW asset limit": your Medi-Cal category, household, spouse and exempt assets all matter. Read the guide to full-scope Medi-Cal with no share of cost.
Can the home charge extra?
Before signing, ask the home to explain every recurring and one-time charge in writing. A charge should never duplicate something ALW already pays for. Ask:
- What amount is due each month, and what does it include?
- Which services are covered through ALW, and which are extra?
- Is the room private or shared?
- Is there an entrance, deposit or community fee?
- How are supplies, transportation, laundry and special diets handled?
- What happens if benefits change, what notice comes before a charge changes, and which charges continue during a hospital stay?
What the home is paid for care (not what you pay)
Daily "tier" rates are not your bill. DHCS publishes these 2026 maximum payable rates for assisted-living services, paid by Medi-Cal to the home:
| Tier | Maximum payable rate | Unit |
|---|---|---|
| Tier 1 | $95.69 | per day |
| Tier 2 | $114.33 | per day |
| Tier 3 | $132.97 | per day |
| Tier 4 | $179.58 | per day |
| Tier 5 | $270.80 | per day |
These are the rates Medi-Cal pays the home for your care, not what you pay for your room. The nurse assessment sets your tier. A home or agency should not promise a tier beforehand. See how the assessment works.
The 2026 figures in one table
The main 2026 figures the Assisted Living Waiver turns on, with their sources. The county applies the Medi-Cal rules; DHCS sets the ALW rates; CDSS publishes the SSI/SSP amounts.
| Figure | Amount | Source |
|---|---|---|
| Medi-Cal income limit with no share of cost, Aged, Blind and Disabled group, one person (two people) | $1,836 a month ($2,490) from April 1, 2026 | DHCS |
| Medi-Cal asset limit, one person, through June 30, 2027 | $130,000, plus $65,000 for each extra person, up to 10 people | DHCS asset limit FAQ |
| Medi-Cal asset limit planned from July 1, 2027 | $21,000 one person, $31,000 two, plus $1,550 each extra person, up to 10 people | DHCS, SB 164 |
| SSI/SSP for a person in a licensed care home (NMOHC) | $1,626.07 a month | CDSS PIN 25-19-CCLD |
| Most a home may charge that person for room, board and basic services | $1,444.07 a month | CDSS PIN 25-19-CCLD |
| Personal and incidental needs allowance the person keeps | $182.00 a month | CDSS PIN 25-19-CCLD |
| ALW daily care rate Medi-Cal pays the home, Tier 1 to Tier 5 (billed as T2031 U1 to U5) | $95.69 to $270.80 a day | DHCS ALW rate sheet, 2026 |
Income and asset limits, explained, what ALW pays and what you pay, the 2026 rates by tier.
Ask for a call and Beta's ALW team will explain which amounts apply to you. How to choose a home covers the visit itself.
About this informationReviewed August 27, 2026. Program details may change. View official sources and page limitations.
Written by Beta's ALW team and reviewed by Sergio B., Program Coordinator, against the official sources this page lists; facts checked through August 27, 2026. Where this page and an official source differ, the source controls.
This page gives general California ALW information. DHCS decides eligibility after the nurse assessment and releases openings. Each home decides its own admissions. Nothing here is an eligibility decision or a promise of enrollment, and it does not guarantee a place in a home. You may choose any Care Coordination Agency listed by DHCS and any participating home.
Something out of date? Tell Beta's ALW team.