ALW guide
Does Medi-Cal pay for assisted living?
Not on its own. Through the Assisted Living Waiver, Medi-Cal pays a participating home for care in fifteen counties. It never pays room and board. The 2026 figures, who may fit and where it works.
Medi-Cal does not pay for assisted living on its own. Through the Assisted Living Waiver (ALW), Medi-Cal pays a participating home for a person's care, in fifteen California counties, for people the state finds eligible when their turn comes on the waitlist. It never pays room and board (the room and meals). The resident pays that from income.
Important: The California Department of Health Care Services (DHCS) decides who is eligible, after a nurse assessment. DHCS keeps one waitlist and releases openings (the state calls them slots) in priority order, when it releases capacity. Beta's ALW team is a Care Coordination Agency (CCA), the state-listed organization that does the ALW paperwork with you. Beta can't promise eligibility, an opening, a date or a room.
What Medi-Cal pays and what you pay
| Cost | Who pays | Good to know |
|---|---|---|
| Care in the home: help with bathing, dressing and medications, and supervision | Medi-Cal, through ALW, to the home | DHCS sets a daily rate by care tier. See the 2026 rates. |
| Care coordination | Medi-Cal, through ALW, to your agency | No charge to you. |
| Room and board (the room and meals) | You, from SSI/SSP or other income | In 2026 a resident on SSI/SSP alone receives $1,626.07 a month, pays the home at most $1,444.07 for basic services and keeps at least $182.00. |
| Medicines, doctor visits and hospital care | Regular Medi-Cal, as before | ALW does not change your other Medi-Cal benefits. |
SSI/SSP is Supplemental Security Income plus the State Supplementary Payment. The 2026 figures come from the California Department of Social Services. What ALW pays for and what you pay explains each part.
Where it works
ALW runs in fifteen counties: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma. The home has to be in one of them. You don't have to live there yet when you first ask.
Who can get it
Six things all have to be true:
- you're 21 or older
- you have full-scope Medi-Cal with no monthly share of cost (an amount some people pay each month before Medi-Cal pays)
- you need the level of care a nursing home gives
- you can live safely in an assisted-living home
- you're willing to live in a county where ALW operates
- you'd rather live in assisted living than in a nursing home
A nurse from your agency does the assessment, and DHCS decides. Read the six requirements.
Since January 1, 2026, Medi-Cal counts assets again for people who are 65 or older, have a disability or need long-term care. The limit is $130,000 for one person, plus $65,000 for each additional person in the household. It may change in 2027, so check DHCS. How to check your Medi-Cal.
Board and care homes
A six-bed "board and care" home is usually a licensed Residential Care Facility for the Elderly (RCFE). An Adult Residential Facility (ARF) serves adults more generally. Either can take ALW residents once it enrolls with DHCS, so a small home can be on the state's list. Being licensed is not the same as being enrolled. Ask the home, or check the list.
What people search and what is true
Does Medi-Cal pay for room and board in assisted living?
No. ALW pays for care, not for the room or meals. Most residents pay room and board from SSI/SSP. If you have other income, ask the home for its rate in writing, because DHCS does not cap it.
Does Medicare pay for assisted living?
No. Medicare does not pay for assisted living or for room and board. It pays for medical care, such as doctor visits and hospital stays. Medicare explains this on its long-term care coverage page. People with both Medicare and Medi-Cal keep both. ALW is a Medi-Cal program.
Is assisted living ever free in California?
No program pays everything. Under ALW, Medi-Cal pays the home for care, and the resident pays room and board from income. The state sets how much an SSI/SSP resident pays. Be careful with anyone who says otherwise.
How do I find an assisted living home that takes Medi-Cal?
Start with the state's list of participating homes. Beta's directory sorts that list by county, with the date we last checked each home. See homes on the state list. A listing is not an open bed. It means the home is enrolled to take ALW residents. Call the home and ask whether it has a room and can meet the person's needs.
What if the person is in a nursing home now?
The waitlist gives first priority to people who have been in a nursing facility or other institutional setting for at least 60 days when the waitlist request is submitted. Priority is not enrollment or a bed. How a nursing-home move works.
What about IHSS instead?
In-Home Supportive Services (IHSS) pays for help in a person's own home. It ends when the person moves into a licensed home. Compare IHSS and ALW.
Before anyone moves
Keep the person safely where they are until three things are in writing: DHCS has found them eligible, your agency has the enrollment date, and the home has agreed to admit them under ALW. Don't give notice on an apartment on the strength of a place on the waitlist. While you wait, tell your agency about any change in health, address or Medi-Cal.
Not sure where to start? Request a callback and Beta's ALW team will tell you which of the six requirements looks uncertain.
About this informationReviewed October 12, 2026. Program details may change. View official sources and page limitations.
Written by Beta's ALW team and checked against the official sources this page lists; facts checked through October 12, 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.