Assisted living that accepts Medi-Cal in California
Medicare doesn't pay for assisted living. Medi-Cal can help through the Assisted Living Waiver (ALW), which pays for care services at 1,210 approved assisted living homes in 15 counties. Residents still pay room and board, and there's a waitlist. Here's how it works, in plain English.
Last reviewed October 14, 2026. ALW home list from DHCS, as of May 11, 2026. General information, not legal or financial advice.
New to all this? See how Medicare, Medi-Cal, ALW and senior housing fit together.
Medicare, Medi-Cal and the rest, side by side
Medicare
Pays for: Doctor visits, hospital care, hospice (even while living in assisted living), and short skilled-nursing stays after a 3-day hospital admission (up to 100 days).
Doesn't: Assisted living rent, meals, or day-to-day personal care. Medicare does not pay for assisted living.
Medi-Cal: Assisted Living Waiver (ALW)
Pays for: Care services in an ALW-approved home — help with bathing, dressing, medications, and care coordination — for people who need nursing-home-level care.
Doesn't: Room and board. Only available in 15 counties, only at participating homes, and there is a waitlist.
Medi-Cal health plan: “Assisted Living Facility Transitions”
Pays for: Some Medi-Cal managed care plans offer a similar assisted living benefit as a CalAIM Community Support.
Doesn't: Room and board. It varies by plan and county, and some plans are ending it (Health Net has said it will stop after December 31, 2026).
SSI / SSP
Pays for: Monthly income that residents commonly use to pay room and board. In 2026 the rate for a licensed residential care home is $1,626.07/month.
Doesn't: Care services.
VA Aid & Attendance
Pays for: A monthly pension add-on for eligible veterans and surviving spouses who need help with daily activities; it can go toward any cost, including assisted living.
Doesn't: It's needs- and income-tested; the amount is the annual maximum minus countable income.
IHSS (In-Home Supportive Services)
Pays for: Caregiving at home.
Doesn't: IHSS is not available to residents of assisted living (RCFEs).
How to use the Assisted Living Waiver
Check eligibility
Age 21 or older, full-scope Medi-Cal with no share of cost, and care needs at the level of a nursing-home resident. The person must be able to live safely in assisted living and be willing to live in one of the 15 ALW counties.
Contact a Care Coordination Agency (CCA)
There is no central application. Families apply through a CCA of their choice, which assesses care needs, places the person on the waitlist, and coordinates care once enrolled.
Expect a wait
Slots are capped. As of April 2026, DHCS reported 11,101 people enrolled and 6,588 on the waitlist. Some exceptions move faster, such as people transitioning out of a nursing home — ask your CCA.
Choose an ALW-approved home
Only homes on the state's participating-facility list can bill ALW. Use the county lists below, then check that the home has an ALW bed open — some have closed ALW enrollment.
Budget for room and board
ALW does not pay rent or meals. Most ALW residents pay room and board from SSI/SSP or other income and keep a small allowance for personal needs.
Find a Care Coordination Agency on the DHCS list of ALW Care Coordination Agencies.
Assisted living homes approved for the Assisted Living Waiver
Every RCFE on the state's participating-facility list, as of May 11, 2026. Always confirm with the home that it has an ALW bed open.
Medi-Cal, Medicare & assisted living FAQ
Does Medicare pay for assisted living in California?
No. Medicare does not pay for assisted living rent, meals, or ongoing personal care. It does cover medical care while you live there — doctor visits, hospital stays, hospice — and short skilled-nursing stays after a qualifying 3-day hospital admission.
Does Medi-Cal pay for assisted living?
Partly, and only in some places. Medi-Cal's Assisted Living Waiver (ALW) pays for care services at participating homes in 15 counties, for people who need nursing-home-level care. Residents still pay room and board, and there is a waitlist. Some Medi-Cal health plans also offer an assisted living benefit, but it varies by plan.
Which counties have the Assisted Living Waiver?
Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma.
How long is the ALW waitlist?
DHCS reported 6,588 people on the waitlist and 11,101 enrolled as of April 2026. Wait times vary; news reports in 2026 described waits of several years. A Care Coordination Agency can tell you where you stand.
How much will I pay for room and board on ALW?
ALW doesn't cover room and board. For a resident on SSI, the 2026 SSI/SSP payment for a licensed residential care home is $1,626.07 a month; the resident keeps a personal-needs allowance (commonly $182) and the rest goes to the home. Confirm the exact room-and-board charge with the home.
Is there a Medi-Cal asset limit?
Yes. Medi-Cal brought back an asset test on January 1, 2026 for people 65+ and people with disabilities: $130,000 for one person, plus $65,000 for each additional household member. It is scheduled to drop to $21,000 for one person and $31,000 for a couple on July 1, 2027. Your home, one car, and household items don't count.
Can IHSS pay for care in assisted living?
No. IHSS is for care at home and isn't available to residents of a residential care facility for the elderly (RCFE).
Talk to someone who doesn't earn a commission
HICAP · 1-800-434-0222
Free, unbiased Medicare counseling
Aging & Adult Information Line · 1-800-510-2020
Connects you to your local Area Agency on Aging (in LA County: Aging & Disabilities Dept.)
Long-Term Care Ombudsman · 1-800-231-4024
Help with problems or complaints in a care facility, 24/7
Apply for Medi-Cal · benefitscal.com
Online, or through your county social services office
Sources
- DHCS — Assisted Living Waiver
- DHCS — ALW participating facilities
- DHCS — ALW Care Coordination Agencies
- DHCS — HCBA/ALW enrollment dashboard (April 2026)
- DHCS — Medi-Cal asset limit FAQ
- SSA — California SSI/SSP payment levels (2026)
- Medicare.gov — Long-term care
- VA — Pension rates (Aid & Attendance)
- CalMatters — Health Net assisted living benefit (Sept 2026)