When a parent or loved one needs assisted living but only has Social Security and no savings, it can feel overwhelming. The good news? There are still meaningful options — especially if you’re willing to navigate a few systems and ask the right questions. Here’s a guide to finding quality care on a limited income.
1. Start with Medicaid
Medicaid is the primary safety net for low-income seniors who need long-term care. While it’s often associated with nursing homes, many states also offer Medicaid waiver programs that help cover the cost of assisted living.
-
Eligibility: Determined by income and assets; requirements vary by state.
-
Coverage: Waivers can help pay for care services (like help with bathing, dressing, or medication) but usually not the room and board.
-
Where to apply: Through your state Medicaid office or online at Benefits.gov.
Tip: Apply even if you’re unsure about eligibility. Some states allow income “spend-downs” or offer pooled trusts to qualify.
2. Search for Medicaid-Approved Assisted Living Facilities
Not all assisted living communities accept Medicaid — but some do. These facilities may set aside a few “Medicaid waiver beds” specifically for qualified residents.
-
Ask facilities directly whether they accept Medicaid waivers.
-
Look for phrases like “AL waiver” or “Medicaid-certified assisted living.”
-
Use online directories like:
Pro Tip: Some facilities may ask for private payment for a few months before accepting Medicaid — this is known as a “Medicaid conversion” option.
3. Consider Residential Care Homes (Adult Family Homes)
These smaller, more home-like environments serve just a handful of residents and often offer lower monthly rates than larger assisted living facilities.
-
Personal care in a quieter, intimate setting.
-
Some accept Medicaid or are willing to work with low-income families.
-
Lower staffing ratios can mean more attention to individual needs.
Search terms: “Board and care homes,” “adult family homes,” or “group homes for seniors” in your area.
4. Look into Subsidized Senior Housing with Services
Another route is income-based senior housing, funded by HUD or local housing authorities. While these aren’t assisted living facilities, many include supportive services like:
-
Meal programs
-
Transportation
-
Housekeeping assistance
-
On-site social workers or care coordinators
Once placed in this type of housing, you can use in-home care services (potentially funded by Medicaid or PACE) to meet her daily needs.
Start here: Contact your local Public Housing Authority (PHA) or HUD.gov.
5. Boost Income Through Other Public Benefits
Even if your loved one only receives Social Security, she might qualify for additional support:
-
Supplemental Security Income (SSI): Adds monthly income for low-income seniors.
-
VA Aid & Attendance: For veterans or surviving spouses who need help with daily tasks.
-
PACE (Program of All-Inclusive Care for the Elderly): In select areas, this program provides medical care, home support, and sometimes housing.
-
SNAP/EBT: Food assistance to help stretch income further.
One-stop help: Call your local Area Agency on Aging at 1-800-677-1116 or visit eldercare.acl.gov to find out which programs she’s eligible for.
6. Legal and Long-Term Planning Considerations
If your loved one has cognitive decline and cannot make safe decisions, you may need to explore legal guardianship or power of attorney to manage care and finances.
An elder law attorney can help:
-
Protect assets (if any remain)
-
Navigate Medicaid rules
-
Plan long-term care options
Final Thoughts: There Are Options — Even Without Savings
Many families are surprised to learn that you don’t need large savings to access safe, supportive care. While the process takes persistence, there is a network of federal, state, and local programs designed specifically for low-income seniors.
Quick Action Checklist:
-
✅ Apply for Medicaid
-
✅ Find facilities that accept Medicaid waivers
-
✅ Consider residential care homes
-
✅ Look into subsidized senior housing
-
✅ Apply for SSI, SNAP, or VA benefits
-
✅ Contact the Area Agency on Aging for local help