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Medicaid Waivers and Assisted Living

Minnesota's Elderly Waiver pays for services inside assisted living, never room and board -- here is what that split actually means for your budget.

HomeCosts & PayingMedicaid Waivers and Assisted Living
Short answer

Minnesota runs one combined HCBS waiver, the Elderly Waiver, that pays for care services -- never room and board -- delivered inside a licensed assisted living facility through a customized living service plan. A near-eligible senior not yet on Medical Assistance can use Alternative Care, a state-only program with a nearly identical service list, as a bridge.

The room-and-board gap families miss

Even after Elderly Waiver approval, the resident (or their family) is still responsible for the community's room-and-board charge -- rent, meals, utilities. Only the care-services portion is covered. For very low-income residents in certain settings, Minnesota's separate state Housing Support benefit can help offset room and board, but it is not automatic and not available everywhere.

Ask this before you sign

Ask directly whether the community holds a Medicaid waiver provider agreement and how many current residents actually use it under the Elderly Waiver. A community can hold an agreement in principle and still have no waiver capacity currently available.

How families pay for care. Minnesota's Elderly Waiver and Alternative Care programs pay for care services -- never room and board -- and VA Aid and Attendance can add tax-free monthly income for eligible veterans. Read the full explanation →

Questions families ask

Is there a published cost for memory care in Minnesota?

No. CareScout, the primary industry cost-of-care survey referenced for Minnesota figures, does not survey memory care as a separate category, so there is no verified statewide or metro median memory-care rate to cite. Any specific memory-care dollar figure circulating online should be treated as unverified.

What does nursing home care cost in Minnesota compared to assisted living?

Third-party sources citing the CareScout survey put a Minnesota nursing home semi-private room at roughly $12,167/month and a private room at roughly $14,068/month, both well above the roughly $6,573/month cited for private one-bedroom assisted living — though all these figures are unverified against CareScout's own primary tables and should be confirmed before publishing or budgeting decisions.

How does VA Aid and Attendance help pay for assisted living or memory care?

VA Aid and Attendance is a needs-based pension add-on for wartime veterans and surviving spouses who need help with daily activities; as of the December 1, 2025 rate year, a veteran alone can receive up to $29,093/year (about $2,424/month) and a surviving spouse alone up to $18,697/year (about $1,558/month), subject to a net worth limit of $163,699 excluding a primary residence and one vehicle.

Are there hidden fees I should watch for when comparing assisted living communities?

Yes — most Twin Cities assisted living communities charge a base rent plus separate, tiered fees for higher levels of personal care, medication management, and sometimes a one-time community or move-in fee, so the advertised 'starting at' rate rarely reflects the total monthly cost for a resident who needs meaningful assistance.

Does home care cost less than assisted living in the Twin Cities?

It depends heavily on how many hours of care are needed — a verified current Minnesota non-medical home care hourly rate could not be confirmed against a primary source, but 24/7 in-home care, once multiple caregiver shifts are factored in, is typically far more expensive than a private-pay assisted living apartment, even though a few hours a week of home care is usually cheaper than a full move.

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