Free senior care guidance for Twin Cities families. No cost to you, ever.
Call (651) 390-4719
Minneapolis Senior AdvisorTwin Cities • Trusted • Free

What Happens When the Money Runs Out

Spend-down, Medicaid waiver transitions, and why you should ask a community about this before you move in.

HomeCosts & PayingWhat Happens When the Money Runs Out
Short answer

If private funds run out, the options generally are a Medicaid HCBS waiver for care inside a licensed community, Medicaid nursing facility coverage, or moving to a community that holds a waiver provider agreement. Confirm your state's specific programs before relying on this.

Ask before you move in, not after

This is the single most consequential question families skip. A community that does not hold a Medicaid waiver provider agreement will ask your parent to leave when private funds are exhausted — often with short notice, at the point when moving is hardest.

Ask directly: do you hold a Medicaid waiver provider agreement, and how many current residents use it? A community can technically hold an agreement and still have no waiver capacity 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 →
The local long-term care ombudsman. Minnesota's Office of Ombudsman for Long-Term Care (1-800-657-3591) is a single statewide office covering the entire Twin Cities metro. Read the full explanation →

Questions families ask

Does an assisted living facility in Minnesota need a separate food service license?

No. Under Minn. Stat. 144G.10, subd. 3, facilities licensed as assisted living under Chapter 144G are not separately required to hold a boarding-establishment, food-and-beverage, hotel/motel, or restaurant license under Minnesota's general lodging and food code, Chapter 157. MDH's assisted living survey process covers that ground instead.

Who regulates home care agencies that send caregivers into a senior's home in the Twin Cities?

Home care providers in Minnesota are licensed and regulated by MDH, and complaints against a licensed home care agency go to the same Office of Health Facility Complaints line as facility complaints: 651-201-4200 (metro) or 1-800-369-7994 (greater Minnesota). No separate, dedicated home-care-only complaint hotline exists.

What is the Elderly Waiver and what does it cover?

The Elderly Waiver (EW) is Minnesota's Medicaid home- and community-based services waiver for seniors 65+ who are Medical Assistance eligible and assessed via MnCHOICES as needing a nursing-facility level of care. It covers personal care assistance, homemaker services, home health aide, case management, adult day services, respite care, home-delivered meals, and — inside licensed assisted living — 'customized living' or '24-hour customized living' service packages, but it never pays room and board.

What is Alternative Care and how is it different from the Elderly Waiver?

Alternative Care (AC) is a Minnesota state-funded program — no federal Medicaid match — for seniors who need Elderly-Waiver-equivalent services but aren't yet financially eligible for Medical Assistance. It uses largely the same service array and cost cap as EW and is designed to delay or prevent a Medicaid spend-down or nursing home placement, while EW itself requires the person to already be MA-eligible.

How do I apply for Medical Assistance long-term care or a waiver in the Twin Cities?

Start by contacting your county human services agency (Hennepin, Ramsey, Dakota, Anoka, or Washington County) or calling the Senior LinkAge Line at 1-800-333-2433 to request a MnCHOICES long-term-care needs assessment, which determines functional eligibility, alongside a separate financial application for Medical Assistance.

Not sure where to start?

Answer five questions and a local advisor will come back with senior care options in your area that actually fit your situation and budget. It is free, and there is no obligation.

Find care options
Find senior care — free