Assisted Living Waiver in California

If you're new to this, start with what Medicare pays for in assisted living.

The Assisted Living Waiver is a Medi-Cal program that pays for your care in assisted living. It helps you stay out of a nursing home, but you pay rent and meals yourself. DHCS, the state Medi-Cal agency, runs it through local care coordination agencies. The long waitlist is hard when a parent needs more help each day.

You may qualify if

• You're 21 or older and have full Medi-Cal with no share of cost.
• You need the kind of care Medi-Cal pays for in a nursing home, but can live safely in assisted living.
• You're willing to live in assisted living or public subsidized housing in one of the 15 counties below.

Not sure you qualify? Apply anyway, because a nurse checks your needs and DHCS makes the call. A Pair Team advocate can walk through it with you in one call.

What the waiver pays for

Which counties have the Assisted Living Waiver?

Fifteen counties have the waiver: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange and Riverside. It's also in Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma.

In other counties, ask about In-Home Supportive Services (IHSS), which pays for help at home. See IHSS in California.

How long is the waitlist?

The waitlist is long and has grown fast. In March 2026, 15,910 people were waiting and 14,831 were in the waiver, by DHCS's count. In December 2023, only 3,104 were waiting.

Having Medi-Cal doesn't get you a spot right away. DHCS tries to release open spots to agencies by the 10th of each month, in this order:

1. Half go to people in a nursing home or similar facility for at least 60 days when their form goes in.
2. A quarter go to people with an urgent need reported by Adult Protective Services.
3. A quarter go to people in a nursing home who get a referral from the long-term care ombudsman.
4. People living at home get spots only if any are left, first come, first served.

How much will I pay for rent and meals?

Most people on the waiver pay rent and meals with their SSI and State Supplementary Payment (SSP), DHCS says. In 2026 that payment is $1,626.07 a month for someone in a licensed care home. You pay the home $1,444.07 of it and keep at least $182 for personal needs. If you have income besides SSI, the home may charge $20 more. See SSI and SSP in California.

How to get on the waitlist

1. Get Medi-Cal with no share of cost. The waiver requires it, so apply at BenefitsCal.com or your county office. See Medicare and Medi-Cal together.
2. Call a care coordination agency in your county. DHCS lists them on its Assisted Living Waiver page. The agency screens you briefly by phone, then sends in your waitlist form.
3. Watch for a letter. The agency must screen your form within 7 days. Within 3 days after that, it writes to you with your date on the list.
4. Answer when they call. When a spot opens, the agency has 60 days to send in your full application. An agency nurse checks your care needs. If they cannot reach you after three tries, you can lose the spot.
5. Pick a home in the program. DHCS keeps a list of homes that take the waiver.

How to check a home in California

Assisted living homes here are called Residential Care Facilities for the Elderly, and the California Department of Social Services (CDSS) licenses them. On the CDSS care facility search, pick "Elderly Assisted Living" to see a home's license and its complaint and inspection reports.

To report a problem with a home, call CDSS at 1-844-538-8766. The long-term care ombudsman hotline, 1-800-231-4024, answers all day and night.

If you are turned down

If Medi-Cal or the waiver says no or cuts your services, ask for a state hearing. Call 1-800-743-8525 within 90 days of the notice.

What a Pair Team advocate does

California families often call us while a parent is still in the hospital or a nursing home. The home they want takes the waiver, but the waitlist is long and the Medi-Cal renewal is due. This is what we do:

• Check if you can likely get full Medi-Cal with no share of cost, in one call.
• Find a care coordination agency in your county and get the waitlist form sent in.
• Help you plan for the wait, like IHSS at home or a short stay after the hospital.
• Help with what usually comes with it: a walker or shower chair, rides, CalFresh and bills.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

Can the ombudsman move me up the list?

Since June 2026, an ombudsman referral can move you up the list only if you're in a nursing home, DHCS says. You must also want a waiver home and have a discharge notice saying you're ready for less care. You or your family must ask the ombudsman yourselves.

Can I get the waiver if I have a share of cost?

No, the waiver is only for people with Medi-Cal and no share of cost. Ask your county if some of your income doesn't count.

What if I leave the nursing home before a spot opens?

You stay in the first group even if you leave the nursing home early. What counts is that you had lived there 60 days when your form went in. The agency will ask for proof, like your nursing home admission record.

Can I get IHSS in assisted living?

No, IHSS is only for people living at home or with family, not in a licensed care home. The waiver pays for personal care there instead.

Is there a savings limit?

Yes, the Medi-Cal savings limit applies: $130,000 for one person in 2026, dropping to $21,000 on July 1, 2027. If you're married, Medi-Cal uses rules that protect some income and savings for the spouse who stays home.

Sources

• Assisted Living Waiver, DHCS
• Assisted Living Waiver Enrollment and Waitlist, January 2019 through March 2026, DHCS
• ALW Policy Letter 24-002, Release of ALW Slots and Waitlist Management, DHCS
• ALW Policy Letter 26-001, Long-Term Care Ombudsman Referrals for the ALW, DHCS
• PIN 25-19-CCLD: SSI/SSP Payment Standards Effective January 1, 2026, CDSS Community Care Licensing
• Assisted Living Waiver Reimbursement Rates 2026, DHCS
• The Assisted Living Waiver Program, description and eligibility, DHCS
• Participating Care Coordination Agencies, DHCS
• SSI/SSP Payment Standards Effective January 1, 2026, DHCS
• Asset Limit Frequently Asked Questions, DHCS
• Community Care Facility Search, California Department of Social Services
• In-Home Supportive Services, California Department of Social Services
• State Hearing Requests, California Department of Social Services
• Long-Term Care Ombudsman, California Department of Aging
• Supplemental Security Income (SSI) in RCFEs, CANHR