Elder Care Index Browse All States

Navigate the Complexities of Medicaid Elder Care

What Medicaid actually pays for in your state — waiver programs, spend-down rules, nursing home eligibility. No lead-gen. No placement pitch. Independent data.

verified Updated for 2026 public Covering all 50 states + DC source CMS, NCOA, State agencies

At a Glance

States + DC

Medically-needy states

Senior HCBS waivers

Pillars of scoring

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Where to start

Pick the question you came with

ABCDF

Researching costs?

State-by-state median pricing for assisted living, nursing homes, memory care, and home aides — every state graded A–F.

See all 51 states ranked

Independent → In-home → Assisted → Memory → Nursing → Hospice

Just starting out?

A plain-English walk-through of the 6 levels of senior care, what each one includes, and how families typically choose.

Read the primer

AL$4,995

NH$9,277

Comparing care types?

Side-by-side monthly cost — assisted living vs. nursing home. What's included, who pays, and when each one fits.

Compare options

Making sense of senior care coverage

We translate opaque state Medicaid policies into actionable, state-specific guides for families figuring out how to pay for care.

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Policy Clarity

Clear explanations of state-specific asset limits, look-back periods, home equity exemptions, and spend-down rules.

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HCBS Waiver Detail

Every senior HCBS waiver enumerated — eligibility, covered services, waitlists, self-direction options.

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Data-Driven Rankings

Every state graded across 5 pillars: Medicaid support, quality, staffing, access, and affordability.

RANKINGS

Top 5 States for Senior Medicaid

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#1 A

District of Columbia

Strong HCBS access, medically-needy pathway

Care Index 56.5

#2 A

Minnesota

Leading in HCBS + medically-needy pathway

Care Index 55.7

#3 C

California

Medi-Cal + IHSS + medically-needy

Care Index 51.5

#4 C

New York

MLTC + medically-needy pathway

Care Index 50.3

#5 C

Maine

Medically-needy + HCBS-forward

Care Index 50.1

Editorial Highlights

FEATURED GUIDE

Why a Nursing Home Can Turn Down Your Parent's Medicaid

Nursing homes aren't required to take Medicaid — acceptance is an economic call. How the reimbursement gap, 'Medicaid pending,' and 2026's new rate data work.

Read Full Guide Updated 2026-07-16

EDITORIAL

Do Medicaid Work Requirements Apply to Seniors? Who's Exempt in 2026

Nearly every senior on Medicaid is exempt from the 2026 work requirements. But near-seniors and family caregivers aren't — and the paperwork is the real risk.

Does Medicaid Pay for Home Care? Yes, But It Comes With a Waitlist

Medicaid covers home care in every state, but through capped waivers with waiting lists, while nursing homes are a guaranteed entitlement. The 50-state gap, explained.

Institutional Trust, Built on Data

Our scoring methodology is developed by independent analysts with public-policy experience and zero commercial ties to facility operators, insurers, or placement services. We verify every data point against its primary source.

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Verified sources only

We cite state Medicaid agencies, CMS, and federal regulations directly.

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Monthly updates

Medicaid figures change. We keep each state page current with the latest rules.

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No lead-gen. No sponsored content.

Nothing on this site is designed to sell you a facility or service.

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Take the first step toward better care

Use our state-by-state guides to see exactly what Medicaid pays for in your parent's state — and what it doesn't.

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