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

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Researching costs?

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

See state rankings

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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

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Comparing care types?

Side-by-side cost comparison between assisted living and nursing home — what's included, who pays, when each 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

Assisted Living vs Nursing Home: Cost Comparison [2026]

Assisted living vs nursing home cost comparison. National medians, what's included, how to pay, and state-by-state pricing for 2026.

Read Full Guide Updated 2026-02-24

EDITORIAL

Florida Medicaid LTC Waitlist Explained: 50K+ People, 116K Slots

Florida's SMMC LTC waitlist had 50,000+ people in late 2023 against ~116,000 enrollment slots. Here's how the federal "Factor C" cap and priority scoring decide who moves first.

How to Pay for Assisted Living: 8 Options [2026 Guide]

How to pay for assisted living: 8 proven options including Medicaid waivers, VA benefits, long-term care insurance, and more. Costs, eligibility, and pros/cons for each.

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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