How to Pay for Memory Care When You Have No Savings

Why Memory Care Costs So Much and What Public Programs Exist

Memory care is the most expensive form of senior living in the United States. According to the Alzheimer's Association, the average monthly cost exceeded $7,000 in 2025 and has continued rising into 2026, with many facilities charging $8,000 or more depending on the region. That is roughly $84,000 to $96,000 a year, a figure that would drain most retirement accounts within two to three years.

Here is the reality: the majority of families cannot pay for memory care out of pocket for long. The Administration for Community Living reports that 70% of people over 65 will need some form of long-term care, and more than 60% of nursing home residents already rely on Medicaid to cover their costs.

If your family has little or no savings, you are not in an unusual position. You are in the majority. And public programs exist specifically for this situation. Medicaid Home and Community-Based Services (HCBS) waivers, VA Aid and Attendance pensions, state supplement programs, and charity care can all help cover memory care. The challenge is knowing which ones apply to you, how to apply, and what to do while you wait for approval.

Medicaid Waivers for Memory Care: What They Cover and Where

Medicaid does not automatically pay for assisted living or memory care. It does cover nursing home care for people who qualify financially and medically. But through HCBS waivers, many states extend Medicaid dollars to cover memory care in assisted living settings, adult day programs, and even in-home care.

How Eligibility Works

In most states, you must meet both financial and medical criteria:

Income: Typically under 300% of the federal Supplemental Security Income (SSI) benefit. For 2026, that threshold is approximately $2,500 per month for an individual, though it varies by state.
Assets: Usually under $2,000 for a single applicant. Your home (if a spouse or dependent lives there) and one vehicle are generally excluded.

These limits sound severe, but many families with "no savings" already meet them. If you have a modest bank account and Social Security as your only income, you may qualify right now.

The State-by-State Problem

Not every state offers a waiver that covers memory care in an assisted living setting. Some states have dementia-specific waivers; others fold memory care into broader HCBS programs. And many states that do offer coverage have capped enrollment and long waiting lists.

Here is a realistic snapshot of the landscape:

State	Waiver Program	Covers Memory Care in Assisted Living?	Typical Wait
Florida	Statewide Medicaid Managed Care (Long-Term Care)	Yes	12 to 36+ months
Texas	STAR+PLUS HCBS	Limited; some assisted living	12 to 24+ months
Ohio	PASSPORT, MyCare Ohio	Yes, in some settings	6 to 18 months
New York	Managed Long-Term Care	Yes	Varies by county
California	CalAIM / HCBS Waiver	Yes, expanding	3 to 12 months
Virginia	Commonwealth Coordinated Care Plus	Yes	6 to 12 months

This table is not exhaustive. Your state's Medicaid office or your local Area Agency on Aging can confirm current waiver availability and wait times. For Texas families specifically, our guide on Medicaid and Assisted Living in Texas walks through the STAR+PLUS program in detail. Ohio families can find waiver specifics in our article on Ohio Home Care Waivers.

What to Do While You Wait

A 12-month waiting list does not help someone who needs memory care now. Here is what families can do in the gap:

Apply for nursing home Medicaid immediately. Medicaid covers nursing home care as an entitlement (no waiting list). If your loved one qualifies financially and needs a nursing home level of care, this is the fastest route to covered care. It offers less autonomy than assisted living, but it is available.
Ask the facility about deferred payment plans. Some memory care communities will accept a resident with a pending Medicaid waiver application and defer a portion of the bill until benefits begin. Get this in writing.
Contact a hospital social worker or discharge planner. If your loved one is currently hospitalized, the discharge team can often expedite placement and connect you with emergency Medicaid.
Reach out to local religious organizations and United Way chapters. Short-term emergency grants for care costs do exist, though they are modest and competitive.

Do not wait until care is urgent to apply. If your parent has a dementia diagnosis, apply for the waiver now, even if they are still managing at home.

Spousal Impoverishment Protections: What Married Couples Need to Know

If one spouse needs memory care and the other is still living at home, Medicaid's spousal impoverishment rules are critical. These rules prevent the healthy spouse from being left destitute.

Under federal law, the "community spouse" (the one staying home) can keep:

A minimum monthly maintenance needs allowance (MMMNA), which in 2026 is approximately $2,555 per month (adjusted annually). If the community spouse's own income falls below this, they can receive a portion of the institutionalized spouse's income.
A protected share of the couple's combined assets, typically between roughly $31,000 and $154,000 depending on the state.
The family home and one vehicle.

These figures are federal minimums and maximums. Each state sets its own rules within that range. This means a married couple with a home, a car, and modest savings may qualify for Medicaid much sooner than they expect.

A common mistake: families assume they must spend every dollar before Medicaid kicks in. That is not true for married couples. The community spouse is explicitly allowed to retain assets and income. Contact your state Medicaid office to learn the exact thresholds where you live.

Veterans Benefits: Aid and Attendance for Memory Care

The VA's Aid and Attendance (A&A) pension is one of the most underused benefits available to families paying for memory care.

Who Qualifies

The veteran must have served at least 90 days of active duty, with at least one day during a wartime period, and received an honorable discharge.
Surviving spouses of qualifying veterans are also eligible.
The veteran (or surviving spouse) must need help with daily activities such as bathing, dressing, or eating, or have dementia that requires supervision for safety.

How Much It Pays

For 2026, the maximum monthly A&A pension is approximately $2,400 for a single veteran and $2,850 for a veteran with a dependent spouse. A surviving spouse can receive roughly $1,550 per month. These amounts are adjusted annually for cost of living.

The Asset Limit and How to Manage It

The VA's net worth limit is approximately $155,000 (adjusted annually), excluding your home and one vehicle. "Net worth" includes all countable assets plus annual income.

If a veteran's countable assets are above this limit but they still cannot afford $7,000 or more per month in memory care, there are legal ways to reduce countable assets:

Pay off existing debts (mortgage, credit cards, medical bills).
Make home repairs or modifications (these are exempt expenses).
Prepay funeral and burial costs through an irrevocable plan.

Be aware: the VA has a 36-month look-back period for asset transfers. If you give away assets to qualify, the VA may impose a penalty period during which benefits are denied. Do not transfer assets to family members without understanding this rule.

Applying

Use VA Form 21-527EZ to apply. You will need the veteran's DD-214 (discharge papers), medical evidence of the care need, and financial documentation. Processing can take 6 to 12 months. A VA-accredited claims agent or your county Veterans Service Office can help at no charge.

Because of the long processing time, apply for A&A at the same time you apply for Medicaid. These benefits are not mutually exclusive, and receiving both is possible in many states.

SSI, State Supplements, and Charity Care

When Medicaid waivers and VA benefits are not enough, or while you are waiting for them, other programs can help:

Supplemental Security Income (SSI): For 2026, SSI provides up to approximately $990 per month for individuals with very limited income and assets. This alone will not pay for memory care, but it can cover personal needs and contribute toward a facility's cost.
State Supplementary Payments (SSP): Many states add money on top of federal SSI. California, New York, and several others provide supplements that can add $100 to $400 per month.
Charity care and sliding-scale facilities: Some nonprofit memory care communities, particularly those affiliated with LeadingAge member organizations, offer reduced fees based on ability to pay. Ask directly. These programs are rarely advertised.
Medicare hospice: Medicare does not cover long-term memory care. But for individuals with advanced dementia who meet hospice criteria (a life expectancy of six months or less as certified by a physician), Medicare hospice provides comfort care wherever the person lives, including in a memory care facility. This can significantly reduce out-of-pocket costs in the final stage of the disease.

Step-by-Step: How to Apply Without a Lawyer

You do not need an attorney to apply for Medicaid or VA benefits, though an elder law attorney can help with complex situations. Here is the process:

Get a formal dementia diagnosis from a physician, with documentation of the specific type and severity.
Gather financial documents: three to six months of bank statements, income records (Social Security award letter, pension statements), and any investment account statements.
For Medicaid: Contact your state Medicaid agency (find it through your state's.gov website) or call the Eldercare Locator at 1-800-677-1116. Apply through your state's online portal or in person at your local Department of Social Services. Approval typically takes 45 to 90 days.
For VA A&A: Gather the veteran's DD-214 and medical evidence. Apply via VA.gov or by mail. Contact your county Veterans Service Office for free help. Expect 6 to 12 months for a decision.
Apply for both simultaneously. This is the single most common mistake families make: applying for one program and waiting to hear back before starting the other. Do not do this. Apply for everything you might qualify for, at the same time.
Understand look-back periods. Medicaid has a 5-year look-back on asset transfers. The VA has a 36-month look-back. Do not give away money or property to qualify faster without understanding the penalties.
Use free help. The Eldercare Locator (1-800-677-1116) connects you to your local Area Agency on Aging. The Alzheimer's Association 24/7 Helpline can provide state-specific program guidance. The National Council on Aging offers a benefits checkup tool that identifies programs you may qualify for.

When Public Programs Are Not Enough: Fallback Options

Sometimes the math does not work, or the waiting list is too long. Here are realistic alternatives:

Medicaid nursing home care: Unlike waiver-based memory care in assisted living, Medicaid nursing home coverage is an entitlement. If your loved one meets the medical and financial criteria, a bed is available. Many nursing homes have dedicated memory care units. The trade-off is less independence, but the care is covered.
Adult foster care or small family care homes: These are often significantly less expensive than large memory care facilities, sometimes $3,000 to $5,000 per month, and some accept Medicaid.
In-home care through HCBS waivers: If your state's waiver covers in-home services, a family member or professional caregiver can provide memory care at home, which can delay or avoid facility placement.
Aging and Disability Resource Centers (ADRCs): Every state has them. They exist specifically to help families in crisis find care options. Call yours.

Imagine a daughter who has just learned her mother's savings account holds $800 and her only income is a $1,400 Social Security check. The diagnosis is moderate Alzheimer's. That daughter should, this week, call the Eldercare Locator, apply for Medicaid, request a VA records search (if her late father was a veteran), and ask every memory care facility within 30 miles whether they accept Medicaid waivers or offer charity care. Doing all of this at once is overwhelming. Doing it one step at a time over months costs thousands of dollars the family does not have.

This article provides general information about public benefit programs and is not legal or financial advice. Eligibility rules vary by state and individual circumstances. Consult your state Medicaid office, a VA-accredited claims agent, or an elder law attorney for guidance specific to your situation.