How to Accept Medicaid in Assisted Living!

assisted living licensing how to accept medicaid managed care organizations medicaid medicaid assisted living medicaid provider certification medicaid reimbursement rates medicaid vs medicare medicaid waiver program Aug 18, 2025

So you’ve heard about Medicaid, and now you're wondering…

👉 Can I really use it to launch or grow my assisted living business?
👉 Will I still be profitable if I accept Medicaid residents?

Good news—you’re in the right place! This guide breaks down everything you need to know to accept Medicaid in your facility while staying financially strong and serving your community.

Let’s get into it! 💪

What Is Medicaid, Really?

Before we talk money and paperwork, let’s clear something up:

Medicaid ≠ Medicare. They sound similar, but they’re not the same.

✅ Medicare is federal and age-based (mostly for people 65+).
✅ Medicaid is federally funded but state-run and usually based on income or disability.

Each state runs its own Medicaid program. Some call it something else (like Medi-Cal in California), and others offer it through waiver programs (like the STAR-PLUS program in Texas).

💡 Tip: If someone tells you your state doesn’t offer Medicaid for assisted living, it might just be called something different.

Why Medicaid Matters for Assisted Living

Most people think Medicaid only covers nursing homes for long-term care. Not true!

In many states, Medicaid pays for assisted living, for the care you provide. This means you can serve low-income or disabled residents and run a profitable business.

There's a little more paperwork involved, but once you get used to it, it's not that bad. Let’s talk about how to get started. 📝

Step 1: Make Sure Your Facility Is Licensed

You can’t accept Medicaid residents if you’re not a licensed facility.

So, before you even apply, make sure your home is officially licensed as an assisted living facility (or equivalent) in your state.

⚠️ Note: Some states call it “residential assisted living,” “personal care home,” "RCFE", or something else. The title doesn’t matter—as long as you’re licensed.

Step 2: Apply to Become a Medicaid Provider

Once you’re licensed, it’s time to apply for Medicaid certification.

Here’s what you’ll usually need to submit:

📌 Proof of licensure
📌 Business and liability insurance info
📌 Bank account details for payment
📌 A completed provider application form (varies by state)

This is where the state Medicaid office or Managed Care Organizations (MCOs) come in. These groups handle provider enrollment and payments.

💡 Some states process applications faster than others. Want to speed things up? Submit all your documents together and double-check everything for accuracy.

Step 3: Start Accepting Residents—Even Before You’re Approved

Once you submit your application, you can often start accepting Medicaid residents right away.

Why? Because once approved, Medicaid back-pays from the date of your application.

🙌 That means you don’t lose money while waiting.

Just make sure you have operating capital to cover staff, food, and bills for a few months.

💡 Pro tip: If you’re using a loan like an SBA 7(a), ask for extra working capital in your funding request.

Step 4: Know Who Really Sends the Check

Even though Medicaid is state-run, many states outsource the day-to-day work to insurance companies called Managed Care Organizations (MCOs).

So when you bill Medicaid, it’s often one of these groups who sends the payment.

Step 5: Get Paid

Worried that Medicaid rates are too low?

In our facilities we've gotten paid as much as $6,000+ per bed per month from Medicaid reimbursements!

When done correctly, Medicaid can be just as profitable as private pay.

📌 Want luxury hotel-style care with $10,000/month residents? Medicaid might not be your route.
📌 Want to serve everyday people who need quality care? Medicaid is a great fit—and it's recession-resistant.

Bonus: Medicaid Can Help With Zoning & Licensing

If you’re struggling with zoning or licensing approvals, telling your city or county that you plan to serve Medicaid residents can help.

Cities love community-focused projects. Medicaid can actually help you get your facility approved faster in some areas.

Next Steps: Launch Your Medicaid Strategy Today! 💼

Want to launch a Medicaid-approved assisted living business in the next 12 months?

✅ Step 1: Download the free Business Plan Checklist to build your foundation
✅ Step 2: Apply for the ALI Mastermind to get hands-on help with certification, funding, and licensing
✅ Step 3: Follow this guide, take action, and start making a difference in your community

💬 Got questions? Drop them below or connect with us!

Download Your FREE Calculator

Send Me My Calculator

Stay connected with news and updates!

Join our mailing list to receive the latest news and updates from our team.
Don't worry, your information will not be shared.

We hate SPAM. We will never sell your information, for any reason.