How to Accept Medicaid in Assisted Living!
Aug 18, 2025
So you’ve heard about Medicaid, and now you're wondering…
π Can I really use it to launch or grow my assisted living business?
π 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! πͺ
Check out this video, too:
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.
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Medicare is federal and age-based (mostly for people 65+).
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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).
π‘ 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. π
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.
β οΈ 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:
π Proof of licensure
π Business and liability insurance info
π Bank account details for payment
π 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.
π‘ 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.
π 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.
π‘ 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.
π Want luxury hotel-style care with $10,000/month residents? Medicaid might not be your route.
π 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! πΌ
Want to launch a Medicaid-approved assisted living business in the next 12 months?
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Step 1: Download the free Business Plan Checklist to build your foundation
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Step 2: Need help figuring out where to start? Join the next Roadmap Challenge and build your launch plan with me.
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Step 3: Follow this guide, take action, and start making a difference in your community
π¬ Got questions? Drop them below or connect with us!
Show full transcript π
Transcript
00:00:00 - 00:00:55
Hey friend, I'm Brandon Gustafson at Assisted Living Investing. I help beginners like you launch their assisted living business in the next 12 months. And today's video, we're going to be getting into how to navigate Medicaid to create the success that you need as you are getting into your assisted living journey. So, if you are interested in that, make sure you stick around for today's [Music] video. Hey friend, welcome back to Assisted Living Investing. Excited to have you here on the channel. Before we
00:00:29 - 00:01:21
get started today, I want to remind you to go to the website assistedlivinginvesting.net. Go to the big blue blocks in the top right corner and grab our free underwriting calculator to help you as you're trying to determine if this is the type of investment that you want to be pursuing. So again, it's assisted livinginvesting.net. Get our free underwriting calculator. Now, let's get into the topic for today's video. Today we're going to be talking about how to leverage Medicaid to turn into assisted
00:00:55 - 00:01:53
living success as you are trying to get into your mode of starting an assisted living business. This is something that there's I feel like there's a lot of misunderstanding around Medicaid. There's a lot of negatives that people have about Medicaid. And I want to really clear those up for people to help them understand exactly what you're getting into as you look at doing Medicaid for your assisted living facilities. So, let's start off here by talking about what Medicaid actually is.
00:01:24 - 00:02:15
So, Medicaid, it's a federally funded program, but it's an administrator at a state level. Meaning, the federal government says, "Okay, we have here's a trillion dollars that that's going out to Medicaid." And then it goes and they divide that out by the different states and based off of population and different reasons and and need and there's applications involved. But basically federal funds and then it's administered at a state level. In most states this is called Medicaid, but in
00:01:50 - 00:02:36
some states they call it different. Sometimes they just call it a waiver program. Sometimes they will call it like in California it's medical. It depends on what it's called in the different states. And if you use the word Medicaid and they say no, we don't do Medicaid. It's probably because they actually call it something slightly different. I was talking with somebody that is doing this in Texas recently and they're like, I can't. There's nothing on Medicaid. I keep asking people and
00:02:13 - 00:02:57
they say, "No, we don't do it." But they have this one waiver program and I looked into it and it was Medicaid. It's just they call it a specific type of a waiver program. So, if that's you and you're just like trying to navigate this, trying to figure out exactly what it is, there's a chance they're going to call it something different. But, at its core, it's Medicaid. It's a federally funded program that's administered at a state level and it provides care to the
00:02:35 - 00:03:34
residents that you're going to be caring for inside of your assisted living facility. I also want to make sure that it's clear that Medicaid is different from Medicare. Medicare is a federally funded, federally administered program. Sometimes you're going to have Med Advantage type programs and those are usually Medicare that is administered by a private healthcare insurance company. But Medicaid is totally different. Medicaid can also work with thirdparty administrators. Oftentimes, it is going
00:03:04 - 00:04:01
to be a a health insurance plan that does this. Like in Idaho, for example, Blue Cross of Idaho and Molina are the third party administrators that we work with. They're healthcare companies. They provide benefits at a commercial level. They also provide like Medicare benefits to some of their consumers, but they also provide Medicaid. And so they they have these different lines of business and and having worked in the health insurance industry previously, I understand exactly what that is and and
00:03:32 - 00:04:33
how that works. But Medicare is going to be that federally funded program. It is part A, which is inpatient care, part B, which is outpatient care, and part D, which is prescription. But there is no benefit for long-term care when it comes to Medicare. They they don't offer that. They will offer like a hospice benefit specifically on Medicare Advantage plans, but they don't offer anything that is specific to assisted living once you get to nursing home. Yes. But assisted living, no. But that is covered
00:04:03 - 00:04:59
by Medicaid. So that's what you want to be looking for. I want to make sure that's very clear that Medicare Medicaid sound the same. Very different programs in the way that they function and the way that they help people. Medicaid qualifications. They come through generally low income or it can be age, combination of the two, could be disability. There's a few different ways that somebody could qualify for Medicaid. And so that just kind of depends. Medicare is much more age-based. There are other ways to
00:04:31 - 00:05:17
qualify for Medicare, but it's largely age- based. So that's another difference there as as you're looking at these two different products. So I want to make sure it's very clear which one is which and how they work and how they impact you doing your assisted living facility. So now let's talk about becoming certified as a Medicaid provider. So let's say you know you close on your business, you're ready to go. You're you're starting to move forward and you decide, I want to serve a Medicaid
00:04:54 - 00:05:48
population. I really want to help that underserved population. I want to get in there. I want to bring them in. I've heard great things about Medicaid. I know I can be profitable with my business. How do I become a Medicaid provider? Now, the first thing that you have to do and and I want to make sure this is absolutely clear as well. If you want to become a Medicaid provider, you have to have a licensed facility. Unlicensed facilities cannot provide care to a Medicaid resident if they're
00:05:21 - 00:06:10
going to use a Medicaid benefit. Now, if it's a a Medicaid person, but they want to pay for it for privately, they have family that want to do it, that's okay. But if you want to use that Medicaid benefit, you have to be a licensed facility. It's a part of your application process, actually, if you're going to become a Medicaid provider. So, as you're filling out that application process, what that's going to look like is very similar to the licensing process that you went through as you are getting
00:05:45 - 00:06:33
your facility license. So, they're going to ask for information about the business. They're going to want to see the license. They're going to want to see insurance. They're going to want to see just all of the the coverage. They also are going to need to have bank information. So, they want to have your bank account so they know where to deposit those funds. They need to have that information there. This was something that was a huge hangup for me as we were getting certified as a
00:06:10 - 00:07:01
Medicaid provider in Colorado. They kept asking for my bank information. I would provide it to them. You know, here's a here's a voided check. They'd say, "Oh, we need it on letter head and it needs to have, you know, this voided check on it." So, I give that to them. I just And every time that I would give them something, it was like 3 to 4 weeks before I could give them the next thing. I had to wait for them to process it. And it was so frustrating for me as a business owner that was trying to get
00:06:35 - 00:07:26
money for the residents that I was caring for and I couldn't do it. And so I finally at one point just gave them, okay, here's the five documents you've asked for cuz apparently you can't go back and look at the previous stuff that I've given you. Here's all of it. And that's when boom, everything clicked. We were able to get our certification. Now the nice thing about Medicaid is you do get pay back pay. So if you are working with this and you have started the application process to become a Medicaid
00:07:00 - 00:07:54
provider at that point you can start serving people with Medicaid. You can start bringing them into your facility. You can start working with them providing care to them and then once you get certified and everything you know boxes are checked and everything with Medicaid all of a sudden that opens up the door and then you can get reimbursed for them. So get back pay. So when we did this for our facility, it took us about four months in Colorado to go through the application process to get that. We got all of that back pay. So we
00:07:27 - 00:08:20
got a check for, you know, $50 $60,000, a huge check for the services we had provided for the past 4 months. And that was a huge just like blessing for us as business owners. It it meant it was just huge for us to be able to get paid that because money was extremely tight as we were going through that. This was another lesson I learned. as you're trying to get started, you want to make sure you have a buffer there because you're still going to have to make payroll. You're still going to have to
00:07:54 - 00:08:47
buy food. So, even though Medicaid's not paying you money, you're still going to have to run that business and and still going to have to have, you know, provide that service to to individuals. So, if you don't have that money up front, this is why as I talk with people about getting funding, you always want to ask for that extra operating capital up front because it's going to save you the headaches and the stress of trying to do all of this without having the funds available. Okay, so that's one thing
00:08:21 - 00:09:14
that I really want to to stress there. Now, I learned from that process and my second facility, the one in Idaho, it took us 3 weeks to get our Medicaid certification in place. So, it does not have to take four months. But if you work with me in one of my programs, if you just go to ali masterastermind.com, fill out the questionnaire, I'll tell you the program that is best suited for you on where you're at in your journey. But if you work with me on one of my programs, what you're going to find is
00:08:47 - 00:09:38
I'm going to share these secrets with you in your specific situations and help you along your path to reach your investment goals of launching your assisted living business to create more time and financial freedom for you and your family. It's something honestly I love doing. I love coaching people. love helping people. So if that's you, go fill out the questionnaire aliastermind.com. All right. And now I talked a little bit as well about who administers Medicaid. It can be Medicaid. It can be the state. So it is
00:09:12 - 00:10:02
a state administered program. That doesn't mean the state is the one that is going to be, you know, filling out all the checks and processing all the claims and everything from that standpoint. They may hire a third party administrator. Like I talked about Blue Cross of Idaho, Molina. Those are somes that some that we work with in a past life. In my professional career, worked for Optum. We did this for mental health claims as well. So managed care organizations is what they're called. They're thirdparty administrators. They
00:09:37 - 00:10:30
manage those claims for the state and then they get a chunk of money for managing that. You know, a percentage of the claims that are processed. They get to keep that. That's how they make their money. So that's the process there of how those claims come through as you're trying to figure out exactly how this is going to work. Now, the question I think most of you that are watching this video are here for is, is Medicaid really a viable solution for you as an assisted living owner business? And the answer to
00:10:03 - 00:10:54
that is absolutely yes. You can be a successful business while providing services to a Medicaid clientele. You can do this in assisted living. You can be very successful with it. And not only that, but you're providing a service in the community that is very much needed. And so if this is actually a little trick as you are trying to get your license and trying to work through zoning and things and if there are roadblocks there, you can just throw it out there. Hey, you know what? We're going to work with a Medicaid
00:10:29 - 00:11:25
population. I know I've looked at the city, you know, minutes and things like that. I know there's a an issue with homeless or with a homeless population or I know there's an issue with this little subset of mental health that that we could help in there and we plan on serving that population. So what can we do to help you make the progress you need to make so you can work with that population and we can serve that population and you can do that through Medicaid. So it can really be a
00:10:57 - 00:11:47
beneficial talking point to you as you are trying to move things along if you are hitting roadblocks and and you're running into issues having that in your in the back of your mind on how you can really expedite some of these things and make it so that you are moving forward and going to reach your goal of of launching that assisted living business. This can be one of those things the catalyst that can really launch you forward. I'm working with somebody on something very similar to that inside of
00:11:22 - 00:12:18
the mastermind program right now and and has been really rewarding to see how the city is working with us as we're having those conversations back and forth and letting them know that we are here to to help them and and the populations that they want to serve. So very rewarding and allows you to also be a successful and viable business that is profitable and is still able to make that difference and really give back to your community. And honestly, that's one of the things that I love the most about
00:11:50 - 00:12:46
assisted living is the ability that you have to make a difference in the lives of the people that are inside of your community and giving back to them. Yes, you can make money off of it. That's great and it and it's good. It's a good business model. It allows you to retire or, you know, do this as as your sole job, but it also allows you to really give back to the community. And that's something that for me is very rewarding. I love that type of work. it it's something that really just like gives me
00:12:18 - 00:13:12
a lot of energy and and invigorates me because of the impact that I get to have on people's lives. It's why I love being in the healthcare industry. Honestly, it's why I want to do all this. And the other thing that I'll note and and we just had a video on this come out a few weeks ago, but I have been able to get over $6,000 per bed for a Medicaid resident. So, it's very possible for you to get up there. And for those of you that want to do really high-end and you're thinking like 12, 15, $20,000 a
00:12:46 - 00:13:40
room for something that's really high-end and very specific, this probably isn't going to be a good fit for you. But for those of you that are just like, "Oh man, I wish I I if I could just get like $4, $4,500 per bed, you can do that with Medicaid and and you can really serve that population and give back there." So, it's not something that is, you know, you're only getting this this little tiny $2,000 chunk and and then you're trying to make ends meet other places. It is an opportunity for
00:13:12 - 00:14:01
you to really use to catapult yourself forward and be successful with the business that you're trying to run. That's one of the things that I really like about Medicaid. There's such a huge need for the residents that that have Medicaid and need that help and you're able to provide that type of service to them. So, if you are interested in learning more about Medicaid, you're thinking that this is a thing that you want to do, type in Medicaid down below. I would love to hear from you there. And
00:13:37 - 00:14:29
if you have questions specifically about Medicaid, how it works, and some of those more specific questions to your state, drop those in the comments below. But more than that, probably fill out my questionnaire. Again, it's ali.com. It's my best way of knowing how to help you and meet you where you're at and give you the guidance that you need so you can successfully launch your assisted living business. So, in today's video to to quickly recap, we gave a history of what Medicaid is, uh, you
00:14:03 - 00:14:49
know, how it works and and how it's different from Medicare, and that's something that's very important for you to understand. We talked about who administers that Medicaid piece. We talked about the application process. And we talked about how Medicaid can really be a viable business option for you as you're trying to launch your assisted living business and make some progress towards, you know, launching a a business that is going to allow you to reach those time and financial freedom
00:14:26 - 00:15:08
goals that you're seeking. That's why you're getting into assisted living. If you found this video to be helpful, make sure you like the video, subscribe, and ring the bell as well so you get notified every time we put out content like this. We go live on Tuesdays, we put out content on Thursdays. We have a bunch of stuff in our social media. So, go down in the links down below and make sure you go and grab all of the free stuff and follow us in in all the different places so you don't miss
00:14:47 - 00:15:28
anything that we put out on the channel. Does residential assisted living sound interesting to you, but you don't know how to get started? At Assisted Living Investing, I'm here to help beginners like you launch their assisted living business in the next 12 months. I love helping and coaching people and guiding them through that process and would love to help you. Go to alimastermind.com to fill out the questionnaire. And remember, it doesn't take a lot, just a little bit. Just keep
00:15:08 - 00:15:29
going step by step by step. And I promise you, if you do and you're consistent and persistent, you are going to be successful. Thanks for watching and have a great day. [Music]
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