Can Social Security Pay for Assisted Living Benefits?

Social Security is a federal government financial program that provides monthly benefits and supplemental income to millions of Americans. The Federal SSI benefit includes older adults, chronically ill workers and people with disabilities.

Many people in these demographics must relocate to an assisted living community at some point, which begs the question: Can Social Security pay for assisted living?

The short answer is yes, but you must meet some eligibility requirements. Social Security can cover some of your personal care expenses, but it may not pay for them completely. Here’s how you might qualify for Social Security payments and receive financial aid for assisted living to supplement your own financial resources.

How Social Security Pays for Assisted Living

Social Security can pay for assisted living in several different ways. The Optional State Supplement (OSS) program is the most common method of financial support, but you could also receive benefits through Social Security Disabilities Insurance (SSDI) and a Supplemental Security Income (SSI.) Each method has its own eligibility criteria, which can differ for various groups, depending on medical needs.

Here’s a quick rundown of these three government programs:

Optional State Supplement Program (OSS)

This optional program is an extra resource that adds to the existing SSI payments for elderly and disabled people in assisted living facilities. OSS payments range from less than $100 to more than $1,000 depending on the state, the facility and the individual’s personal care needs.

Social Security Disability Insurance (SSDI)

This insurance program is specially made for people who are still of working age but can’t work due to a medical condition and have to seek assisted living. When eligible individuals reach the full retirement age of 65 while on SSDI, disability benefits automatically convert to retirement benefits. The average SSDI payment is roughly $1,537 a month in 2024.

Supplemental Security Income (SSI)

The government gives financial assistance to adults and children with disabilities or people 65 and up without disabilities who have a monthly income below the SSI’s benefit rate. Federal SSI benefits cover hospital visits, prescription medications, medical equipment and other expenses related to SSI recipients’ treatment. The maximum SSI is $943 for an individual as of 2024.

Before exploring these options in greater detail, it’s important to clarify that federal Social Security Income benefits rarely cover 100% of your assisted living expenses. It’s also a very good idea to discuss with a family member and especially a financial advisor. Other areas to consider are your personal savings or possibly a reverse mortgage. This is where a financial planning professional plays a significant role in helping guide your decisions.

Costs of Assisted Living

The average Social Security check was $1,767 in December 2023, with retirees and assisted living seniors receiving an above-average payout. This number can cover a sizable portion of your expenses but not all of them. According to the 2020 Genworth Cost of Care Survey, these were the average assisted living costs for American seniors:

• $141 per day
• $4,300 per month
• $51,600 per year

Using these numbers as a benchmark, the average assisted living resident would still need to cover roughly $2,600 a month to stay at their facility. Of course, individual average cost can widely vary. Some older adults only need help with certain household chores, while others require round-the-clock assistance with activities of daily living.

Social Security recipients can also look forward to bigger payments in the future, thanks to an 8.7% cost of living adjustment that will increase your monthly check. This nice boost can help pay for more assisted living costs.

Your Social Security monthly benefit can cover room and board, medicines, skilled nursing, and other long-term care costs. Your personal assets, retirement savings, and investment earnings must take care of any costs that the monthly payments don’t cover. It’s impractical, and often impossible, to completely rely on Social Security for your assisted living facility payments.

For assisted living residents looking to transition to nursing home care or another facility, social security payments can help offset some medical expesnes. Medicaid can help you pay for nursing home care if you get Supplemental Security income and are 65 and older.

There are different types of Social Security benefits you could use — Optional State Supplements, Social Security Disabilities Insurance and Supplemental Security Income.

Optional State Supplements (OSS)

Optional State Supplements are the most common ways Social Security helps people pay for their assisted living facilities. Eligibility rules are relatively similar from state to state, but a handful don’t provide OSS at all:

• Arizona
• Arkansas
• Mississippi
• North Dakota
• Tennessee
• West Virginia

If your state has an OSS program, you can become eligible today. The first eligibility requirement most states have is an income limit. Some have their own scale, but the income cutoff is usually the SSI federal benefit rate, which is currently $841 a month for an individual and $1,261 for a couple.

You’re off to a good start if your monthly income doesn’t exceed the SSI federal benefit rate. You might also be automatically eligible if you have Medicaid coverage or live in a Medicaid facility in certain states:

• Indiana
• Kansas
• Louisiana
• Michigan
• Missouri
• Nebraska
• Nevada
• New York
• Texas

Many states listed above also cap the amount assisted living facilities can charge for room and board. However, you must know that not all places have to abide by this cap. If a facility does not accept Medicaid, it can charge as much as it wants. The caps also do not apply to personal care costs, such as special medicines and physical therapy.

Regardless of your state’s policy, these are the main documents you must provide to demonstrate your eligibility:

• Proof of age (must be 65 or older) or proof of disability
• Social Security number
• Proof of citizenship
• Proof of income
• Employment history
• Evidence that you live in an assisted living facility or adult foster care facility

These requirements seem straightforward but keep in mind that each state has different definitions of assisted living and adult foster care facilities. It’s your responsibility to determine your state’s unique definition and how their Medicaid program works.

The application process for OSS also varies by state. Some states, like Kansas, don’t have an application process and find eligible recipients by going through their Medicaid and SSI databases. States that do have applications usually handle them through their Social Security Administration offices:

• California
• Delaware
• Hawaii
• Massachusetts
• Michigan
• Nevada
• New Jersey
• New York
• Pennsylvania
• Texas
• Utah
• Vermont
• Virginia
• Washington
• Wisconsin

As you can see, location is critical in determining your OSS benefits. Read up on the details of your state program and discuss with family members and a financial advisor to ensure you meet all the eligibility requirements.

Social Security Disability Insurance (SSDI)

SSDI is a Federal program available to people who can’t work for one year or longer due to a debilitating medical condition. This demographic primarily consists of older adults near retirement age and people with permanent disabilities, so most recipients are already in assisted living facilities.

Working-age adults must also pass multiple disability evaluations to qualify for SSDI. The first test proves your age at the time when you became disabled and the second shows the length of time you were employed before the medical condition put you out of work. You can file a disability claim through your local Social Security Administration office.

SSDI benefits are based on the disabled individual’s average lifetime earnings, just like regular Social Security. The amount of SSDI allotted monthly can also decrease if you simultaneously benefit from other disability payments, such as temporary state benefits or workers’ compensation.

The only way to increase your SSDI payment is to work at least a year with a higher income than your average amount of indexed monthly earnings, which is impossible if you have a disability. Fortunately, you will still receive benefits during your application’s wait time. SSDI applications tend to be time-consuming affairs due to lengthy disability evaluations.

Supplemental Security Income (SSI)

Supplemental security income is a needs-based program, unlike OSS and SSDI. That means its monthly payment directly depends on your personal care needs rather than your location or employment history. There are also no restrictions on how you can spend your SSI. Both adults and children can qualify.

Eligibility Requirements for Adults

• Aged 65 or older or have a disability
• Has a limited income (both wages and pensions)
• Has limited essential resources
• Has full United States citizenship, is a U.S. national or has legal residency as a noncitizen
• Resides in one of the 50 states, Washington, D.C. or the Northern Mariana Islands
• People living in other U.S. territories are not included, except for military families and students studying abroad

Eligibility Requirements for Children

• Under the age of 18
• Have a physical or mental condition that impedes their daily life for 12 months or longer
• Live in a household with limited income and resources

SSI has more flexibility than OSS and SSDI when it comes to paying for the expenses to live in assisted living communities. You can use the funds to cover any payment, as you would with your own money.

However, there is still a fixed monthly cap on your supplemental income. The state determines how much you receive by increasing the unrounded annual amounts for the current year by the upcoming year’s cost-of-living adjustment.

Although SSI gives you more spending freedom, it doesn’t have the same monthly income potential as OSS and SSDI. The qualification process for SSI is also more arbitrary since the state determines whether or not you have limited income or resources.

Increase Your Social Security Benefits

If you’re an older adult well into retirement, odds are you already receive Social Security in some way. However, this initial payment might not be enough to make a sizable dent in your assisted living expenses. If you find yourself in this dilemma, consider increasing your benefits through OSS, SSDI or SSI.

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About the Author

Beth Rush

Beth Rush is the Managing Editor and Content Manager at Body+Mind.

Body+Mind features articles about diet, fitness, mental health, parenting and health care.