How a Medicaid waiver made a home affordable

A family trying to make a hard choice

The family in this story was caring for an older adult who needed more day-to-day help than could be managed safely at home. They wanted a small, family-style setting, not a large facility, and they wanted to keep the move as dignified and calm as possible.

Like many families, they started with two questions: What kind of home feels right, and how can we pay for it? They had heard about Medicaid, but the rules were confusing. They also did not want to guess about what was covered or what each home would cost.

Learning what Medicaid waivers may help with

As a general matter, Medicaid rules vary by state. In some states, Medicaid waiver programs may help with the personal-care part of care in an adult family home, while room and board are often paid separately and usually privately. Whether a waiver applies depends on state rules, eligibility, and the home’s settings.

This family took time to confirm the basics with the state’s Medicaid office, the home, and the state licensing agency. That helped them understand what was only an estimate, what might be covered, and what still needed to be paid out of pocket. HearthRow did not make any financial decision for them; it simply helped them find licensed homes to consider. For more general background, see our guides.

Finding a smaller home that fit

The family wanted a licensed adult family home with a quieter feel and a clear daily routine. HearthRow helped them connect with homes near them that said they accepted the kind of payment setup they were exploring.

That first step did not guarantee a place, and it did not guarantee a price. It just helped them start conversations faster. They still had to ask each home about current availability, services, staffing, house rules, and whether the home’s current state license or certification was active.

What they checked before deciding

Before making a choice, the family visited the homes in person. They asked simple, direct questions and took their time.

• Is the home currently licensed or certified in this state?
• What services are included, and what costs extra?
• How does the home handle meals, medication reminders, and daily support?
• What is the monthly room-and-board cost estimate?
• How does the home work with Medicaid waivers, if at all?

They also asked their loved one how the home felt. Comfort, trust, and dignity mattered just as much as paperwork. A tour gave them a clearer picture than any phone call could.

How the waiver changed the picture

The waiver did not remove every cost, and it did not solve everything. But it helped make the home more realistic for the family’s budget by reducing the part tied to personal care, depending on the state rules and the home’s setup.

That was enough to move forward. The family could focus on whether the home felt safe, respectful, and manageable over time instead of feeling stuck at the start. They still confirmed details directly with the home and the licensing agency before making any decision.

A simple next step for other families

If you are in a similar situation, it can help to separate the questions:

• What type of home feels right for your loved one?
• What does your state say about Medicaid waivers?
• What is the home’s current license status?
• What will you pay privately, and what might be covered?

If you want help starting that search, get matched with licensed adult family homes near you. HearthRow is free for families, and some homes pay HearthRow a flat fee when we connect them with a family. It never changes what you pay, and you are never under any obligation.