If you are researching care options for an aging parent, cost is probably the first wall you hit. Assisted living in California often runs $4,200 to $8,500 a month, and that number climbs even higher for memory care. For context, our own published rates start between $4,750 and $5,250, at the low end of that range. Many families assume the only options are paying out of pocket until the money runs out, or moving a parent into a nursing home.
There is a third option that too few families know about: the Medi-Cal Assisted Living Waiver (ALW). This program allows eligible seniors to receive nursing home level care inside a licensed residential care facility, like Genesis Manor, instead of an institutional setting. Medi-Cal covers the cost of care and services, while the resident is responsible for room and board.
Below is a plain-language breakdown of how the program works, who qualifies, and how to start the application process.
What Is the Medi-Cal Assisted Living Waiver?
The ALW is a Home and Community-Based Services waiver created by the California Department of Health Care Services (DHCS). It was designed to give Medi-Cal eligible seniors an alternative to nursing homes by allowing them to receive equivalent care in a residential care facility for the elderly (RCFE) or, in limited cases, public subsidized housing.
In simple terms: if your parent already qualifies for nursing home level Medi-Cal benefits but would be better served living in a home-like setting with other residents, the ALW may allow Medi-Cal to pay for their care services in a facility like ours.
The program is currently approved to run through February 2029, though it operates with a limited number of slots and is not available in every county.
Is San Bernardino County Covered?
Yes. San Bernardino County is one of the 15 California counties currently participating in the ALW program, along with Los Angeles, Riverside, Orange, San Diego, and others. Because Genesis Manor’s homes are located in Rancho Cucamonga, Claremont, and La Verne, families in the Inland Empire may be able to use the waiver toward care in one of our homes, subject to eligibility and enrollment.
It is worth noting that a resident does not need to already live in a participating county. They only need to be willing to move into a facility that is located in one.
Who Qualifies for the ALW?
To be eligible, an applicant generally must:
- Have full-scope Medi-Cal with no share of cost
- Require a nursing facility level of care, meaning they need substantial help with daily activities like bathing, dressing, mobility, or medication assistance
- Be willing to live in an assisted living setting instead of a nursing facility
- Be able to reside safely in a licensed RCFE
- Be willing to live in a facility located in one of the 15 participating counties
The program also supports individuals with Alzheimer’s, other forms of dementia, traumatic brain injury, or behavioral health conditions, since the waiver can fund augmented care plans and additional one-on-one support for higher-need residents.
Income and Asset Limits to Know
Because the ALW requires full-scope Medi-Cal with no share of cost, income and asset limits matter.
Income: As of April 2026, a single applicant can generally have income up to roughly $1,836 per month, and a couple where both spouses are applicants up to roughly $2,490 per month. If only one spouse is applying, the income of the non-applicant spouse is not counted, and some income can even be transferred to that spouse through a Monthly Maintenance Needs Allowance.
Assets: After a period with no asset limit, California reinstated an asset test on January 1, 2026. The current limit is $130,000 for an individual and $195,000 for a couple where both spouses are applicants. This is far more generous than the old $2,000 limit that used to worry so many families. A primary home, one vehicle, household furnishings, and personal belongings are generally not counted toward this limit.
Room and board: The ALW pays for care services, not rent. Residents who receive SSI typically contribute their income toward room and board, keeping a small Personal Needs Allowance for themselves, with the facility receiving the rest to cover housing costs.
These figures change periodically, so we always recommend confirming current numbers with a Care Coordination Agency or a Medi-Cal planning professional before assuming eligibility.
How the Application Process Works
- Apply for Medi-Cal. If your parent is not already enrolled, the first step is a Medi-Cal application through the county Department of Public Social Services.
- Confirm full-scope eligibility with no share of cost. This is required before the ALW can be requested.
- Contact a Care Coordination Agency (CCA). These agencies manage ALW enrollment for each county and will schedule a nursing assessment to confirm the applicant needs a nursing facility level of care.
- Get on the list. Because slots are limited, most applicants are placed on a waitlist after their assessment. Wait times vary significantly by county, and demand has consistently outpaced available slots statewide.
- Choose a participating facility. Once approved, you will need a licensed RCFE that participates in the ALW program. This is where family research matters most, since not every community accepts waiver residents or has an open bed.
From application to confirmation, the full process commonly takes three to six months, so it is worth starting well before a placement becomes urgent.
Why Families Should Start Early
The honest truth about the ALW is that it is a valuable program with real limits. It is not available statewide, slots are capped, and waitlists exist in nearly every participating county. Families who wait until a crisis point, a fall, a hospital discharge deadline, a caregiver burnout, often find themselves needing a bed faster than the waiver process can move.
The families who navigate this most smoothly are the ones who start the conversation early: applying for Medi-Cal ahead of time, getting on a CCA’s radar, and touring facilities before a decision has to be made in a hurry.
How Genesis Manor Can Help
Genesis Manor has operated residential care homes in the Inland Empire since 1999, and we understand that pricing and payment options are often the deciding factor for families choosing between a nursing facility and a real home environment. We accept both Medi-Cal and VA benefits, and our team is happy to talk through what the Assisted Living Waiver could mean for your family’s specific situation. Compare all five homes side by side.
This article is intended for general informational purposes and is not legal, financial, or medical advice. Income limits, asset limits, and program availability change periodically. Please confirm current figures with a Care Coordination Agency, your county Medi-Cal office, or a qualified Medi-Cal planning professional.
More guides for families are in our resource library.
Where Families Usually Get Stuck
The Assisted Living Waiver has two hard realities: the wait can run up to two years, and slots are limited. Both mean the same thing, which is that the application should start well before the day it is needed. Our administrators can tell you which county office to contact, which Care Coordination Agency handles your area, and what we have seen actually move applications forward.
All five of our homes participate. We will also tell you honestly if the waiver is not the right route for your family’s situation.
