How to Pay for Assisted Living in Washington, DC (2026)

When you're working out how to pay for assisted living in Washington, DC, start here: DC Medicaid can pay for the care in assisted living, but it never pays the room and board.1

That one rule shapes every plan below. Private income and savings usually come first, then long-term care insurance or VA Aid and Attendance if your parent has them. For residents who get or qualify for Supplemental Security Income (SSI), the District's Optional State Supplemental Payment (OSSP) adds monthly income toward living expenses, and DC Medicaid's Elderly and Persons with Physical Disabilities (EPD) Waiver pays for the assisted living care itself.1 This guide takes each payer in turn, so you can see which ones fit your family and what to do next.

In This Guide

• What Assisted Living Costs in DC
• Paying Privately, and Why Medicare Won't Cover the Bill
• Long-Term Care Insurance
• OSSP: Extra Monthly Income for SSI-Level Residents
• Does Medicaid Pay for Assisted Living in DC? The EPD Waiver
• How to Pay for Assisted Living in Washington, DC: Putting It Together
• Frequently Asked Questions

What Assisted Living Costs in DC

It helps to know the number you're planning against, even when that number is hard to look at. In CareScout's 2025 Cost of Care Survey, released for Washington, DC on March 2, 2026, the median annual cost of assisted living was $77,934, based on 12 months of care in a private one-bedroom unit.2 CareScout collects its rates across a metropolitan area, and its DC-area region can include counties in nearby states, so treat the median as a planning anchor rather than a quote for any one residence.2

In the District, assisted living is licensed as an Assisted Living Residence under the Assisted Living Residence Regulatory Act of 2000, and DC Health regulates it. Every DC Assisted Living Residence must provide 24-hour supervision, three meals a day plus snacks, at least some help with daily activities, and laundry and housekeeping.5 When you ask a residence for its price, ask it to separate the base monthly charge from any care-level fees, because the payers below treat those two parts very differently.

Paying Privately, and Why Medicare Won't Cover the Bill

Many families are surprised, and a little angry, to learn that Medicare won't pick up this cost. Medicare Part A and Part B don't pay the room-and-board or custodial-care costs of an assisted living facility, meaning the help with bathing, dressing, and eating that most assisted living provides.3 A Medigap policy doesn't cover assisted living's room and board or custodial care either. A Medicare-covered medical service stays covered while your parent lives in assisted living; what Medicare won't pay is the facility's own room-and-board and personal-care charge.3

So most families start with private money:

• Income: Social Security, pensions, and retirement-account withdrawals.
• Savings and investments, drawn down on a schedule you write out in advance, so you know roughly which month they would run low.
• The family home, sold or rented once no one is living in it. If Medicaid may be needed later, get advice on timing first, because how the proceeds are held can affect eligibility.

That written timeline matters more than it seems. Knowing the month when savings would run short is what lets you apply for the programs below before a crisis, not during one.

Long-Term Care Insurance

If your parent bought a long-term care insurance policy years ago, find it now, even if no one has looked at it in a decade. Read it for the daily or monthly benefit, the elimination period you pay out of pocket before benefits start, and whether assisted living is a covered setting.

You may also hear about a state Long-Term Care Partnership policy, which can protect some assets from Medicaid. Long-Term Care Partnership programs are a state option, not a national program: one exists only where a state has an approved Medicaid state plan amendment.6 We could not confirm whether the District currently runs one, so if a policy is described as a Partnership policy, ask the insurer and the DC Department of Health Care Finance (DHCF) how it would be treated in the District before you rely on it.

OSSP: Extra Monthly Income for SSI-Level Residents

If your parent lives on a small income and is eligible for Supplemental Security Income (SSI), this is the program worth knowing about, because it's built for people living in a residence like assisted living. The District's Optional State Supplemental Payment (OSSP) program is administered by the Social Security Administration (SSA) in partnership with the District. The District's OSSP provides a monthly supplemental payment to eligible people who live in an Adult Foster Care Home, which DHCF defines to include Certified Residential Facilities (CRFs) and Assisted Living Facilities (ALFs), or in a nursing facility.1

Your parent may qualify for OSSP if they:1

• Are a District resident living in a District-licensed CRF, ALF, or nursing facility.
• Are eligible for SSI or meet SSI eligibility standards.
• Meet the SSI resource limit of $2,000 for an individual or $3,000 for a couple.1

The OSSP table shows combined SSI-plus-OSSP totals, not an extra payment on top of SSI. For an individual in a DC assisted living facility with 50 or fewer beds, the 2026 total is $994 in federal SSI plus $681 from OSSP; in a larger facility, it's $994 plus $791.1

A few details make a real difference in practice.1

• You have to apply. In DC, a resident of an assisted living facility must submit an OSSP application, or have a representative submit it. DC nursing facility residents on SSI get OSSP automatically, but DC ALF residents don't. The District and SSA decide OSSP applications within 45 days.
• The check goes to the person, not the residence. SSA pays SSI and OSSP as a single payment to the beneficiary or their representative payee. The combined SSI and OSSP payment reaches the ALF directly only if the ALF is chosen as representative payee and SSA approves the ALF as payee.
• A personal needs allowance is protected. For 2026, the personal needs allowance for DC OSSP residents of adult foster care homes is $141 a month, and an ALF acting as payee must pay the $141 allowance to the resident.1
• OSSP opens the door to Medicaid. A person found eligible for OSSP is automatically eligible for DC Medicaid.

That last point connects OSSP to the EPD Waiver below, which can pay for the care side of the same residence.

Does Medicaid Pay for Assisted Living in DC? The EPD Waiver

This is the question most families arrive with, and the honest answer is "partly." It's better to learn that now than the month savings run out.

What the EPD Waiver pays, and what it doesn't

DC Medicaid's Elderly and Persons with Physical Disabilities (EPD) Waiver is a home and community-based services waiver that lets DC residents who would otherwise need nursing-home care get services at home or in an assisted living community instead.1 For DC assisted living, Medicaid pays an EPD Waiver all-inclusive per diem rate for services, set under 29 DCMR 4238 of the District of Columbia Municipal Regulations and published in DHCF's fee schedule under procedure code T2031.1

DHCF's own FAQ is plain about the limit: "Medicaid reimbursement will not be made for 24-hour skilled care costs associated with facility maintenance, upkeep and improvement, and room and board."1 In practice, your parent's monthly bill splits in two: the EPD Waiver covers the care, and the room-and-board charge stays with your family. That's why the question to ask every residence is what its room and board costs on its own. For an SSI-level resident, OSSP is the District program that helps with living expenses on that side of the bill.1

Who qualifies for the EPD Waiver

Your parent generally needs to meet all of these, according to the DC Department of Aging and Community Living (DACL) and DHCF:1

• A District resident and a U.S. citizen or qualified immigrant.
• Age 65 or older, or 18 to 64 with a physical disability.
• Needs help with daily activities and meets a nursing home level of care.
• Countable income under 300% of the SSI rate, which puts the 2026 DC EPD Waiver income limit at $2,982 a month for an individual.4
• Countable assets, such as a savings or checking account, no higher than the EPD Waiver's $4,000 limit for an individual.1
• Chooses home and community-based services rather than institutional care.

DACL's EPD Waiver page still shows an income limit of $2,743 a month, a figure labeled 2023; the 2026 DC EPD Waiver income standard is $2,982 a month.4

Income over the EPD Waiver limit isn't automatically the end of the road. DACL lists spend-down as an EPD Waiver alternative, and DHCF's long-term care rules let someone with high medical expenses qualify by meeting a spend-down obligation over a six-month period.1,7 DC Medicaid coverage through spend-down doesn't roll over on its own: at the end of each six-month period, your parent must file a new application.7

Two more points from DHCF's long-term care rules. A person already receiving SSI has no separate DC Medicaid income or asset limit to meet, because SSI recipients are categorically eligible for DC Medicaid. And for a married applicant, DC Medicaid's $6,000 resource figure for a couple is a limit on the applicant's own countable resources, not the rule for a spouse who stays at home, so read our guide to DC spousal impoverishment rules before you assume the worst.7

The look-back and estate recovery

Federal Medicaid law sets a 60-month look-back on assets given away for less than fair market value. A transfer inside the 60-month Medicaid look-back window can trigger a penalty period during which Medicaid won't pay for nursing facility care or for services under a Section 1915(c) home and community-based services waiver, though the rest of your parent's Medicaid coverage continues.8 Ask DHCF or an elder law attorney before moving money.

DHCF must also ask for repayment from the estate of a DC Medicaid beneficiary who received coverage at age 55 or older, with protections for a surviving spouse and certain children. Our guide to DC Medicaid estate recovery explains who is protected.9

How to apply for the EPD Waiver

1. Get the Prescription Order Form. For the EPD Waiver, a DC Medicaid provider, usually your parent's doctor, completes a Prescription Order Form (POF).1
2. Complete the assessment. For the EPD Waiver, Liberty Healthcare does a face-to-face assessment to set your parent's level of need.1
3. Apply for DC Medicaid if your parent isn't enrolled. You can apply online at District Direct, by phone at (202) 727-5355, by mail, or in person at a DC Department of Human Services (DHS) Economic Security Administration (ESA) Service Center; the District doesn't require an in-person interview.10
4. Ask the residence whether it takes EPD Waiver residents, and ask DACL whether there is any wait for assisted living under the waiver. We could not confirm whether EPD assisted living has a waiting list or a cap, so don't assume a slot is open until DACL tells you.

For eligibility detail beyond assisted living, see our guides to DC's EPD Waiver and other HCBS waivers and DC Medicaid long-term care.

How to Pay for Assisted Living in Washington, DC: Putting It Together

No two families fit the same plan, and it's fine if yours takes a few tries to work out. Here is how the payers usually line up, by situation.

• Your parent has savings or a home. Private pay covers the early months. Write out how long the money lasts, and if Medicaid may be needed later, learn Medicaid's 60-month look-back before you move assets.8
• Your parent is a wartime veteran. Look into VA Aid and Attendance early; our guide to how VA Aid and Attendance pays for assisted living covers who qualifies, and a VA-accredited representative can help before your family moves any money.
• Your parent lives on SSI-level income. OSSP and the EPD Waiver work as a pair: OSSP raises monthly income for living expenses, and OSSP eligibility brings DC Medicaid, the first requirement for EPD Waiver services, which also require a nursing home level of care.1
• Your parent is already on DC Medicaid. Start the EPD Waiver steps above, then ask whether they also qualify for OSSP to help with the room-and-board side.1

Whichever row fits, the hardest step is usually the first phone call. Making it before savings run low gives you time to choose a residence on your own terms.

Learn More

Find personalized help paying for assisted living in Washington, DC at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.