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Minnesota's Elderly Waiver, Explained

The Elderly Waiver pays for services -- never room and board -- inside a licensed Minnesota assisted living facility. Here is how it actually works.

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Short answer

The Elderly Waiver (EW) is the Minnesota HCBS Medicaid waiver that can pay for care services, through "customized living" or "24-hour customized living" service packages, delivered inside a licensed assisted living facility, for seniors who are already Medical-Assistance-eligible and assessed as needing a nursing-facility level of care.

What it covers, and what it does not

EW pays for the care-services portion of assisted living -- personal care, medication management, health monitoring, and similar services billed under a customized living service plan. It does not pay for room and board. A resident using EW still owes the community's room-and-board charge out of pocket, from income, a family contribution, or (for very low-income residents in certain settings) Minnesota's separate state Housing Support benefit.

Administration and how to apply

The Minnesota Department of Human Services (DHS) sets policy for EW, but applications and assessments are handled locally through county or Tribal human services agencies, using the state's MnCHOICES assessment tool to determine nursing-facility-level-of-care eligibility. Start with your county's human services agency or call the Senior LinkAge Line at 1-800-333-2433 for a warm handoff.

Current waitlist and capacity status for EW was not confirmed during this site's research and should be verified directly with DHS or your county before advising a specific family.

Where to get free help in the Twin Cities

The entire seven-county Twin Cities metro -- Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington counties -- is served by a single Area Agency on Aging: Trellis (formerly the Metropolitan Area Agency on Aging). Because one agency covers the whole metro, families anywhere in the region use the same contact points rather than being split across regional agencies.

  • Senior LinkAge Line -- 1-800-333-2433 -- Minnesota's free, statewide information and assistance helpline for older adults and caregivers, operated by Trellis under contract with the Minnesota Board on Aging. Handles Medicare counseling, long-term-care options counseling, and waiver/assessment referrals. trellisconnects.org
  • Trellis (Area Agency on Aging) -- funds and coordinates caregiver support and respite, nutrition programs, and community-based aging services across the metro. trellisconnects.org
  • Disability Hub MN -- 1-866-333-2466 -- a companion statewide resource line for people with disabilities of any age. disabilityhubmn.org

Questions families ask

What senior care options exist in Ramsey County?

Ramsey County, anchored by St. Paul, Minnesota's state capital, is served by Regions Hospital (HealthPartners) and is home to the headquarters of the Minnesota Office of Ombudsman for Long-Term Care. Senior housing in Ramsey County, including Roseville and White Bear Lake, often includes communities in converted historic buildings alongside newer construction along transit corridors.

What senior care options exist in Dakota County?

Dakota County's fast-growing southern suburbs — Eagan, Burnsville, and Apple Valley — form the county's highest concentration of assisted living and memory care communities. Dakota County residents access the same Trellis Area Agency on Aging, Senior LinkAge Line, MAARC, and MDH licensing verification tools available across the entire seven-county metro.

What senior care options exist in Anoka County?

Anoka County's north metro suburbs, including Blaine and Coon Rapids, are served by the same statewide MDH licensing framework, MAARC abuse-reporting line, and Trellis Area Agency on Aging as the rest of the Twin Cities metro — there is no separate north-metro-specific regulatory or funding structure.

What senior care options exist in Washington County?

Washington County, including Woodbury and Stillwater along the St. Croix River valley, has the metro's highest share of residents age 65+ at 18.8% — meaning it is, proportionally, the fastest-aging of the seven Twin Cities metro counties. It uses the same statewide Trellis, Senior LinkAge Line, MDH licensing, and MAARC resources as the rest of the metro.

Is care different in Bloomington versus other Hennepin County suburbs?

No — Bloomington operates under the identical Minnesota statewide licensing (Chapter 144G), Medicaid waiver (Elderly Waiver/Alternative Care), and abuse-reporting (MAARC) framework as every other city in Hennepin County and the broader metro. What varies city to city is the local supply, style, and pricing of individual communities, not the underlying regulatory or funding structure.

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