Updated September 4, 2026. Quick answer: yes, through Family Care (Wisconsin’s managed long-term care program combining 1915(b)/(c) authority). Medicaid does not pay the facility’s room and board either way; only the care and service component.
What Wisconsin covers
| Waiver / state plan option | Family Care (Wisconsin’s managed long-term care program combining 1915(b)/(c) authority) |
|---|---|
| Covers an assisted living setting? | Yes: “Family Care members can live in their own home, a licensed CBRF, a licensed or certified AFH, or certified RCAC.” |
| Room and board | Never covered by Medicaid, in Wisconsin or any state; see below. |
The room-and-board split
Federal law is the floor every state builds on: “The Secretary may by waiver provide that a State plan approved under this subchapter may include as “medical assistance” under such plan payment for part or all of the cost of home or community-based services (other than room and board) approved by the Secretary” (42 U.S.C. §1396n(c)(1), Social Security Act §1915(c)). The words in parentheses do the work: whatever a state’s waiver pays for inside an assisted living community, it is not the rent, the meals, or the room itself. That portion stays the resident’s own to fund, out of income, savings, or a family contribution; the waiver only ever reaches the care and service layer on top of it. Wisconsin’s own materials say the same thing directly: “IRIS and Family Care do not cover room and board. Room and board are the responsibility of the program members who must pay these costs out of pocket.” (Wisconsin DHS, “Assisted Living: Understanding Assisted Living Licensure and Certification and its Intersection with Medicaid” (dhs.wisconsin.gov)).
The waitlist
Open (no waitlist) : “Governor Walker and the state expand Family Care to the entire state. The wait list ends.” (as of 2015 (Family Care reached full statewide coverage by 2018 per the same DHS program-history timeline))
What you get to keep: the personal needs allowance
$55/month (Institutional Medicaid personal needs allowance) a month: “Effective July 1, 2024, the Institutional Medicaid personal needs allowance is $55 per month.” This is the amount of a waiver participant’s own income the state lets them keep for personal spending after the rest goes toward the cost of their care; it varies by state because each state sets its own figure inside the federal floor.
What this doesn’t answer
Coverage, room-and-board exclusion, waitlist history, and PNA amount are all backed by primary DHS sources read this session. One inconsistency flagged honestly: WI Admin Code DHS 10.34(3)(b)5.c names a separate $65 personal maintenance allowance for a person in a nursing home/CBRF/AFH in a different eligibility-determination context, while the DHS operations memo states the general Institutional Medicaid personal needs allowance is $55/month effective July 1, 2024: the $55 figure was used as the primary answer since it is explicitly labeled and dated, but the $65 figure suggests the allowance may vary by eligibility pathway.
Figures verified against the Wisconsin DHS assisted living and Medicaid page, the Wisconsin DHS Family Care page, DMS Operations Memo 24-13, Wisconsin Administrative Code DHS 10.34(3)(b) and 42 U.S.C. §1396n(c)(1) on September 30, 2026; the Family Care 1915(b)/(c) authority description and whether the $55 allowance applies to waiver members were not re-checked.
Sources
- Wisconsin DHS, Assisted Living and Medicaid Coverage
- Wisconsin DHS, Family Care program page and history timeline
- Wisconsin DHS Division of Medicaid Services, Operations Memo 24-13, “Institutional Medicaid Personal Needs Allowance Increase,” June 24, 2024
- Wisconsin Administrative Code DHS 10.34(3)(b)
Read September 4, 2026.
Same question, other states: Wyoming · District of Columbia.
Related: what assisted living actually costs · assisted living vs. staying home vs. a CCRC · why home care has a waitlist and a nursing home doesn’t.
General information drawn from each state’s own Medicaid agency and federal statute, not legal, tax or financial advice. Medicaid is administered state by state; waiver names, coverage decisions, waitlists and allowance amounts change by state budget and legislative action. This page cannot see your own state’s current caseload. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.
Related: Wisconsin’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.
Related: use the Medicaid spend-down calculator to estimate how much you would need to spend down to qualify for long-term-care Medicaid in your state.