Social Security Benefits and Assisted Living

If you arrived on this webpage, you likely have questions about Social Security’s benefits for assisted living. You are wondering if Social Security pays for assisted living or if there exists a little-known, secret benefit that can help. You might be confused about the relationship between Supplemental Security Income, Optional State Supplements, Medicaid, nursing homes, and non-medical, residential care. You are likely bewildered by a swarm of acronyms like RCFE, SSI, OSS and NMOHC. Don’t worry, this article will sort it all out for you.

Social Security Definitions & Acronyms Explained

To help in understanding, it is best to provide some definitions and clear up any misconceptions.

• Social Security provides retirement income for seniors who have paid into the program, which includes almost everyone who has worked legally in the U.S.
• Supplemental Security Income (SSI) is financial help for persons with limited income and assets. SSI evaluates one’s income and fills in the gap to bring their income up to a pre-set amount. Learn more here.
• Optional State Supplements (OSS) is state-based financial help provided on top of the federal SSI benefits. OSS benefit amounts differ for each recipient and may vary depending on where they live (i.e. at home or in assisted living). It is under OSS where Social Security provides financial help for assisted living. OSS is also called State Supplementary Payments (SSP). Learn more here.
• Assisted Living provides non-medical care, meals, and activities in a group living environment. Bellow are other terms that may be used to refer to assisted living:

AFC – Adult Foster Care or Adult Family Care
ARCH – Adult Residential Care Homes
CBRF – Community Based Residential Facilities
CCFFH – Community Care Foster Family Homes
CRCF – Community Residential Care Facilities
NMOHC – Non-Medical Out of Home Care
OPNMI – Other Private Non-Medical Institution
RCAC – Residential Care Apartment Complex
RCF – Residential Care Facilities
RCFE – Residential Care Facilities for the Elderly
SCU – Special Care Unit

How Optional State Social Security Supplements Work

Optional State Social Security Supplements are complicated and confusing. However, families caring for an aging loved one need not understand every nuance. In a simplified view, OSS can help seniors pay for assisted living by providing money for assisted living room and board costs.

For persons who are financially eligible, states, through their Optional State Supplements, provide assistance to help pay for the room and board fees associated with assisted living or adult foster care. The benefit is provided as additional money over and above the amount they receive from Social Security SSI. However, the individual does not receive the money directly. Instead, it goes directly to their assisted living community or adult foster care home.

The exact amount of assistance is determined at the state level, with a national average of $145 per month. Though mentioned previously, it should be re-emphasized that the actual OSS amounts are calculated based on the individual’s income.

Eligibility for Optional State Supplement

Income Limits

Each state sets its own eligibility requirements for their Optional State Supplement (if they offer one). Most states base eligibility on the candidate’s income level. If their income is at or below the federal SSI benefit rate level, then they are also eligible for the Optional State Supplement. Having said that, some states make the income cut-off higher or lower than the federal SSI level. A few states use a different scale entirely; they set the income eligibility level based on a percentage of the state median income. In 2024, to be eligible for the federal SSI benefit, individuals must earn less than $1,971 per month from a job, or receive less than $963 per month from non-work sources, like unemployment or pensions.

Place of Residence

To be eligible for OSS for assisted living or adult foster care room and board costs, the recipient must live in an assisted living community or adult foster care home. Many states define assisted living and adult foster care differently. State by state assisted living and adult foster care definitions are available here. Note that this is not written for a consumer audience.

State-by-State Guide

The information below is the best data available as of March 2024. However, when a state provides assistance, the actual amounts may vary slightly from the numbers shown. Unlike the federal SSI rate, OSS amounts are not adjusted annually with a Cost of Living Adjustment (COLA). Again, it should be emphasized that an individual’s actual benefit amount is calculated based on their income. Therefore, any figures in the table below are relative, not fixed amounts.

How to Apply for Optional State Supplements

Prior to applying, it is recommended that one take the federal governments online screening for benefits located here. The application process and administering agencies are different in each state. In some states, eligibility for Medicaid automatically determines eligibility for SSI, which in turn automatically makes one eligible for the Optional State Supplement. In other states, one must apply directly for the Optional State Supplement. Finally, in other states, OSS is administered by the federal Social Security Administration. The table below contains the name of the administrative agency for OSS for each state. Persons interested in applying should contact these agencies. During the application process, one should expect to provide some or all the following documents for evidence of eligibility:

• Social Security Number
• Proof of Age
• Proof of Income
• Proof of Living Arrangements (specifically when living in assisted living or adult foster care)
• Proof of Citizenship
• Work History