Free senior care guidance for Twin Cities families. No cost to you, ever.
Call (651) 390-4719
Minneapolis Senior AdvisorTwin Cities • Trusted • Free

In-Home Waiver Help: Elderly Waiver and Alternative Care

Minnesota does not run a separate in-home-only waiver -- the Elderly Waiver covers in-home services too, with Alternative Care as a pre-Medicaid bridge program.

Get matched freeCall (651) 390-4719
Home›State Rules›In-Home Waiver Help: Elderly Waiver and Alternative
Short answer

Minnesota does not split "assisted living" and "in-home" into separate waiver programs the way some states do. The same Elderly Waiver (EW) that pays for services inside assisted living also covers in-home personal care, homemaker services, home health aide visits, and related supports for Medical-Assistance-eligible seniors assessed as needing a nursing-facility level of care.

Alternative Care: the pre-Medicaid bridge

For seniors who need EW-equivalent help but are not yet Medical-Assistance-eligible, Minnesota funds a second, state-only program: Alternative Care (AC). It offers a nearly identical service array and cost cap to EW, specifically designed to delay or prevent a Medicaid spend-down or a premature nursing home placement.

Who administers it

Both programs are set at the state level by DHS and administered locally through county and Tribal human services agencies, coordinated regionally through Trellis, the Twin Cities' Area Agency on Aging, and the Senior LinkAge Line (1-800-333-2433).

Free help in your area. Trellis, the Twin Cities Area Agency on Aging, and the Senior LinkAge Line (1-800-333-2433) cover the entire metro at no cost. Read the full explanation →

Questions families ask

What are Minnesota's income and asset limits for nursing home Medical Assistance in 2026?

Minnesota is a '209(b) medically needy' state with no fixed income cap — income above the Medically Needy Income Limit (commonly cited around $1,305/month for an individual in 2026) must be spent down on medical or care costs each budget period. Countable assets are generally limited to around $3,000 for a single applicant and $6,000 for a couple both applying, though these specific dollar figures are third-party sourced and should be reconfirmed against DHS's Eligibility Policy Manual before relying on them for a specific case.

How much can a healthy spouse keep if their partner needs Medicaid-covered nursing home care in Minnesota?

Under Minnesota's Community Spouse Asset Allowance (Minn. Stat. 256B.059), a non-applicant spouse can generally protect between $32,532 and $162,660 in assets (2026 federal figures), plus a Minimum Monthly Maintenance Needs Allowance of income ranging from about $2,705 to $4,066.50 per month, depending on their own income and housing costs.

What is Minnesota's Medical Assistance Estate Recovery Program, and can the state take my parent's house?

Minnesota's Estate Recovery Program (MERP), under Minn. Stat. 256B.15, lets the state file a claim after a Medical Assistance recipient's death (and, if married, generally after the surviving spouse's death too) to recover what MA paid for long-term services and supports. Minnesota's program can reach beyond the probate estate to jointly held property, life estates, transfer-on-death deeds, and revocable trusts, so common probate-avoidance planning doesn't automatically shield a home.

What is Minnesota Senior Health Options (MSHO) and who qualifies?

MSHO is Minnesota's voluntary integrated managed-care program for people 65+ who are enrolled in both Medical Assistance and Medicare Parts A & B — it combines Medicaid, Medicare, and Part D benefits into one coordinated plan with a single care coordinator. Plan availability varies by county and by year, so families should confirm which MSHO health plans currently serve their specific Twin Cities county.

What does assisted living cost in the Twin Cities?

Minnesota's statewide median for a private one-bedroom assisted living apartment is cited at roughly $6,573/month in third-party sources referencing the CareScout Cost of Care Survey — figures that could not be independently verified against CareScout's own published tables during this research and should be confirmed before relying on them. CareScout publishes state-level figures only, not a Twin-Cities-specific median, and metro-area facilities likely run above the state figure given regional cost of living.

Not sure where to start?

Answer five questions and a local advisor will come back with senior care options in your area that actually fit your situation and budget. It is free, and there is no obligation.

Find care options
Find senior care — free