No. North Carolina does not have a Medicaid HCBS waiver dedicated to covering assisted living or adult care home room and board. Instead, low-income adult care home residents may qualify for the State/County Special Assistance (SA) program, a state- and county-funded cash supplement (not a Medicaid waiver) that helps pay for room and board, with SA recipients also automatically becoming eligible for Medicaid to cover medical and personal care costs.
The detail behind the number
Families researching how to pay for assisted living sometimes search for a 'Medicaid assisted living waiver' modeled on programs that exist in some other states, but North Carolina has no such waiver in its Medicaid portfolio. The mechanism that actually helps low-income NC residents afford adult care home placement is the State/County Special Assistance program, which is explicitly a state- and county-funded cash assistance program layered with automatic Medicaid eligibility, not a 1915(c) Medicaid waiver -- this distinction matters because SA has its own eligibility rules and payment structure set by the NC DHHS Special Assistance Manual, separate from Medicaid waiver rules. A higher SA payment rate applies to residents with Alzheimer's disease or a related disorder living in a licensed Special Care Unit. Because SA payment rates change periodically, Triangle families should confirm current rates with their county DSS office rather than relying on outdated figures found online.
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