Comparing options, answered plainly

What's the difference between assisted living and a supported home?

Size, who they serve, and who pays — the real differences.

Both are non-medical residential care, but they differ in size, who they serve, and who pays. Assisted living is usually a larger licensed community for older adults, often private-pay (some states cover the services via a Medicaid waiver). A supported home is smaller — often a handful of residents in a house — and frequently serves adults with I/DD or behavioral-health needs, commonly funded by Medicaid HCBS waivers with SSI for room and board.

Size and setting

Assisted living is typically a larger, apartment-style community. A supported home (also called a residential care home or supported-living home) is usually a single house with a few residents and staff support. The smaller setting is often a better fit for someone who needs a quieter, more individualized environment.

Who each one serves

Assisted living most often serves older adults who need help with daily activities. Supported homes frequently serve adults with intellectual/developmental disabilities, serious mental illness, or other specialized needs — including younger adults — though both vary by each state’s license type.

Who pays

Assisted living is often private-pay, though some states cover the services (not room and board) through a Medicaid waiver. Group-home services are commonly paid by a Medicaid HCBS waiver, with the resident’s SSI covering room and board. Neither is generally paid by Medicare.

Source: Medicaid.gov, HCBS — medicaid.gov.

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About Mai Heaven: this page is educational, not eligibility advice. We build small, permanent supported homes — also called group homes — for adults who are hard to place. Join the waiting list and we’ll reach out when a home opens near you. Need help now? Call or text 988, or dial 211.