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Medicaid Supplementation Overview
Summary
Medicaid has strict rules about when a senior living provider can request a supplemental payment from a Medicaid resident or their family. These guidelines protect residents from improper charges and help professionals give accurate, consistent advice. This page provides a clear overview of the requirements and links to the full ASRP summary for easy reference.
Medicaid has clear rules about when a licensed adult family home or assisted living community can charge a supplemental payment. These rules protect residents from unexpected fees, and they help professionals give accurate guidance to families. Many people are surprised to learn that providers cannot add extra charges for services or items already included in the Medicaid daily rate. Supplemental payments are allowed only in limited situations, usually when a unit has a unique amenity that others do not offer.
Understanding these guidelines is important for anyone supporting a Medicaid-funded resident. Families can make more confident decisions when they know what a provider can and cannot charge for, and professionals can help ensure that policies are consistent with state regulations. These rules also clarify what happens when someone converts from private pay to Medicaid and what notices a provider must give.
This resource was prepared by the Association of Senior Referral Professionals of Washington to support transparency, informed decision-making, and consistent standards across senior housing and care.