Surviving long housing waitlists while relying on Medicare

Content

Why senior housing waitlists are so long in the United States and what that means for Medicare
How long senior housing waitlists can be across the U.S.
What to do while you are on a senior housing waitlist
Using Medicare covered care to stay stable while you wait
Short term skilled nursing facility (SNF) stays
Home health services through Medicare
Using PACE to stay in the community
Temporary rent help, motel vouchers, and other bridge options
Roommate and shared housing strategies for older adults
How to avoid losing your spot on a housing waitlist
Talk with your care team and get coordinated support
Frequently asked questions
References

Why senior housing waitlists are so long in the United States and what that means for Medicare

If you are waiting for affordable senior housing in the United States, you are not alone. Many public and subsidized housing programs have more eligible people than units available.

National data that draw on federal housing sources show that people who ultimately receive subsidized housing wait about two years on average before moving in, and in some states the typical wait is significantly longer.

Housing authorities and nonprofit researchers also describe a pattern of closed waiting lists, lotteries, and long delays for vouchers or senior buildings, especially for people with very low incomes.

At the same time, Medicare is a health insurance program. It does not pay for most long term housing or custodial care, such as assisted living or ongoing room and board in a nursing home.

Medicare’s own guidance explains that you pay 100 percent of the cost for most long term care services that mainly involve help with daily activities like bathing, dressing, or using the bathroom, rather than skilled medical care.

Because of this, you might find yourself searching phrases like:

• “Senior housing waitlist what to do meanwhile”
• “Medicare and senior housing wait list options”
• “How long are senior housing waitlists in my city”

This article focuses on what you can do anywhere in the U.S. to stay as safe and stable as possible while you wait, and how to avoid losing your place on the list.

How long senior housing waitlists can be across the U.S.

Wait times vary by program and location, but several national sources show the same overall picture.

• A nationwide analysis that uses U.S. Department of Housing and Urban Development (HUD) data reports that in 2024, people who received subsidized housing had already waited about 27 months on average.
• Policy analyses of housing choice vouchers (often called Section 8) describe families waiting years before receiving assistance, especially in larger metropolitan areas.

When you look up “How long are senior housing waitlists in [city],” you will usually see that:

• Wait times vary widely between cities, suburbs, and rural areas
• Some housing agencies temporarily close lists when demand is high
• Many programs require you to still meet income and eligibility rules at the time your name is pulled, not just when you first applied

You cannot fully control how long a housing waitlist will take. You can control how you care for your health, protect your current housing, and stay active on every list.

What to do while you are on a senior housing waitlist

It can help to think in three parts:

1. Use Medicare covered services to stay medically stable and reduce crises
2. Look for short term housing and financial help to prevent homelessness
3. Stay in good standing on every housing waitlist so you do not lose your spot

The next sections explain each area in more detail.

Using Medicare covered care to stay stable while you wait

Medicare will not solve a housing waitlist, but it can support your health while you wait. Covered services can reduce hospitalizations, falls, and other crises that put your housing at risk.

Short term skilled nursing facility (SNF) stays

Medicare Part A may cover a short stay in a skilled nursing facility if you meet certain conditions, usually after a hospital stay.

According to Medicare:

• You generally need a qualifying inpatient hospital stay and a doctor’s order stating that you need daily skilled nursing or therapy
• The facility must be Medicare certified
• In each benefit period, Medicare may cover up to 100 days if you continue to meet coverage rules, with no daily coinsurance for days 1 through 20 and a daily coinsurance for days 21 through 100

These short SNF stays are designed for rehabilitation and skilled care. They are not long term housing. However, they can give you time to recover, work with therapists, and coordinate next steps.

If you are in the hospital and worried about housing:

• Tell the hospital case manager or social worker that you are on a senior housing waitlist
• Ask if you qualify for a short SNF stay, and how long it might realistically last
• Use the time to update your housing paperwork, collect documents, and connect with community agencies

Home health services through Medicare

If leaving your home is very difficult and you need skilled care, Medicare may cover home health services.

Medicare explains that home health services are covered when:

• A doctor or certain other qualified clinician orders your care and develops a plan
• You need part time or intermittent skilled nursing care, or physical, speech, or occupational therapy
• You are considered “homebound,” meaning leaving home is a major effort and not recommended for your health
• A Medicare certified home health agency provides the services

When these conditions are met, you typically pay nothing for covered home health visits, although you may pay 20 percent of the Medicare approved amount for certain durable medical equipment.

Home health can be very helpful if you are:

• Waiting on a housing list but still living in your own place
• Staying with family or friends and need help managing chronic conditions
• Trying to avoid hospital readmissions that could further disrupt your housing

Home health is not round-the-clock caregiving, housekeeping, or long term personal care. It focuses on skilled care and short visits, often combined with limited home health aide help when you are also getting skilled services.

Using PACE to stay in the community

The Program of All Inclusive Care for the Elderly (PACE) is a joint Medicare and Medicaid model that provides comprehensive medical and social services to certain older adults who meet nursing home level of care but can live safely in the community with support.

CMS and Medicare describe PACE as a program for people who:

• Are age 55 or older
• Live in a PACE service area
• Meet their state’s criteria for nursing home level of care
• Can live safely in the community at the time of enrollment with PACE services

A PACE organization coordinates:

• Primary and specialty medical care
• Adult day health services
• Home care and personal care
• Medications, transportation, and equipment

If you qualify and PACE is available near you, it may be one of the strongest ways to remain in the community safely while you wait for senior housing. The PACE team can also help document your medical needs for housing applications.

Other Medicare supports that can help

Depending on your coverage and where you live, you may also have access to:

• Telehealth visits for certain kinds of follow up or behavioral health care
• Outpatient mental health services for depression, anxiety, or stress related to housing insecurity
• Durable medical equipment, such as walkers, shower chairs, or raised toilet seats that make a temporary living situation safer

Understood Care advocates and clinicians can help you understand which Medicare benefits apply in your situation and how to put them in place while you wait for a housing opening.

You can learn more about how Understood Care supports this type of planning at:

• Understood Care Care Coordination: https://understoodcare.com/care-types/care-coordination
• Understood Care Home Care: https://understoodcare.com/care-types/home-care

Temporary rent help, motel vouchers, and other bridge options

While Medicare focuses on health, other systems focus on housing stability and homelessness prevention. These programs vary across the U.S., but there are common types of support.

Emergency rental assistance and eviction prevention

Many communities offer short term help with rent or utilities, often funded through federal, state, or local dollars. These programs may run through:

• Local public housing agencies
• Community action agencies
• Faith based and nonprofit organizations

Federal and national resources highlight several types of programs:

• Emergency Solutions Grants (ESG) support outreach, emergency shelters, rapid rehousing, and homelessness prevention activities.
• National housing and aging agencies emphasize using a mix of rent support and community based services to help older adults remain housed.

To look for temporary rent help anywhere in the U.S.:

• Call 211 if available in your area and ask about rent help or eviction prevention for older adults
• Contact your local Area Agency on Aging or Aging and Disability Resource Center
• Use the Eldercare Locator, a national service sponsored by the Administration for Community Living, to find local aging services by ZIP code

Programs may help with:

• One time or short term rent payments
• Utility shutoff prevention
• Security deposits for a more affordable unit
• Referrals to legal aid or financial counseling

Motel and hotel vouchers as short term safety

In some areas, homeless service systems or social service agencies use motel or hotel vouchers as a short term option when shelters are full or when someone is medically fragile.

These vouchers are usually:

• Time limited
• Focused on people at immediate risk of sleeping outside
• Linked to case management or housing navigation when possible

If you think you may lose your housing soon:

• Tell your doctor, social worker, or care coordinator right away
• Ask 211, your local aging network, or homeless services program if motel vouchers, medical respite, or other short term shelter options exist for older adults or people with disabilities
• Explain any serious health issues, oxygen needs, or mobility challenges, because those can affect which options fit your situation

Finding local help anywhere in the U.S.

Agencies at the national level encourage people to connect health care, housing, and social services instead of trying to manage each system alone.

You can:

• Use the Eldercare Locator to find your local Area Agency on Aging
• Ask specifically about emergency housing, rent help, and legal aid
• Reach out to Understood Care for help coordinating local referrals and benefit applications

For help connecting to community resources, you can also visit:

• Understood Care Social Support: https://understoodcare.com/care-types/social-support
• Understood Care Application Help: https://understoodcare.com/care-types/application-help‍

Roommate and shared housing strategies for older adults

Because rents are high in many parts of the U.S., shared housing has become more common for older adults.

AARP and other national organizations describe house sharing as one way to:

• Lower housing costs
• Reduce loneliness
• Make it easier to age in place

At the same time, they stress the need for careful planning and safety.

Deciding if a roommate is right for you

Ask yourself:

• Are you comfortable sharing a kitchen, living room, or bathroom
• Do you need a very quiet space because of pain, sleep issues, or dementia
• Do you use mobility aids or oxygen that a roommate would have to live around
• Do you feel safer with a roommate of a certain gender or age range

Some common arrangements include:

• Two older adults renting a place together and splitting costs
• An older homeowner renting out a room to a carefully screened tenant
• Matches made through a structured homeshare program that screens participants and helps draw up agreements

Safety, screening, and legal tips

To keep shared housing as safe as possible:

• Whenever you can, use a structured homeshare program or a reputable nonprofit that specializes in roommate matching for older adults
• Meet potential roommates multiple times and, at least at first, in public places
• Ask for references and permission to run a background check
• Use a written rental agreement that covers the rent amount, payment date, house rules, quiet hours, guests, pets, and what happens if someone needs to move out
• Contact legal aid or a tenants rights group for help understanding landlord–tenant laws in your state

An Understood Care advocate can help you think through whether a roommate fits with your health needs and can coordinate with your clinicians if you decide to move.

How to avoid losing your spot on a housing waitlist

One of the biggest risks while you wait is being removed from a housing waitlist without realizing it.

Federal regulations for the Housing Choice Voucher program, and public housing administrative guidance, allow public housing agencies to remove applicants who do not respond to requests for information or fail to keep their contact information up to date, as long as these rules are written in the agency’s plan.

That means staying reachable is critical.

Keep your contact information current

Most housing authorities and property managers rely on:

• Mailing addresses
• Phone numbers
• Email addresses, if available

If any of these change while you are on a list:

• Notify every public housing agency, voucher program, and senior building where you applied
• Ask them to confirm that they updated your record
• Keep a simple log with the name of the program, the date you updated them, and any reference number

If you have trouble managing mail or voicemail, consider asking a trusted family member, friend, or advocate to help you check regularly.

Respond to every letter, email, or text

Housing agencies may send notices that:

• Ask you to confirm that you still want to remain on the waitlist
• Request updated income, disability, or household information
• Offer you an apartment or voucher and give a short deadline to respond

If you do not reply within the time stated in the letter, the agency may move on to the next person or remove you from the list.

To protect your place:

• Open and read every letter from housing agencies as soon as possible
• Call the phone number on the letter if anything is unclear
• If you have a disability that makes it hard to respond, let the agency know and ask about reasonable accommodations, such as extra time or help with forms

Document everything and ask about appeals

If you are told your application has been closed or you think a mistake was made:

• Save copies or photos of all applications, letters, and emails
• Write down the date, time, and name of any staff member you speak with
• Ask for information about the agency’s appeal or grievance process

Federal regulations require public housing agencies to have written admission policies and to manage their waiting lists according to those policies.

Legal aid organizations, disability rights groups, or tenants rights groups in your state may be able to help if you believe you were removed from a waitlist unfairly.

Talk with your care team and get coordinated support

Managing Medicare, multiple housing applications, and daily health needs at the same time can feel overwhelming. You do not have to do this alone.

Bring housing into your health care conversations:

• Tell your primary care clinician and specialists if you are on a senior housing waitlist
• Ask them to document any health and safety risks in your current housing, like frequent falls on stairs, lack of elevator access, or difficulty bathing safely
• Request referrals to social workers, case managers, or community health workers who understand local housing resources

National aging and disability agencies emphasize that combining housing support with health and community services helps people live more safely in the community.

Understood Care advocates can:

• Help organize and track your housing waitlists
• Prepare and organize medical documentation for housing applications
• Coordinate Medicare covered services such as home health or rehabilitation
• Connect you with community resources and financial help for related benefits

You can learn more at:

• Understood Care Application Help: https://understoodcare.com/care-types/application-help
• Understood Care Social Support: https://understoodcare.com/care-types/social-support
• Understood Care Care Coordination: https://understoodcare.com/care-types/care-coordination‍

Frequently asked questions about senior housing waitlists and Medicare

• How long are senior housing waitlists in the United States?
  National summaries based on HUD data show that people who receive subsidized housing have typically waited about two years or more, and in some places the average is significantly longer. Individual waiting times depend on how many people are ahead of you, how many units are available, and local funding.
• What can I do while I am on a senior housing waitlist and relying on Medicare?
  You can use Medicare covered services such as short stays in skilled nursing facilities, home health care, and possibly PACE to stabilize your health. At the same time, you can look for temporary rent help, utility assistance, motel vouchers, or shared housing options and stay in close contact with housing agencies so you keep your spot on the list.
• Does Medicare pay for assisted living or long term housing costs?
  No. Medicare is health insurance and does not pay for most long term custodial care, including room and board in assisted living or ongoing nursing home stays when you only need help with daily activities. Medicare may cover limited skilled nursing facility care, home health services, and hospice care when specific medical criteria are met.
• Can I use a skilled nursing facility as a place to live while I wait for housing?
  Medicare only pays for skilled nursing facility care for limited periods when strict conditions are met, usually after a qualifying hospital stay and when you need daily skilled care. Coverage is generally limited to up to 100 days per benefit period. After that, you pay all costs yourself. A SNF stay can be a short bridge for rehabilitation but is not a long term housing solution.
• What is PACE and how does it help with senior housing waitlist issues?
  PACE, the Program of All Inclusive Care for the Elderly, is a joint Medicare and Medicaid model that provides comprehensive medical and social services to people age 55 and older who need a nursing home level of care but can live safely in the community with support. PACE can help you stay in your current home or community setting while you wait for senior housing by coordinating medical care, personal care, transportation, and other services.
• Where can I find rent help, motel vouchers, or other emergency housing support in my area?
  You can start anywhere in the U.S. by calling 211, contacting your local Area Agency on Aging, or using the Eldercare Locator to find local aging services. These agencies can tell you whether emergency rental assistance, eviction prevention, motel vouchers, or medical respite programs are available in your community.
• How do I avoid losing my place on a housing waitlist?
  Update your contact information with every housing program whenever your address, phone number, or email changes. Open every letter or email from housing agencies and respond by the stated deadline. Federal rules allow agencies to remove applicants who do not respond to requests for information, so staying reachable and replying quickly is one of the best ways to protect your spot.
• Who can help me coordinate Medicare benefits and housing applications?
  Your primary care clinician, hospital social worker, local aging network, and legal aid organizations are important partners. Understood Care advocates can also help coordinate your Medicare covered care, connect you with community resources, organize documentation, and track multiple housing applications so you are not doing it all by yourself.

References

• Medicare.gov. Long term care coverage. https://www.medicare.gov/coverage/long-term-care Medicare
• Medicare.gov. Home health services coverage. https://www.medicare.gov/coverage/home-health-services Medicare+2Medicare Interactive+2
• Medicare.gov. PACE (Program of All Inclusive Care for the Elderly). https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE Medicare
• Centers for Medicare & Medicaid Services. Program of All Inclusive Care for the Elderly (PACE). https://www.cms.gov/medicare/medicaid-coordination/about/pace Centers for Medicare & Medicaid Services+2Medicaid+2
• USAFacts. How long do people wait for subsidized housing in the United States. https://usafacts.org/answers/how-long-do-people-wait-for-subsidized-housing/country/united-states/ USAFacts+1
• Center on Budget and Policy Priorities. Families wait years for housing vouchers due to inadequate funding. https://www.cbpp.org/research/housing/families-wait-years-for-housing-vouchers-due-to-inadequate-funding Center on Budget and Policy Priorities
• National Low Income Housing Coalition. Housing Spotlight: A Long Wait for a Home. https://nlihc.org/news/closed-waiting-lists-and-long-waits-await-those-seeking-affordable-housing-according-new-nlihc National Low Income Housing Coalition
• Electronic Code of Federal Regulations. 24 CFR 982.204 Waiting list: Administration of waiting list. https://www.ecfr.gov/current/title-24/part-982/section-982.204 eCFR
• Administration for Community Living. Eldercare Locator. https://eldercare.acl.gov/Home eldercare.acl.gov+2ACL Administration for Community Living+2
• Administration for Community Living. Housing and Services Resource Center. https://acl.gov/HousingAndServices ACL Administration for Community Living+2ACL Administration for Community Living+2
• U.S. Department of Housing and Urban Development. Emergency Solutions Grants (ESG) program and related homelessness resources. https://www.hudexchange.info/programs/esg/ HUD Exchange
• National Council on Aging. Seven things you should know about Medicare’s home health care benefit. https://www.ncoa.org/article/seven-things-you-should-know-about-medicares-home-health-care-benefit/ National Council on Aging
• AARP. How house-sharing can help your retirement plan. https://www.aarp.org/money/retirement/house-sharing-for-retirement-savings/ AARP+2Senior Planet from AARP+2
• Seniors Guide. Home sharing for seniors. https://www.seniorsguide.com/aging-in-place/home-sharing-for-seniors/ Seniors Guide

This article is for general education across the United States and does not replace professional medical, legal, or housing advice. If you are in immediate danger of losing housing or feel unsafe where you live, contact local emergency services or a crisis line right away.