Senior Housing for Low-Income Residents

For seniors who have modest incomes, paying for housing- whether a home they own, a rental, or a room in a facility that provides additional senior care assistance- can feel nearly impossible. According to the National Council on Aging, in 2019 over 25 million Americans 60 and older were living on $31,225 or less per year, a status recognized as “economically insecure.” For those who rent, have housing debt, or need some form of assisted living, such an income is often inadequate for their housing needs. 

According to Harvard’s Joint Center for Housing Studies 2020 report on housing costs, between 2013 and 2016 the number of affordable rentals (those costing $600 or less per month) fell from occupying 33% of the rental market to just 25%. Low-cost options are shrinking, and seniors who need a rental are facing a tight market for the kinds of units they can afford. Seniors who need to live in assisted living facilities and nursing homes face additional challenges as the costs in those facilities are dramatically higher than the costs of living independently in a rental. Assisted living cost an average of $48,612 in 2019, and living in a nursing home cost $102,200 per year for a private room. 

There are resources available for seniors who have inadequate incomes to pay the above housing costs. Finding a low-income housing option isn’t always easy, but knowing which government and nonprofit programs exist to help with housing can make all the difference. Below you’ll find information on programs that provide housing assistance to low-income seniors with a variety of housing needs. 

Matching Low-Income Seniors with Appropriate Housing Settings

Before you read about the assistance programs and low-cost housing options that are available, you’ll want to have a firm understanding of the kind of housing that’s likely to work for you or the low-income senior in your life. There are many forms of housing that seniors can use, and each has a slightly different purpose. We’ve divided the programs that we discuss into three basic categories: independent housing, supportive housing, and housing that includes significant medical care or supervision. Below you’ll find a table that briefly lays out the categories and the types of assistance that are associated with each. 

Overview of Housing Settings for Low-Income Seniors

Type of Senior  Assistance Required Appropriate Housing Settings
Seniors Living Independently  -Financial help with rental/housing costs -Single-family home
-Townhouse
-Apartment 
Senior Needing Supportive Housing  -Financial help
-Help with maintenance and some chores
-Some disability accommodations
-May need other services like transportation, social support, care coordination, or non-medical help
-Assisted living community/supportive housing for the elderly
-Virtual retirement community
-Any of the settings in the previous category if part-time caregivers or hired help can attend the senior regularly 
Senior Needing Nursing Home-Equivalent Housing -Financial help
-Help with all aspects of self-care
-May need accommodations for disabilities
-Needs constant supervision or a high level of medical care
-Memory care unit of an assisted living facility
-Nursing home
-Adult foster care/group home
-Any of the settings from the other two categories if comprehensive supervision, medical care, and other appropriate in-home services are present 

As you’ll notice in the table above, there’s some overlap of needs between categories. It’s helpful to see these categories as a continuum. A doctor may be able to help families determine when it’s time for a senior to seek out a less independent setting than they previously inhabited. It’s important to fully explore options and frankly discuss whether the senior’s social and physical needs are truly being met in their current housing setting.

Independent Living for Low-Income Seniors

Some seniors are in good enough health to live on their own or with a family member who helps them, but they may struggle to afford their current housing situation for a variety of reasons. Unforeseen financial hardships or retiring without sufficient savings can leave many seniors in a bad place when it comes to paying rent or maintaining a home that they own. Below we’ve listed some important programs that can help with these challenges. All of the programs in this category are focused solely on housing. No additional assistance is offered. 

Housing Choice Vouchers (HCV/Section 8)

The Housing Choice Voucher (HCV) is the largest housing assistance program in America. This program was initially established in 1974 as the Section 8 Voucher, and many people still call it that despite the recent name change. The HCV program subsidizes monthly rent costs for 2.3 million low-income households. Currently, 26% of people who participate in the Housing Choice Voucher program are seniors (defined as 62+). The Department of Housing and Urban Development (HUD) administers this program in partnership with local Public Housing Agencies (PHAs or HAs). Note that these organizations are also frequently referred to as “Public Housing Authorities”. These organizations are classified as nonprofits, and they work closely with HUD and various local or state-level branches of government. 

Housing Options 

A Housing Choice Voucher recipient can choose to live in a townhouse, single-family home, or an apartment. Those who receive the voucher look for their own rental, though they may ask their local PHA for help in the selection process. With the voucher, the tenant only pays 30% of their income in rent (which includes utilities), and HUD covers the rest of the cost. The PHA will handle the disbursement of this money to the local landlords, so the money will never go directly to the tenant. 

Vouchers can’t be used on all rental properties. The PHA must deem the rental costs “reasonable,” and in many locations, the landlord must agree to take the voucher (refusing to accept tenants who use vouchers is only illegal in a few areas of the country). Usually, reasonable rent is defined as no higher than 90%-110% of “fair market rent,” a number that the local PHA sets yearly based on data on new leases in the area. Fair market rent numbers can be obtained from the PHA directly or from HUD’s website.

Eligibility and Availability

To qualify for a voucher, applicants must meet the following criteria:

  • Be a U.S. Citizen or have “eligible” immigration status 
  • Be over the age of 18
  • Have an income that is no more than 50% of the area’s median income
  • Pass a background check (see details in the HCV PHA Guidebook)

The above requirements are general and will not apply everywhere, as certain locations have more specialized rules for eligibility. Those who are interested in getting a voucher must apply to their local PHA. The PHA assesses the family income, including some assets like bank accounts and retirement funds. They also will check with banks and employers to verify income claims.

As seniors apply for the Housing Choice Voucher program, they need to be aware that eligibility does not automatically equal timely help. There are a couple of barriers that exist in the program that can make accessing housing help a long process. Read more about these barriers below. 

Barriers to Housing in the HCV program:

  • Waitlists: Due to limited funding, it’s common for eligible families to remain on voucher waitlists for three or more years. Even getting on a waitlist can be a challenge, with some locations using a lottery system to dole out waiting list spots. In many areas, waitlists may only be open for about one month out of the year.
  • Landlord Denials: As mentioned earlier, in most locations landlords can choose not to accept new residents who want to use a voucher to help with their rent payments. A 2019 HUD task force found that in Fort Worth, Texas, rental applicants who have vouchers are denied as much as 78% of the time. Similar denial rates exist in other major cities as well. Landlords decline voucher residents for a variety of reasons, including hesitancy to engage with HUD and PHA bureaucracy, fear that reimbursements will be inadequate for operating costs, and potential stereotyping of voucher users as being irresponsible tenants. Denials limit a resident’s ability to live in neighborhoods of their choice.

HUD and local agencies are working to overcome the above problems, but progress can be slow and budgets are limited. Getting assistance through the Housing Choice Voucher program will be a multi-year process for the majority of eligible applicants.

Rural Rental Assistance (Section 521)

Most people think of HUD as the primary resource for assistance with paying rent, but they may be surprised to find that the U.S. Department of Agriculture (USDA) also has a Rural Housing Division that provides rental assistance. Through the Rural Rental Assistance (Section 521) program, non-profit and “limited” profit organizations can build multifamily rental properties with government assistance, and they can then offer these subsidized rental units to low-income residents. This program helps as many as 1,204,500 families, according to a 2018 report.

Housing Options

This program offers far fewer options for housing than broad programs like the Housing Choice Voucher do. Those who are eligible for this program must rent from a housing project that was built using funds from either the Rural Rental Housing or Farm Labor Housing programs. These properties can be found through the interactive map that the USDA provides

Some of the apartment buildings in this program are designated for specific populations, such as the elderly. Seniors that are eligible to rent through the Rural Rental Assistance program will be required to pay 30% of their monthly income towards their unit’s rent. The rest of the rent will be paid to the property owner by the USDA. 

Eligibility and Availability

Determining eligibility for a rental unit from this program is fairly straightforward. To be eligible, a family needs to have no more than between 50%-80% of the area’s median income (depending on the location). Those that have 50% or less of the median income are considered “very low income,” while those who have 50%-80% are considered “low-income.” On the interactive property finder map that we linked above, actual income limits are listed for different areas. Looking at properties in your area can help you determine if you’re likely to qualify. However, some programs and some areas can have additional eligibility requirements and possible waiting lists, depending on demand for low-income housing. 

To gain more precise information on eligibility in your rural area and to proceed with an application, you’ll need to contact your state’s USDA office. Not every state or county offers Rural Rental Assistance. 

The Housing Improvement Program (HIP) 

The Bureau of Indian Affairs (BIA or simply IA) is a division of the United States Department of the Interior, and it offers the Housing Improvement Program (HIP) specifically to ameliorate the problem of substandard housing and homelessness in or near tribal lands. This program was conceived as a solution for those with a high degree of financial need- those for whom other public assistance programs simply cannot offer enough help. The HIP is frequently referred to as a “safety net” program. Over half of eligible applicants for this benefit apply because they are seeking renovations and other work on existing homes, while the rest of applicants are seeking an entirely new home. The emphasis, in either case, is providing housing that’s safe and sanitary for members of federally recognized tribes. 

Housing Options

The HIP program is geared towards homeownership and thus has a very different low-income housing assistance model than previously discussed programs that offer rental assistance. Within this program, there’s quite a bit of flexibility to account for differing situations. HIP offers four different levels of assistance, which we list below.

HIP Assistance Categories:

  • Interim Improvements: Relatively small fixes to homes for the sake of safety (up to $7,500 in assistance).
  • Repairs and Renovation: Major changes to the home to bring it up to building code standards (up to $60,000 in assistance).
  • Replacement Housing: Provision of a “modest” replacement if the existing home is in too bad of a condition to be brought into compliance with code (dollar limits not provided).
  • New Housing: Building of an entirely new, “modest” home for those that own property but not a home (dollar limits not provided).

Eligibility and Availability

As mentioned earlier, this program benefits those who have no other financial recourse to improve their housing situation. A variety of criteria must be met before a person is considered eligible. 

Eligibility for HIP:

  • Be a member of a federally recognized tribe
  • Own or lease property within your tribe’s approved tribal service area or in another tribe’s service area if that tribe agrees to work with you
  • Be determined to have a need for housing help in one of the categories detailed above
  • Have exhausted other options for assistance
  • Have an income no higher than 150% of the federal poverty level (FPL) 

In addition to the general limit of no more than 150% of the FPL, there are some additional income guidelines. Applicants to the program are assigned point values based on exactly how low or high their income is, how many members are in the household, and other factors. These points systems are different in Alaska than they are in other states, and details can be found on the HIP website. An applicants’ point value determines the urgency with which his or her application will be treated when there are waitlists for funds.

Funding for this program comes from the federal government and is distributed through tribal governments as well as through various Bureau of Indian Affairs offices. Those who want to obtain these funds need to contact either their tribal government or their local BIA office which will handle the disbursement of funds upon verifying eligibility and availability. 

Assisted Living for Low-Income Seniors 

low income supportive housing

For many seniors, the need for affordable housing goes beyond just a place to stay. Many seniors need housing that will provide supportive services like help with medication, transportation, access to social services, and a host of other non-medical but vital forms of assistance. Housing that offers some or all of these services can go by a variety of names, but “supportive housing” or “assisted living” are the two most common designations. Below you’ll find some housing assistance programs that can meet these needs for seniors.

Supportive Housing for the Elderly (Section 202)

The Supportive Housing for the Elderly program (also called Section 202) was authorized in 1959 and is run by HUD in cooperation with local partners. Section 202 is HUD’s best rental assistance program for seniors since each Section 202 facility is built specifically to address the needs of the elderly rather than the needs of the general population. Construction of Section 202 housing is funded via capital advances provided by HUD to a local organization. Projects that were built in previous decades were built using different forms of funding, usually direct loans. In its over 60 years of existence, this program has funded the development of over 8,000 housing projects that together contain almost 400,000 individual units. 

Housing Options

The exact features of a housing project built with Section 202 funding can vary, particularly since locations built in different decades may have been built to different standards. In general, most Section 202 housing projects will have grab rails, ramps, and at least a few specially constructed wheelchair-accessible units. Communal spaces for eating, mingling, and events are also quite common. These features are all intended to improve the lives of those who are elderly and who may also be considered “frail” according to HUD standards. 

In addition to construction that caters to age and disabilities, Section 202 housing also frequently has a care coordinator on staff. This coordinator helps residents to take advantage of any and all assistive services that are paid for by Medicaid and other cooperating agencies, including sometimes local nonprofits. In this kind of housing, it’s quite common for seniors to be able to get assistance with meals, bathing, medications, transportation, and other daily activities. The exact level of assistance offered will depend on the location.

In order to make this supportive housing affordable for seniors, HUD has established Project Rental Assistance Contracts (PRACs). These contracts mean that low-income renters will pay 30% of their income for rent each month and HUD will pay the difference between that amount and the actual cost that needs to be charged in order to successfully operate the Section 202 facility. 

Eligibility and Availability

To be eligible for a Section 202 housing unit, a household needs to include one or more seniors (62+ years old). Moreover, the household income must be no higher than 50% of the area’s median income. To find your area’s median income limits, you can check the HUD database. You may also want to look at the HUD’s document that details how assets are counted in income. Technically, HUD housing assistance has no asset limits, but certain assets like whole life insurance, savings and checking accounts, and various retirement funds are counted as part of the senior’s income.

Seniors apply to a Section 202 housing project by directly approaching the location in question. However, if you’re not sure where to find a Supportive Housing for the Elderly program in your area, you can contact your local PHA for information. The housing authority may be able to inform you of multiple local options, and they may also be able to counsel you on your eligibility.

It’s also important to note that if a senior’s household meets the income limits mentioned in the previous paragraph, they will technically be eligible but will likely face a waitlist. In many areas, qualified seniors will remain on a waitlist for two years or longer due to increasing demand for affordable senior housing as the baby boomer generation ages.

Virtual Retirement Communities 

For those who have a modest income but who are seeking a home that includes supportive services, sometimes the best option doesn’t involve a move at all. A recent development in senior services is something called a virtual retirement community or a “retirement village.” This is a model of care in which seniors save money by staying in their current residence and receiving supportive services from a local network of providers that has been put together by a nonprofit organization. 

An organization called the Village to Village Network is the primary proponent of virtual retirement communities. Many people see the “village” model as an alternative to buying long-term care insurance, which people used to rely on for similar retirement community benefits. Recently, long-term care insurance has become less available, less inclusive, and more expensive than it used to be, making it impractical for those with small incomes. Unlike most programs on our list, this virtual retirement communities don’t depend on government aid but instead can be described as a grassroots approach to the problem of finding affordable supportive housing for seniors.

Housing Options

As alluded to earlier, a virtual retirement community isn’t exactly housing. In fact, using a virtual retirement community requires that a senior already has stable housing. However, it is a set of low-cost services that, for some seniors, eliminates the need for a move to a more expensive residence such as an assisted living community. 

Every virtual retirement community is a little different, but many offer help with transportation and errands, home repairs, social and educational activities, health and wellness programs, and some resources for finding affordable care if other forms of in-home assistance are needed. These organizations do not directly offer medical assistance of any kind. 

Virtual retirement communities usually operate using a mix of volunteer and paid staff. The services they offer will vary depending on local resources and on what the organization perceives to be the main needs of local seniors. Participants may pay anywhere from about $50-$900 for a yearly membership to a virtual community, but ultimately the yearly cost of membership varies depending on your region.

Eligibility and Availability

Although virtual retirement communities are a smart way to gain affordable assistance for many seniors, they aren’t a free or government-subsidized service. They don’t generally have strict income limits or any of the other restrictive eligibility standards that other assistance programs that we have mentioned have. To be eligible to join, one must simply be a senior (usually 65+, though this may vary), live within the service area of a virtual village/other virtual retirement community, and be able to afford to 1) remain in their own home and 2) pay the yearly or monthly fee for membership. There generally aren’t waitlists for joining virtual retirement communities.

Low-income seniors may wish to enquire with their local virtual retirement community to see if there are any special provisions for those who have low incomes. Some communities may offer extra assistance in some cases. However, there’s no guarantee that the organization will be able to offer any discounts since they already offer services at a very low-cost thanks to a mix of donations and volunteer help. 

Virtual retirement communities are not available in all areas. To find out if there’s one near you, use the Village to Village Network interactive map. 

HUD-VASH 

The U.S. Department of Housing and Urban Development-Veteran’s Affairs Supportive Housing program- much more easily referred to as HUD-VASH– brings together HUD’s Housing Choice Voucher system and the numerous supportive services that the VA offers. This program isn’t specifically targeted to seniors but instead serves chronically homeless veterans of all kinds, including those with disabilities. 

Established in 1992, the HUD-VASH program has always been based on a “housing first” philosophy of care. Even veterans who are struggling with substance abuse or other problems can receive housing because the program’s philosophy maintains that housing is the first step to stability. Once some stability through housing is achieved, the program’s care coordinator can provide additional support for mental and physical health and a host of other needs. 

Housing Options

The HUD-VASH program uses resources from the Housing Choice Voucher program to meet veteran housing needs. As such, the voucher should be usable at any townhouse, apartment, or even a single-family home rental property in which the landlord will accept the voucher. However, to stay in the program veterans need to meet on a regular basis with their case managers from the VA. Therefore, the veteran does need to choose housing within an “easy traveling distance” of the local VA facility. The VA does not provide a maximum allowable distance, but more information on compliance with the program can be found in the program booklet.

This program is suitable for those who have disabilities since care coordinators from the VA are able to connect senior veterans with complex care needs to resources that will help them meet their needs. Special financial provisions, allowances for service animals, and other forms of help can be provided.

The exact amount of rental fees and other services that this program subsidizes vary according to the veteran’s situation. Because this program is intended to help the chronically homeless, its terms tend to be quite generous. Usually, veterans are required to pay 30% of their income in rent or to pay a minimum payment ($50, for example) that the local Public Housing Agency sets. Fees can even be waived in certain circumstances.

Eligibility and Availability 

To participate in this program, the veteran must meet eligibility requirements from both the VA and the local Public Housing Agency (PHA). First, the veteran must be homeless according to federal standards, which means that they are “lacking a fixed, regular, adequate nighttime, residence,” or they are staying only in temporary/transitional housing such as a hotel. Next, they must be eligible for VA healthcare services. Eligibility for this is somewhat complex, but full details can be found here. Those who served in active duty or who have a disability caused by their active duty service are usually eligible. Finally, the veteran must usually meet the income limit requirements of the local PHA for the Housing Choice Voucher program. This may mean that the resident will need to have an income lower than between 50%-80% of the area median income (AMI). 

Since the HUD-VASH program is for veterans in extremely unstable housing situations, the program focuses on making an urgent change in the veteran’s life. As such, veterans are likely to bypass the waitlists that they would otherwise face if they were to apply for housing help through the traditional Housing Choice Voucher (HCV) Program. 

Nursing Home-Equivalent Housing for Low-Income Seniors 

Nursing Home-Equivalent Housing for Low-Income Seniors

Housing often becomes most difficult to afford when a senior needs care that goes beyond just assistance with a few tasks. For those that need constant supervision or help with complex medical needs, the thought of paying for care in a nursing home or equivalent setting can be quite daunting. Thankfully, there is help available through a variety of programs for those who have these more serious needs. Read on to learn more about some of the programs that meet the most complex housing needs for low-income seniors.

Medicaid Institutional Long-Term Care 

Low-income seniors are typically familiar with Medicaid as a source of help with doctor visits and other forms of healthcare, but they may not realize that Medicaid can provide for some forms of long-term care in institutional settings. For seniors with serious medical or mental health needs, staying in a Medicaid-approved nursing facility can provide a level of consistent care and supervision in a safe environment. Becoming institutionalized is not most seniors’ first choice, but if this level of care is not possible in a senior’s home then Medicaid long-term care may be the answer. It can also be utilized on a short-term basis if the senior is expected to regain some independence or soon be able to return to an at-home care alternative. 

Housing Options

Institutional care options available through Medicaid are limited to hospitals and nursing homes that are certified and licensed as a Medicaid Nursing Facility (NF). However, according to the Medicaid website, many nursing homes already meet this qualification, so options should be plentiful. Often, a senior will begin their time at the nursing home using benefits from Medicare, and when that initial Medicare coverage runs out Medicaid can kick in to cover expenses if the patient has no other assets or long-term care insurance. 

Every financial situation will be a little different, but there are federal guidelines for what Medicaid will cover in an institutional setting. Note that a private room, as opposed to a shared one, may cost the patient extra. Specialized foods, personal items like clothing, and various items that are considered nonessential, such as television and telephones, may be charged directly to the patient and not covered by the program. 

Eligibility and Availability 

Medicaid eligibility has always been complex, but in recent years the government has taken steps to simplify it. Seniors who are not sure if they are eligible for Medicaid should start with the official Medicaid Eligibility Guidelines and then move on to contact their state Medicaid office if they need more information. Seniors can qualify on the basis of income or of disability, and even if they have a comparatively high income they may still be able to qualify under the “medically needy” provisions of the law. 

Once someone knows that they are eligible for Medicaid, the next step is to determine if they are eligible for long-term care through Medicaid. States, rather than the federal government, determine eligibility in this area. However, some federal regulations govern the decision-making process. You can read about how medical and mental health needs for long-term care services are screened on the official Medicaid website. In general, Medicaid will only institutionalize those who have no other options for care. Those who are deemed eligible for nursing home care will not be subject to waiting lists.

Medicaid Home and Community Based Services (HCBS) Waivers

For those who have a significant need for supervision and daily help or medical care, a Medicaid Home and Community Based Services Waiver can provide a high level of care that eliminates the need for moving into a costly nursing home. The care offered through an HCBS Waiver does not always include housing, but it can. These waivers vary greatly by state, and not all states will offer them at all times, but they are all based upon Section 1915(c) of the Social Security Act, as explained on the main Medicaid website.

Housing Options

By using Medicaid Home and Community Based Services Waivers, many seniors can obtain either funding to stay in an assisted living setting such as an adult foster home, an adult daycare, a memory care unit (for patients with dementia), or some other specialized residential setting. They may alternatively receive funds to hire caretakers and otherwise improve their home setting so that they can continue to live at home despite their increasing needs for assistance. 

The amount of help that is provided varies greatly from state to state, so it’s very difficult to generalize. Seniors who are interested in HCBS waivers should seek out information from their state’s own Medicaid program. In most cases, the point of the HCBS waiver is to provide nursing home-equivalent care in a home-like setting. Reach out to your state’s Medicaid program to learn about your local options.

Eligibility and Availability

To be eligible for an HCBS Waiver you must also be eligible for Medicaid in general. Refer to the previous program listing (Medicaid Long-Term Care Services) for information on Medicaid eligibility. Beyond basic eligibility for Medicaid, states can set additional requirements that limit the eligibility of their waiver to a specific population. For example, a waiver could be targeted for the elderly, those with autoimmune diseases, those with dementia, or almost any other population that the state deems to have an urgent, unmet need. 

Funding is typically limited for HCBS waivers, and waitlists can be months or years long in some cases. A phone call to your state’s Medicaid office should give you the information that you need about HCBS waitlists. A waiver won’t always provide immediate help, and sometimes seniors use Medicaid institutional services first while waiting to receive a waiver that they are eligible for. 

VA Long-Term Care Services 

In addition to services directed at helping veterans who are homeless (as discussed earlier), the Veterans Affairs (VA) also provides a wide range of supportive services that are collectively referred to as “long-term care services”. These services include “services at home and in the community” and “residential settings and nursing homes.” Utilizing the available long-term care resources that the VA offers can greatly reduce veteran costs for nursing home stays and other forms of residential care.

Housing Options

The long-term care services program can include a variety of residential settings for low-income seniors. Seniors can choose to stay in their own homes but receive extensive medical care at home. They can also choose to be moved to a residential setting such as an assisted living facility, a nursing home, a private home where a caregiver supports a small group of individuals, or even an adult day health center. These facilities and programs can be run by the VA itself or by community partners that the VA has a relationship with. This program truly offers options for those who need a high level of care and/or supervision.

The VA generally does not cover room and board costs, but it can cover many other costs associated with living in the above facilities. Additionally, veterans who receive VA pensions due to disability and certain other needs can use those funds to help cover their room and board cost. The Paying for Long-Term Care page on the VA website covers the topic of costs in more detail with several articles relevant to veterans. 

Eligibility and Availability

To be eligible for the services discussed above, a veteran must be eligible for and enrolled in VA healthcare. They also must be assessed by their VA healthcare providers and determined to need the level of care that comes with these long term care solutions. Finally, eligibility sometimes depends on the availability of services in the veteran’s area. If the residential location in question is too crowded then the veteran may have to use in-home care instead. In some instances, a veteran may be able to move to a location that offers the most suitable services for his or her needs.

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