Generally, a distinction is made between medical and social care, and often times the latter is much less likely to be covered by insurance or public funds. In the United States there are approximately 1 million residents in assisted living facilities, of these is estimated that 86% pay for care out of their own funds. Help from family, friends and from state agencies covers the rest. Medicare does not pay unless skilled-nursing care is needed and given in certified skilled nursing facilities. Many assisted living facilities do not meet Medicare's requirements. However, Medicare does pay for some skilled care if the elderly person meets the requirements for the Medicare home health benefit.

There are thirty-two states that pay for care in assisted living facilities through their Medicaid waver programs. Similarly, in the United Kingdom the National Health Service provides medical care for the elderly, as for all, free at the point of use, but social care is only paid for by public authorities when a person has exhausted their private resources.

Much of modern elderly care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire and deserve to age with dignity. This is an important point in that the design of housing, services, activities, and employee training should be truly customer-centered, i.e., geared towards the needs and desires of the elderly person.