Food assistance programs serve the majority of low-income, homebound older adults, yet food insecurity remains.

Introduction: Low-income homebound older adults face a disproportionately high risk of food insecurity, yet national evidence of food assistance program uptake among this population is limited. Methods: Using nationally representative data of Medicare beneficiaries aged 65 and older from the National Health and Aging Trends Study Round 13, we examined Supplemental Nutrition Assistance Program (SNAP) and Meals on Wheels (MOW) participation among 1091 low-income community-dwelling older adults who were homebound and income-eligible for SNAP. Results: More than half (55.5%) of low-income homebound older adults, representing 2.18 million nationally, participated in at least one program: 35.1% received SNAP only, 10.9% received MOW only, and only 9.4% received both. Despite receiving food assistance, 36.4% still reported food insecurity. We identified 1.75 million low-income homebound older adults who did not receive SNAP or MOW (non-recipients), among whom 24.0% experienced food insecurity and 21.8% lived alone. Among non-recipients, those experiencing food insecurity reported significantly more functional dependencies and were more likely to live alone than those who were food secure. Conclusion: Policies that expand program capacity, strengthen screening for food insecurity, and streamline enrollment could improve access for this high-need population.