Wealthy PotAverage Cost of Assisted Living and Nursing Homes: National, by State, and Who Pays
The national median cost of assisted living is $6,200 a month, or $74,400 a year, for a private one-bedroom unit. A nursing home costs more: a median $9,581 a month ($114,975 a year) for a semi-private room and $10,798 a month ($129,575 a year) for a private room. Those are the latest figures from the CareScout Cost of Care Survey (formerly the Genworth survey), collected from providers between July and November 2025 and published in March 2026. Prices run from about $4,400 a month for assisted living in Mississippi to more than $12,000 in Hawaii. Medicare does not pay for this kind of long-term care, so most families pay out of pocket until they qualify for Medicaid, use long-term care insurance, or get help from the VA. This page has the national and state numbers, the recent trend, and the rules for each way of paying.
Table of Contents
The Short Answer
- Assisted living: a median $6,200 a month ($74,400 a year) nationally, up 5% from 2024 (CareScout 2025).
- Nursing home, semi-private room: $315 a day, or $9,581 a month and $114,975 a year.
- Nursing home, private room: $355 a day, or $10,798 a month and $129,575 a year.
- In-home care: $35 an hour for a non-medical caregiver, which comes to $80,080 a year at 44 hours a week. Adult day care is $95 a day.
- Medicare does not pay for long-term custodial care. It covers up to 100 days in a skilled nursing facility after a qualifying hospital stay, and in 2026 you pay $217 a day from day 21.
- Medicaid covers nursing home care for people who meet their state's income and asset limits, and states must try to recover the cost from the estates of enrollees 55 and older.
Cost by Type of Care
CareScout, a Genworth subsidiary, has run the Cost of Care Survey since 2004. The 2025 edition collected more than 25,000 rates from providers across the country. The figures are medians, the middle price quoted by providers, not the average of what residents actually pay after discounts or add-on fees.
| Type of care | Daily | Monthly | Yearly | Change from 2024 |
|---|---|---|---|---|
| Assisted living (private one-bedroom) | $204 | $6,200 | $74,400 | +5% |
| Nursing home, semi-private room | $315 | $9,581 | $114,975 | +3% |
| Nursing home, private room | $355 | $10,798 | $129,575 | +1% |
| Non-medical in-home caregiver (44 hours a week) | $220 | $6,673 | $80,080 | +3% |
| Adult day health care (5 days a week) | $95 | $2,058 | $24,700 | −5% |
What each setting buys is different. Assisted living is housing plus help with daily tasks such as bathing, dressing and medications, and the median price is for a private one-bedroom unit, so rent is a large part of it. CareScout notes that assisted living prices track rental housing for exactly that reason. Nursing homes add 24-hour nursing care. A private room costs about $1,217 a month more than a shared one at the national median (our arithmetic).
Home care is priced by the hour, so the total depends on how much help someone needs. The $80,080 figure assumes 44 hours a week; 20 hours a week at the same $35 rate would be about $36,400 a year (illustrative). From 2025 CareScout stopped reporting separate figures for "homemaker" and "home health aide" services because their prices had converged, and it now reports both as "non-medical caregiver." Skilled nursing at home is a separate, new category: a median $90 an hour or $160 a visit for a private duty nurse.
Cost of Assisted Living and Nursing Homes by State
Location matters more than almost anything else. The median assisted living bill in Hawaii is nearly three times the one in Mississippi, and a semi-private nursing home room in Alaska costs almost five times as much as one in Texas.
| State | Assisted living (monthly) | Nursing home, semi-private (monthly) | Nursing home, private (monthly) | In-home caregiver, 44 hrs/week (monthly) |
|---|---|---|---|---|
| United States | $6,200 | $9,581 | $10,798 | $6,673 |
| Alabama | $4,425 | $8,334 | $8,787 | $5,148 |
| Alaska | $9,882 | $27,831 | N/A | $7,245 |
| Arizona | $6,250 | $8,365 | $11,437 | $7,245 |
| Arkansas | $4,637 | $7,452 | $8,060 | $4,767 |
| California | $7,000 | $12,167 | $15,178 | $7,627 |
| Colorado | $6,584 | $10,159 | $12,182 | $7,913 |
| Connecticut | $9,118 | $15,208 | $16,729 | $6,864 |
| Delaware | $7,600 | $14,494 | $15,132 | $6,673 |
| Florida | $5,610 | $10,342 | $12,167 | $6,101 |
| Georgia | $5,300 | $8,821 | $9,429 | $6,101 |
| Hawaii | $12,096 | $15,473 | $16,395 | $7,817 |
| Idaho | $5,175 | $10,494 | $12,167 | $7,341 |
| Illinois | $6,219 | $8,304 | $9,216 | $6,864 |
| Indiana | $5,639 | $8,943 | $10,326 | $6,673 |
| Iowa | $5,381 | $9,277 | $10,038 | $7,836 |
| Kansas | $5,975 | $8,669 | $9,064 | $6,435 |
| Kentucky | $5,528 | $9,718 | $11,254 | $6,197 |
| Louisiana | $5,163 | $7,604 | $8,076 | $4,957 |
| Maine | $8,205 | $13,976 | $14,904 | $8,485 |
| Maryland | $7,173 | $12,927 | $14,448 | $6,673 |
| Massachusetts | $9,600 | $14,448 | $15,817 | $7,627 |
| Michigan | $5,818 | $11,254 | $11,969 | $6,626 |
| Minnesota | $6,573 | $10,646 | $13,870 | $8,389 |
| Mississippi | $4,369 | $9,581 | $9,885 | $4,576 |
| Missouri | $5,400 | $6,741 | $7,604 | $6,292 |
| Montana | $6,075 | $8,973 | $9,581 | $7,245 |
| Nebraska | $6,350 | $8,377 | $9,216 | $6,864 |
| Nevada | $6,241 | $11,786 | $14,463 | $7,055 |
| New Hampshire | $8,025 | $12,243 | $13,444 | $7,627 |
| New Jersey | $8,710 | $12,775 | $14,448 | $7,245 |
| New Mexico | $5,950 | $9,125 | $10,633 | $5,720 |
| New York | $7,110 | $15,528 | $16,729 | $6,673 |
| North Carolina | $6,496 | $9,733 | $10,798 | $5,720 |
| North Dakota | $4,729 | $11,528 | $12,304 | $6,483 |
| Ohio | $6,103 | $9,186 | $10,389 | $6,483 |
| Oklahoma | $6,150 | $7,026 | $7,756 | $6,292 |
| Oregon | $6,875 | $16,760 | $18,448 | $7,627 |
| Pennsylvania | $6,480 | $11,954 | $13,688 | $6,483 |
| Rhode Island | $7,781 | $12,106 | $13,383 | $7,627 |
| South Carolina | $5,350 | $9,034 | $9,612 | $5,982 |
| South Dakota | $4,900 | $9,444 | $10,190 | $8,437 |
| Tennessee | $5,845 | $9,429 | $10,038 | $5,911 |
| Texas | $5,666 | $5,627 | $7,604 | $5,720 |
| Utah | $5,475 | $8,669 | $10,646 | $7,484 |
| Vermont | $8,597 | $14,113 | $15,528 | $8,580 |
| Virginia | $6,945 | $10,250 | $11,680 | $6,673 |
| Washington | $7,600 | $13,155 | $15,969 | $8,580 |
| West Virginia | $6,340 | $12,836 | $13,262 | $5,720 |
| Wisconsin | $6,540 | $10,646 | $12,319 | $6,912 |
| Wyoming | $5,325 | $9,916 | $10,923 | $8,771 |
The cheapest and most expensive states in the 2025 survey:
- Assisted living: lowest in Mississippi ($4,369), Alabama ($4,425) and Arkansas ($4,637); highest in Hawaii ($12,096), Alaska ($9,882) and Massachusetts ($9,600).
- Semi-private nursing home room: lowest in Texas ($5,627), Missouri ($6,741) and Oklahoma ($7,026); highest in Alaska ($27,831), Oregon ($16,760) and New York ($15,528).
- Private nursing home room: lowest in Missouri and Texas (both $7,604) and Oklahoma ($7,756); highest in Oregon ($18,448), with Connecticut and New York tied at $16,729.
State medians hide a lot of variation inside each state, since CareScout collects rates by metro area. CareScout's own online calculator gives figures for individual metro areas. A family comparing facilities should ask each one for its base rate and its care-level fees in writing, since many assisted living communities charge extra as needs increase.
How Fast Costs Are Rising
| National annual median | 2023 | 2024 | 2025 |
|---|---|---|---|
| Assisted living | $64,200 | $70,800 | $74,400 |
| Nursing home, semi-private room | $104,000 | $111,325 | $114,975 |
| Nursing home, private room | $116,800 | $127,750 | $129,575 |
| Home care (home health aide through 2024; non-medical caregiver in 2025) | $75,500 | $77,792 | $80,080 |
| Adult day health care | n/a | $26,000 | $24,700 |
Over two years, the median assisted living bill rose about 16% and nursing home rooms about 11% (our arithmetic from the table). Most of that came in 2024, when assisted living jumped 10% and private nursing home rooms 9%. In 2025 the increases slowed to between 1% and 5% for most settings, and adult day care fell 5%. For planning, a slower year does not mean prices have stopped rising: in the 2024 survey, increases for most care types outpaced inflation.
Set against retirement income, these prices are steep. Even the largest Social Security benefit at full retirement age in 2026, $4,152 a month, is about $2,000 short of the median assisted living bill, and the typical check is far smaller (see the average Social Security check and average retirement income). That gap is why the question of who pays matters so much.
Does Medicare Pay for Assisted Living or Nursing Homes?
For long-term care, no. Medicare.gov is direct: "Medicare doesn't pay for long-term care," and "Medicare and most health insurance, including Medicare Supplement Insurance (Medigap), don't pay for long-term care services, including care in a nursing home or in the community." Long-term care here means custodial help with daily activities such as dressing, bathing and using the bathroom. Assisted living is almost all custodial care, so Medicare pays none of the rent or personal care there.
What Medicare Part A does cover is a short stay in a skilled nursing facility for rehabilitation or skilled care, and only if you meet all the conditions, including:
- A medically necessary inpatient hospital stay of at least 3 days in a row, not counting the day you leave. Time spent "under observation" or in the emergency room before admission does not count.
- You enter the facility within a short time, generally 30 days, of leaving the hospital.
- A doctor says you need daily skilled care, such as intravenous medication or physical therapy.
| Days in a skilled nursing facility (each benefit period) | What you pay in 2026 (Original Medicare) |
|---|---|
| Days 1 to 20 | $0 a day, after the $1,736 Part A deductible |
| Days 21 to 100 | $217 a day |
| Day 101 and beyond | All costs |
A full 100-day stay would cost a patient up to $19,096 in 2026 if the deductible had not already been paid ($1,736 plus 80 days at $217; illustrative). Several Medigap supplement plans cover all or part of that coinsurance; Plans K and L, for example, pay 50% and 75% of it. After day 100, or as soon as the patient no longer needs daily skilled care, the stay becomes ordinary long-term care at the private rates above. Part B premiums and other costs are on our Medicare Part B premium 2026 page.
How Medicaid Pays for Long-Term Care
Medicaid is the public program that pays for long-term care once you qualify. Nursing facility services and home health services are mandatory Medicaid benefits in every state; personal care at home is optional, so coverage varies. Eligibility is set state by state and is based on income and assets, which is why many people pay privately first and qualify only after their savings run down.
Assisted living is the weak spot. Many states pay for services in assisted living through home- and community-based services (HCBS) waivers, but federal rules (42 CFR 441.310) bar federal matching funds for room and board in those programs. The resident usually still pays the housing part, often from Social Security or a pension.
Federal rules that apply in every state:
- A 60-month look-back. Gifts or transfers for less than fair market value in the 60 months before applying can trigger a period of ineligibility. Federal law sets its length as the value given away divided by the average monthly cost of a private patient in a nursing facility in the state.
- Protection for a spouse at home. When one spouse needs nursing home care, the "community spouse" keeps a share of the couple's assets. For 2026 the federal floor is $32,532 and the ceiling $162,660; states choose within that range. The spouse's minimum monthly income allowance is $2,705 (from July 1, 2026, in the lower 48 states) and the maximum is $4,066.50.
- A home equity cap. An applicant with home equity above the state's limit, set between $752,000 and $1,130,000 for 2026, is not eligible for long-term care coverage, unless a spouse or certain dependents live in the home.
- Estate recovery. For enrollees 55 and older, states must seek repayment from the estate for nursing facility services, home and community-based services, and related hospital and drug costs. They may not recover while a spouse, a child under 21, or a blind or disabled child survives, and they must have a hardship waiver process.
Medicaid rules are where professional advice pays for itself. An elder law attorney or your state Medicaid agency can explain your own state's limits.
VA Benefits, Insurance and Tax Breaks
VA pension with Aid and Attendance. Veterans with wartime service (and their surviving spouses) who receive a VA pension can get a higher rate if they need help with daily activities such as bathing, feeding and dressing, are bedridden, or live in a nursing home because of lost mental or physical abilities. The pension pays the difference between countable income and a cap called the Maximum Annual Pension Rate (MAPR). Unreimbursed medical expenses, including care costs, can be deducted from income above a small threshold.
| VA pension with Aid and Attendance (from Dec. 1, 2025) | Maximum per year | Per month (our arithmetic) |
|---|---|---|
| Veteran, no dependents | $29,093 | $2,424 |
| Veteran with 1 dependent | $34,488 | $2,874 |
| Surviving spouse, no dependents | $18,697 | $1,558 |
Even the top rate for a single veteran covers well under half of the median assisted living bill, but combined with Social Security it can close much of the gap.
Long-term care insurance. A policy pays a set daily or monthly amount once you need help with daily activities or have a severe cognitive impairment. Benefits from a tax-qualified policy are generally tax-free; for policies that pay a fixed daily amount regardless of actual costs, the 2026 tax-free limit is $430 a day. Coverage has to be bought while you are healthy. Our guide to long-term care insurance covers the odds of needing care, typical policy terms and whether it makes sense to buy.
Tax deduction. Long-term care costs can count as medical expenses on Schedule A, but only the part of all your medical expenses above 7.5% of adjusted gross income is deductible. IRS Publication 502 sets the rules:
- Nursing home: the whole cost, including meals and lodging, counts if a principal reason for being there is medical care. If the reason is personal, only the medical and nursing part counts.
- Qualified long-term care services (which can include personal care in assisted living or at home) count when they are provided under a plan of care from a licensed health care practitioner to someone certified as chronically ill: unable to do at least two of the six activities of daily living (eating, toileting, transferring, bathing, dressing, continence) without substantial help for at least 90 days, or needing substantial supervision because of severe cognitive impairment.
- Long-term care insurance premiums count up to an age-based limit. For 2026: $500 at 40 or under, $930 at 41 to 50, $1,860 at 51 to 60, $4,960 at 61 to 70, and $6,200 over 70.
Because a year of care can easily exceed 7.5% of a retiree's income, this deduction is often worth more to families paying for care than they expect. Families who pay for a parent's care may also be able to claim the costs if the parent qualifies as their dependent for this purpose; a tax professional can check. Other sources people use are home equity (see the pros and cons of a reverse mortgage) and planned withdrawals from savings, which you can model with the retirement withdrawal calculator.
Sources & Methodology
- CareScout, Cost of Care Survey 2025: national medians, year-over-year changes and survey method; Median Cost Data Tables (PDF) for state figures; Ranked Median Costs by State (PDF).
- CareScout, "CareScout Releases 2025 Cost of Care Survey Results", March 2, 2026; earlier releases for the 2024 survey and the 2023 survey.
- Medicare.gov, Long-term care and Skilled nursing facility care; CMS MLN MM14279, CY 2026 deductible and coinsurance rates.
- Medicaid.gov, Mandatory and optional benefits; Estate recovery; CMCS Informational Bulletin, Updated 2026 SSI and Spousal Impoverishment Standards, April 27, 2026.
- 42 U.S.C. 1396p(c): transfer-of-assets look-back and penalty; 42 CFR 441.310: HCBS room-and-board exclusion.
- VA.gov, Current pension rates for Veterans, survivors pension rates and Aid and Attendance eligibility.
- IRS Publication 502, Medical and Dental Expenses; IRS Rev. Proc. 2025-32, sections 4.27 and 4.62, for 2026 premium and per diem limits.
Method notes. CareScout figures are medians of provider-quoted private-pay rates by metro area, not averages of what residents pay; many sites call them "average" costs. Assisted living is a monthly rate for a private one-bedroom unit; nursing home rates are daily rates multiplied by 365; in-home care assumes 44 hours a week for 52 weeks. Monthly figures for nursing homes and home care are CareScout's annual figures divided by 12. The two-year percentage changes, the private-room premium, the 20-hour home care example, the 100-day Medicare example and the VA monthly amounts are our arithmetic. CareScout reports a 2022 series on its website that does not match older Genworth releases because the survey was recalibrated in 2023, so this page starts the trend at 2023.
This article is for general information and is not financial, tax, legal or benefits advice. Figures are from CareScout, Medicare.gov, CMS, Medicaid.gov, the VA and the IRS, checked against those sources on 2026-10-08. Examples are illustrative. Care prices vary by provider and level of care, and Medicaid and VA eligibility depends on your state and circumstances; consider speaking to an elder law attorney, your State Health Insurance Assistance Program or an accredited VA representative before acting.
FAQ
What is the average cost of assisted living per month?
The national median is $6,200 a month, or $74,400 a year, for a private one-bedroom unit, according to the CareScout Cost of Care Survey 2025. State medians range from $4,369 in Mississippi to $12,096 in Hawaii.
What is the average cost of a nursing home?
A semi-private room has a national median of $315 a day, which is $9,581 a month or $114,975 a year. A private room is $355 a day, $10,798 a month or $129,575 a year (CareScout 2025).
Does Medicare pay for assisted living?
No. Medicare does not pay for long-term custodial care, which includes assisted living. Part A covers up to 100 days in a skilled nursing facility after a qualifying 3-day inpatient hospital stay; in 2026 days 1 to 20 cost $0 after the $1,736 deductible and days 21 to 100 cost $217 a day.
Does Medicaid pay for assisted living?
Sometimes. Many states pay for care services in assisted living through home- and community-based waiver programs, but federal rules exclude room and board, so the resident usually pays the housing cost. Nursing home care is a mandatory Medicaid benefit for people who qualify.
How much does in-home care cost?
A non-medical caregiver costs a median $35 an hour nationally. At 44 hours a week that is about $6,673 a month or $80,080 a year. A private duty nurse costs a median $90 an hour or $160 a visit.
Which state has the cheapest assisted living?
Mississippi, at a median $4,369 a month, followed by Alabama ($4,425) and Arkansas ($4,637). Hawaii is the most expensive at $12,096.
Is assisted living tax-deductible?
Partly, in many cases. Qualified long-term care services for someone certified as chronically ill under a plan of care count as medical expenses, and nursing home costs count in full when the main reason for being there is medical care. Only total medical expenses above 7.5% of adjusted gross income are deductible, and you must itemize.
How much does VA Aid and Attendance pay?
It raises the VA pension cap. From December 1, 2025, the maximum annual pension with Aid and Attendance is $29,093 for a veteran with no dependents, $34,488 with one dependent and $18,697 for a surviving spouse with no dependents, minus countable income.
Cite This Page
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"Average Cost of Assisted Living and Nursing Homes: National, by State, and Who Pays." Wealthy Pot, 2026. https://wealthypot.com/average-cost-of-assisted-living/
