Long-term care is the biggest cost most families never put in their budget. A shared room in a nursing home now has a national median price of $315 a day, which is about $115,000 a year. Assisted living runs a median $6,200 a month. Even part-time help at home can cost more than a mortgage payment.
And the odds of needing some of it are high. The federal government’s LongTermCare.gov estimates that someone turning 65 today has almost a 70% chance of needing some type of long-term care services during their remaining years.
This guide shows what each type of care costs in every state, based on the 2025 CareScout Cost of Care Survey, and explains how families actually pay for it.
National long-term care costs in 2025
CareScout, formerly known for publishing the Genworth Cost of Care Survey, contacted more than 200,000 providers between July and November 2025 and completed about 16,000 surveys. The national medians:
| Type of care | 2025 national median | Change from 2024 | Yearly cost |
| Home care (non-medical caregiver) | $35 per hour | Up 3% | $80,080 at 44 hours a week |
| Adult day health care | $95 per day | Down 5% | $24,700 at 5 days a week |
| Assisted living | $6,200 per month | Up 5% | $74,400 |
| Nursing home, semi-private room | $315 per day | Up 2% | $114,975 |
| Nursing home, private room | $355 per day | Up 1% | $129,575 |
| Private duty nurse at home | $90 per hour | New in 2025 | Varies with hours |
What each type of care means
It helps to know what you are comparing, because the names get used loosely.
- Home care (non-medical) means a caregiver who comes to the house to help with bathing, dressing, meals, light housekeeping, errands and companionship. It is billed by the hour.
- Home health care is medical care at home, such as nursing or therapy ordered by a doctor. Medicare may cover it for a limited time if certain conditions are met.
- Adult day health care provides supervision, meals, activities and some health services during the day, often so a family caregiver can work.
- Assisted living is a residential community with private apartments or rooms, meals, housekeeping and help with daily activities. It does not usually provide round-the-clock nursing.
- Nursing homes, also called skilled nursing facilities, provide 24-hour nursing care and supervision for people with serious health needs.
Long-term care costs by state
The table below shows 2025 state medians. Home care is shown as a monthly figure at 44 hours a week, the standard the survey uses, so you can compare it directly with the facility costs.
| State | Home care, 44 hrs/week, per month | Assisted living per month | Nursing home shared room per month | Nursing home private room per month |
| Alabama | $5,150 | $4,425 | $8,334 | $8,787 |
| Alaska | Not available | $9,882 | $27,831 | Not available |
| Arizona | $7,250 | $6,250 | $8,365 | $11,437 |
| Arkansas | $4,770 | $4,637 | $7,452 | $8,060 |
| California | $7,630 | $7,000 | $12,167 | $15,178 |
| Colorado | $8,010 | $6,584 | $10,159 | $12,182 |
| Connecticut | $6,860 | $9,118 | $15,208 | $16,729 |
| Delaware | $6,670 | $7,600 | $14,494 | $15,132 |
| Florida | $6,100 | $5,610 | $10,342 | $12,167 |
| Georgia | $6,100 | $5,300 | $8,821 | $9,429 |
| Hawaii | $7,820 | $12,096 | $15,473 | $16,395 |
| Idaho | $7,250 | $5,175 | $10,494 | $12,167 |
| Illinois | $6,860 | $6,219 | $8,304 | $9,216 |
| Indiana | $6,670 | $5,639 | $8,942 | $10,326 |
| Iowa | $7,820 | $5,380 | $9,277 | $10,038 |
| Kansas | $6,480 | $5,975 | $8,669 | $9,064 |
| Kentucky | $6,100 | $5,528 | $9,718 | $11,254 |
| Louisiana | $4,960 | $5,162 | $7,604 | $8,076 |
| Maine | $8,390 | $8,205 | $13,976 | $14,904 |
| Maryland | $6,670 | $7,172 | $12,927 | $14,448 |
| Massachusetts | $7,630 | $9,600 | $14,448 | $15,817 |
| Michigan | $6,670 | $5,818 | $11,254 | $11,969 |
| Minnesota | $8,390 | $6,572 | $10,646 | $13,870 |
| Mississippi | $4,580 | $4,369 | $9,581 | $9,885 |
| Missouri | $6,290 | $5,400 | $6,741 | $7,604 |
| Montana | $7,250 | $6,075 | $8,973 | $9,581 |
| Nebraska | $6,860 | $6,480 | $8,377 | $9,216 |
| Nevada | $7,050 | $6,241 | $11,786 | $14,463 |
| New Hampshire | $7,630 | $8,025 | $12,243 | $13,444 |
| New Jersey | $7,250 | $8,710 | $12,775 | $14,448 |
| New Mexico | $5,720 | $5,950 | $9,125 | $10,633 |
| New York | $6,670 | $7,110 | $15,528 | $16,729 |
| North Carolina | $5,720 | $6,496 | $9,733 | $10,798 |
| North Dakota | $6,480 | $4,729 | $11,528 | $12,304 |
| Ohio | $6,480 | $6,102 | $9,186 | $10,389 |
| Oklahoma | $6,290 | $6,150 | $7,026 | $7,756 |
| Oregon | $7,630 | $6,874 | $16,760 | $18,448 |
| Pennsylvania | $6,480 | $6,350 | $11,954 | $13,688 |
| Rhode Island | $7,630 | $7,780 | $12,106 | $13,383 |
| South Carolina | $5,910 | $5,350 | $9,034 | $9,612 |
| South Dakota | $8,390 | $4,900 | $9,444 | $10,190 |
| Tennessee | $5,910 | $5,845 | $9,429 | $10,038 |
| Texas | $5,720 | $5,666 | $5,627 | $7,604 |
| Utah | $7,440 | $5,475 | $8,669 | $10,646 |
| Vermont | $8,580 | $8,597 | $14,113 | $15,528 |
| Virginia | $6,670 | $6,945 | $10,250 | $11,680 |
| Washington | $8,580 | $7,600 | $13,155 | $15,969 |
| West Virginia | $5,720 | $6,340 | $12,836 | $13,262 |
| Wisconsin | $6,860 | $6,540 | $10,646 | $12,319 |
| Wyoming | $8,770 | $5,325 | $9,916 | $10,923 |
Source: CareScout Cost of Care Survey 2025, state median tables. Home care monthly figure is our calculation at 44 hours a week. A state home care median was not available for Alaska.
Where care costs the most and least
Assisted living is least expensive in Mississippi ($4,369 a month), Alabama ($4,425), Arkansas ($4,637) and North Dakota ($4,729). It is most expensive in Hawaii ($12,096), Massachusetts ($9,600), Connecticut ($9,118) and New Jersey ($8,710).
Nursing homes show an even wider range. A shared room costs about $5,627 a month in Texas and $6,741 in Missouri, compared with $15,000 or more in Connecticut, Hawaii, New York and Oregon, and more than $27,000 in Alaska.
Home care rates are closer together, from about $24 an hour in Mississippi to $46 in Wyoming. Because assisted living is cheap in some states and expensive in others, the choice between home care and a facility can come out differently depending on where you live. Our home care vs assisted living break-even guide works that out state by state.
How long people need care
Cost per month only matters alongside how long care lasts. LongTermCare.gov estimates that women who need care use it for an average of 3.7 years and men for 2.2 years. About one in five people will need care for more than five years.
At the national assisted living median, three years comes to about $223,000. Three years in a shared nursing home room is about $345,000. Those totals are why long-term care is often described as the largest financial risk in retirement.
Who pays for long-term care
Most families use a combination of the sources below. It is worth knowing the rules before you need them.
Medicare
Medicare does not pay for long-term custodial care, which is help with everyday activities like bathing, dressing and eating. It does not pay assisted living rent. It does cover up to 100 days of skilled nursing facility care after a qualifying inpatient hospital stay of at least three days, with full coverage for the first 20 days and a daily coinsurance after that. It also covers part-time home health care when a doctor orders skilled services and you are homebound.
Medicaid
Medicaid is the largest payer of long-term care in the United States. It pays for nursing home care for people who meet its income and asset limits, and every state also runs home and community-based services programs that can pay for care at home or in some assisted living settings. Rules differ by state, and most states review five years of past financial transfers when you apply, known as the look-back period. Many home care programs have waiting lists.
Long-term care insurance
A traditional long-term care policy pays a daily or monthly benefit once you need help with at least two activities of daily living or have a cognitive impairment such as dementia. Premiums are lower the younger you buy, and many insurers will not cover people with certain health conditions. Hybrid policies that combine life insurance with long-term care benefits have become more common. People in their 40s and 50s are the main buyers, because that is when coverage is most affordable.
Veterans benefits
Wartime veterans and surviving spouses with limited income may qualify for the VA pension with Aid and Attendance, which adds a monthly amount toward care at home, in assisted living or in a nursing home. Some veterans also qualify for VA nursing home or home care programs.
Personal savings and home equity
Savings, investments, pensions, Social Security and the sale of a home cover much of the rest. Some families use a reverse mortgage or a home equity line to pay for care at home, though both carry costs and risks that deserve careful review.
Planning ahead, whatever your age
If you are in your 40s or 50s, the most useful step is a conversation. Ask your parents what they would want if they needed help, where their documents are, and whether they have any coverage. It is also the cheapest time to price long-term care insurance for yourself.
If you are in your 60s, decide how you would pay for three years of care in your state, using the table above. That might mean earmarking part of your savings, buying a policy, or planning to use home equity.
If care is needed now, start with a needs assessment from a doctor or your local Area Agency on Aging, which can also explain state programs. Then get quotes from at least two providers of each type of care you are considering.
Frequently asked questions
How much does a nursing home cost per month? The 2025 national median for a semi-private room was $315 a day, or about $9,581 a month. A private room was $355 a day, about $10,798 a month. Costs vary widely by state.
How much does assisted living cost per month? The national median was $6,200 a month in 2025. State medians ranged from about $4,400 in Mississippi and Alabama to more than $12,000 in Hawaii.
Does Medicare pay for assisted living? No. Medicare does not pay assisted living rent or ongoing help with daily activities. Medicaid programs in many states can cover some assisted living services for people who qualify.
What is the cheapest state for long-term care? For assisted living, Mississippi and Alabama have the lowest medians. For nursing homes, Texas, Missouri and Oklahoma are the least expensive.
Sources
- CareScout, Cost of Care Survey 2025, national results and state median tables (released March 2026)
- LongTermCare.gov (U.S. Administration for Community Living), “How Much Care Will You Need?”
- Medicare.gov, skilled nursing facility and home health coverage
- Medicaid.gov, long-term services and supports and home and community-based services
- U.S. Department of Veterans Affairs, VA pension with Aid and Attendance
Costs are state medians and will vary by city and provider. This article is general information, not financial, legal or medical advice.
