Cost of Long Term Care
The high cost of receiving Long Term Care can erode the nest egg you've worked so hard to save. Understanding today's costs — and where they're heading — is the first step in protecting your retirement.
National Average Care Costs
Annual cost of care by type — these figures represent national medians and can vary significantly by location.
Source: CareScout Cost of Care Survey, 2025 national medians. Annual figures follow the survey's own basis — a daily rate over 365 days for nursing home care, a monthly rate over 12 months for assisted living, and $35 an hour at 44 hours a week for a home health aide.
Major cities cost significantly more. Nursing home care in Boston and New York City exceeds $150,000 per year. Always check costs specific to your area when planning coverage.
Costs Vary Dramatically by State
Alaska sits in a class of its own at $378,140 a year for a nursing home room, which is why the map colours it outside the scale on the two nursing-home views. Set Alaska aside and the most expensive state still runs about 2.5× the cheapest for a private room and 2.8× for a semi-private one, while assisted living spans about 2.1× and home care about 1.7×. Toggle a care type to compare states within it — but don't compare one care type against another here: this table mixes survey vintages, and we can't confirm the four care types share one (note under the map).
Alaska tops the map at $378,140/yr for private nursing home — that's 239% above the median state in this table, $111,690.
Alaska shown in deep bronze — a severe outlier at $378K/yr for nursing home care.
These state figures are an older cost-of-care compilation, not current Cost of Care Survey medians, and every percentage on this map compares a state with the median state in the same table.
New York
About these state figures: they come from an older cost-of-care compilation, not from the 2025 CareScout survey behind the national numbers above, and we cannot tie them to a specific survey year. As a set they run low — the median state's private room, $111,690, is about 14% under the $129,575 national median — while individual states on the map sit far above and far below that national figure. So read the map for how sharply cost varies by geography, not as today's price in any one state. The four care types are not one snapshot either: each column is built on its own basis, and the cells that do reproduce a published national figure point at different survey years — two private-room cells, an assisted-living value, and home-care values among them. That means part of any gap the map shows between one care type and another is a difference in when each column was collected rather than in price; for that comparison use the four 2025 national medians at the top of this page, which are all one survey year. Our state guides break this same table down by metro area and carry its vintage with it; for a current figure where you live, CareScout publishes the survey's own national and state medians.
Browse our state guides →CareScout Cost of Care state medians →
Who Pays for Long-Term Care?
These are shares of the money — $563.7 billion of long-term services and supports in 2023 — not shares of people. Medicare's slice looks large because federal accounting counts post-hospital skilled nursing and short-term home health as long-term services; toward ongoing custodial care, Medicare pays nothing.
The largest payer, and it starts only after a spend-down to your state's asset limit
Up to 100 days of skilled nursing after a qualifying hospital stay, plus short-term home health — not custodial care
Families paying directly from savings, income, and home equity
Long-term care policies, plus the long-term services private health coverage happens to pay for
Other public programs such as the VA, plus philanthropy and other private funds — CRS's two residual categories, folded together here
Source: Congressional Research Service, Who Pays for Long-Term Services and Supports? (In Focus IF10343, updated August 2025), analysing Centers for Medicare & Medicaid Services National Health Expenditure Accounts data for 2023. The five shares cover every payer in that accounting and add to 100%.
The Sobering Reality
- •Someone turning 65 today has close to a 70% chance of needing some form of long-term services and supports, and about 1 in 5 will need them for longer than five years.
- •Medicare is not a long-term care benefit. It covers up to 100 days of skilled nursing care following a qualifying hospital stay, and does not cover long-term nursing facility care at all.
- •More than 60% of the 1.2 million people living in US nursing facilities have Medicaid as their primary payer — a share of residents rather than of spending, and one Medicaid reaches only after a spend-down to the state's asset limit.
Sources: Administration for Community Living, How Much Care Will You Need? (acl.gov); KFF, 5 Key Facts About Nursing Facilities and Medicaid (resident counts as of July 2024).
Costs Are Rising Fast
This site uses 4.5% a year as an illustrative planning rate for long-run care-cost growth — the same default as the inflation-protection lab, and within the 4–5% range often cited. At that rate, $150/day of care today would cost about $451/day in 25 years.
| Care Type | Today | Projected (10 years) | Projected (20 years) |
|---|---|---|---|
| Home Health Aide | $80,080 | $124,400 | $193,100 |
| Assisted Living | $74,400 | $115,500 | $179,400 |
| Semi-Private Nursing | $114,975 | $178,600 | $277,300 |
| Private Nursing | $129,575 | $201,200 | $312,500 |
The “Today” column is the 2025 CareScout national medians shown above; projections apply a 4.5% annual planning rate (the same illustrative rate used on the inflation-protection lab), rounded to the nearest $100.
Putting Costs in Perspective
Nursing home care costs more than two years' worth of paychecks for an average American
Assisted living costs roughly the same as average annual mortgage payments on THREE houses
Home health care costs more than average tuition for a four-year state college
Three years in a private room at today's median. ACL puts long-term care use at about three years on average across all settings — most of it in cheaper ones than this
Five years in a private room at today's median — the outer edge, not a typical bill. ACL's "1 in 5 need care longer than five years" counts care in any setting, mostly unpaid help at home; about 35% of people ever use a nursing facility, and those who do average about 1 year in it
Estimated cost of living to age 100 — a growing reality as life expectancy increases
What Does LTC Insurance Cost?
Premiums are based on your age at purchase, health, and coverage level. Rate differences between carriers range from 15% to 65% for basically the same policies — comparison shopping is critical.
| Age at Purchase | Annual Premium | Total Paid to Age 90 |
|---|---|---|
| Age 50 | $2,219 | $88,760 |
| Age 55 | $2,998 | $104,930 |
| Age 60 | $4,050 | $121,500 |
| Age 65 | $5,471 | $136,775 |
An illustration, not a quote. The age-60 row prices our typical client — a 60-year-old woman in standard health, married with both spouses applying, in a mid-cost state — buying a $200/day benefit with a 3-year benefit period, 3% compound inflation and a 90-day elimination period. The other rows hold that profile and that design fixed and move only the age at purchase. The couples discount is already inside these figures; without it — a single applicant, or at many carriers one spouse applying alone — the same policy runs roughly 43% more. Age at purchase, gender, health class, marital status, benefit design, carrier and state each move the number, in either direction. The last column simply holds the premium level from the purchase age to 90 — 40 payments at age 50, 25 at age 65 — and premiums on traditional policies are not guaranteed: carriers can request rate increases from state regulators.
Find Out What Coverage Costs in Your Area
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