Cost comparison with 2026 national and state-level data
If you're researching care options for a parent or loved one, cost is probably one of your biggest concerns -- and it should be. The difference between assisted living and a nursing home can be thousands of dollars every month, and the right choice depends on more than just price. Here's what you need to know.
Assisted living costs between $3,000 and $7,000 per month nationally, with a median around $4,995. Nursing homes cost between $5,600 and $16,000 per month, with the national median for a semi-private room at approximately $9,277 per month.
That's a significant gap. But the two options serve very different needs, and choosing based on price alone can lead to a placement that doesn't work -- which often costs more in the long run when you have to move a loved one again.
This guide walks through what each type of care includes, when each makes sense, how to pay for them, and how costs vary by state so you can make an informed decision.
| Care Type | National Median (Monthly) | What's Included | Best For |
|---|---|---|---|
| Assisted Living | $4,995 | Room, meals, ADL help, social activities | Seniors who need daily help but not medical care |
| Memory Care | $6,200 | Everything in AL + dementia-specific programming | Seniors with Alzheimer's or other dementia |
| Nursing Home (Semi-Private) | $9,277 | 24/7 skilled nursing, therapy, physician oversight | Seniors who need ongoing medical care |
| Nursing Home (Private Room) | $10,646 | Same as semi-private, own room | Same needs, more privacy preferred |
Sources: Genworth Cost of Care Survey, AARP Long-Term Care Cost Data, 2025-2026 figures.
The annual difference between assisted living and a semi-private nursing home room is roughly $51,000 per year. That's a life-changing amount of money for most families, which is why it's so important to understand whether your loved one truly needs the higher level of care.
Assisted living facilities are designed for older adults who are mostly independent but need help with some daily tasks. Think of it as a middle ground between living at home and being in a medical facility. Your parent gets their own apartment or room, but staff are available to help when needed.
Most assisted living facilities charge a base rate that covers room, board, and a standard level of care. If your loved one needs extra help -- for example, assistance with transfers or incontinence care -- there may be additional "level of care" charges that add $500 to $2,000 per month on top of the base rate.
Nursing homes (also called skilled nursing facilities or SNFs) provide a much higher level of medical care. They're staffed by registered nurses around the clock, and a physician oversees each resident's care plan. If your loved one has serious, ongoing medical needs, this is the level of care they need.
Nursing homes are regulated as healthcare facilities, which means more oversight, more staffing requirements, and more documentation. That regulatory burden is one reason they cost significantly more than assisted living.
See how assisted living, memory care, and nursing home costs compare for your state.
Calculate Your Costs →This table breaks down the key differences between assisted living and nursing homes so you can see at a glance which level of care matches your loved one's needs.
| Feature | Assisted Living | Nursing Home |
|---|---|---|
| Monthly cost (median) | $4,995 | $9,277 |
| Living space | Private apartment or suite | Shared or private room |
| Nursing staff on-site 24/7 | No (aides, not nurses) | Yes (RNs and LPNs) |
| Physician oversight | No | Yes |
| Physical/occupational therapy | Contracted (extra cost) | Included on-site |
| Medication management | Reminders and administration | Full medical management |
| Meals included | Yes (3/day + snacks) | Yes (3/day + snacks) |
| Social activities | Extensive programming | Available, varies by facility |
| Autonomy and independence | High -- come and go freely | Lower -- structured environment |
| Medicaid coverage | Limited (varies by state) | Yes (once assets depleted) |
| Medicare coverage | No | Up to 100 days post-hospital |
| Average length of stay | 2 - 3 years | 1 - 2 years |
Assisted living is the right choice when your loved one needs help with daily tasks but doesn't have medical conditions requiring round-the-clock nursing. Here are some common situations where assisted living is the better fit:
A nursing home becomes necessary when the level of medical care your loved one needs goes beyond what assisted living can safely provide. These situations typically call for skilled nursing:
An important note: many families feel guilty about a nursing home placement, but it's sometimes the only option that keeps a loved one safe. An assisted living facility that can't meet your parent's medical needs isn't saving money -- it's putting them at risk.
Memory care is a specialized type of assisted living designed specifically for people with Alzheimer's disease or other forms of dementia. It sits between standard assisted living and a nursing home in terms of both cost and level of care.
Memory care typically costs about 25% more than standard assisted living in the same area. If the base assisted living rate is $5,000 per month, expect to pay around $6,200 for memory care. Nationally, memory care ranges from roughly $4,000 to $8,500 per month depending on location and facility quality.
Some families try to keep a loved one with early-stage dementia in standard assisted living to save money. This can work temporarily, but once the dementia progresses to the point where wandering, aggression, or severe confusion becomes an issue, a move to memory care becomes necessary for safety. Planning ahead for this transition can reduce the stress on everyone involved.
This is the question that keeps most families up at night. Senior care is expensive, and there's no single program that covers everything. Here are the main ways families pay:
The most common payment method for assisted living. Families use a combination of the senior's Social Security income, pension, retirement savings, and proceeds from selling a home. About 70% of assisted living costs are paid privately.
Medicaid is the largest payer for nursing home care in the United States. Once a person's assets are depleted to their state's eligibility threshold (typically $2,000 in countable assets for an individual), Medicaid covers the full cost of a nursing home. For assisted living, Medicaid coverage is limited and varies dramatically by state -- some states have Medicaid waiver programs that cover part of the cost, while others offer nothing.
Important: Medicaid has a "look-back period" (typically 5 years) where they review financial transactions. Giving away assets to qualify faster can result in a penalty period where Medicaid won't pay. If Medicaid is part of your plan, consult an elder law attorney sooner rather than later.
Medicare does not cover assisted living under any circumstances. For nursing homes, Medicare covers up to 100 days of skilled nursing care following a qualifying hospital stay of at least 3 days. Days 1-20 are covered in full. Days 21-100 require a daily copay (about $204/day in 2026). After day 100, Medicare coverage ends completely.
This means Medicare is useful for short-term rehab after a hospital stay, but it is not a long-term payment strategy for nursing home care.
If your parent purchased a long-term care insurance policy years ago, now is the time to review it carefully. These policies typically pay a daily or monthly benefit once the insured person needs help with 2 or more ADLs. Benefits usually last 2-5 years and may cover assisted living, memory care, or nursing home care depending on the policy.
The catch: most people don't have this coverage. Long-term care insurance is expensive, and many people either never purchased a policy or let theirs lapse. If your parent does have one, contact the insurance company early in the process -- there's often a waiting period before benefits kick in.
The VA's Aid and Attendance pension benefit provides up to $2,431/month for a veteran (or $1,564/month for a surviving spouse) to help pay for assisted living or nursing home care. This benefit is underutilized -- many eligible veterans don't know it exists. The veteran must have served during a qualifying wartime period and meet income/asset thresholds.
VA nursing homes (Community Living Centers) are also available to eligible veterans, often at no cost or reduced cost. Wait lists can be long, but they're worth exploring.
See how assisted living, memory care, and nursing home costs compare for your state.
Calculate Your Costs →Where your parent lives (or where you're considering placing them) has an enormous impact on cost. The difference between the cheapest and most expensive states for assisted living is more than double.
| State | Median Monthly Cost | Compared to National Median |
|---|---|---|
| Missouri (cheapest) | $3,000 | -40% |
| Arkansas | $3,293 | -34% |
| Georgia | $3,600 | -28% |
| Ohio | $4,538 | -9% |
| National Median | $4,995 | -- |
| Massachusetts | $6,250 | +25% |
| Alaska | $6,830 | +37% |
| Washington, D.C. (most expensive) | $6,978 | +40% |
Sources: Genworth Cost of Care Survey, state aging agency data, 2025-2026 figures.
The same pattern holds for nursing homes, with costs in the Northeast and West Coast running significantly higher than the Midwest and South. A semi-private nursing home room in Alaska or Connecticut can exceed $14,000 per month, while Missouri and Oklahoma may be closer to $5,600.
One strategy some families consider: relocating a parent to a lower-cost state. This can save significant money, but it also means moving your loved one away from their community, friends, and familiar surroundings. For someone with dementia, this can be especially disorienting and is generally not recommended. It works best when the move also brings the parent closer to family who can visit regularly.
Yes, and this is actually the most common path. Many seniors spend 2-3 years in assisted living before their care needs increase to the point where skilled nursing becomes necessary. Some larger communities offer a "continuum of care" with assisted living, memory care, and skilled nursing all on the same campus, which makes transitions easier. If you think a move may be needed eventually, choosing a community with multiple care levels upfront can save a lot of stress later.
It can be, partially. If a physician certifies that your loved one is "chronically ill" (needs help with 2+ ADLs for at least 90 days), then the portion of assisted living costs attributable to personal care services may qualify as a medical expense deduction. You can only deduct medical expenses that exceed 7.5% of your adjusted gross income, and you must itemize deductions. Nursing home costs are generally fully deductible as a medical expense if the stay is medically necessary. Consult a tax professional for your specific situation.
Start by contacting your state's Area Agency on Aging (find yours at eldercare.acl.gov or call 1-800-677-1116). They can connect you with Medicaid waiver programs, state-funded assistance, local nonprofit resources, and sliding-scale facilities. For veterans, the VA Aid and Attendance benefit is often overlooked. Some assisted living facilities also accept Medicaid or offer financial assistance programs. Don't assume the sticker price is the only option -- there are more resources available than most people realize.
Ask their physician for a formal care needs assessment. Many assisted living facilities also provide free assessments as part of the admissions process. Look at how many ADLs they need help with, whether they have medical conditions requiring daily nursing intervention, and whether they can be safely left alone for periods of time. If you're unsure, a geriatric care manager (also called an aging life care professional) can do a comprehensive evaluation and recommend the appropriate level of care. This typically costs $200-500 but can save thousands by ensuring the right placement from the start.
Choosing between assisted living and a nursing home is rarely a clear-cut financial decision. It's a balance between your loved one's care needs, their quality of life, their preferences, and your family's financial reality.
Here's a practical framework:
You're not alone in this process, and there's no single "right" answer. The best choice is the one that keeps your loved one safe, maintains their dignity, and is financially sustainable for your family.
See how assisted living, memory care, and nursing home costs compare for your state.
Calculate Your Costs →