Long-Term Care Cost
How much does long-term care cost?
Updated April 1, 2026 · Editorial policy
Long-term care is the biggest predictable expense most families never plan for. Costs depend heavily on where you live and what level of care you need. Here are the 2025 national medians and the rules of thumb to translate them to your situation.
Costs by setting (2025 national median)
These figures come from the Genworth Cost of Care Survey, the standard reference for U.S. long-term care prices.
- Adult day health care: about $2,200/month.
- Homemaker (non-medical home care): about $6,300/month for full-time.
- Home health aide: about $6,500/month for full-time.
- Assisted living: about $5,900/month.
- Memory care (assisted living dementia wing): typically $1,500–$2,500 more than assisted living, so about $7,500–$8,500/month.
- Nursing home, semi-private room: about $9,000/month.
- Nursing home, private room: about $10,600/month.
What drives the price
The biggest variables are:
- Geography — costs in coastal metros (Boston, San Francisco, NYC) can be 50–100% higher than the national median; some Southern and Midwestern cities are 20–40% lower.
- Level of care — assisted living facilities charge a base rate plus 'levels of care' that add $500–$2,000/month as needs grow.
- Hours of home care — a few hours a day is affordable; 24/7 home care often exceeds the cost of skilled nursing.
- Memory care surcharge — secured units, higher staffing ratios, and dementia-trained care add $1,500–$2,500/month.
- Length of stay — the average nursing home stay is just under 2 years, but Alzheimer's care can run 4–8 years.
How families pay
The funding mix depends on income, assets, and planning lead time. The big sources, in rough order:
- Personal savings + Social Security + pensions.
- Long-term care insurance — strongest if bought 55–65 in good health.
- Selling the home — most common funding event for assisted living.
- Medicaid — largest payer of nursing home care; HCBS waivers help with home and assisted living for qualifying low-income seniors.
- VA Aid & Attendance — for qualifying wartime veterans and surviving spouses.
- Reverse mortgage, life insurance accelerated benefits, viatical settlements — used in specific situations.
Sources
- Genworth Cost of Care Survey
- Medicare.gov — What Part A covers
- Medicaid.gov — HCBS
- IRS Pub 502 — Medical expenses
Sandwich is a directory and information site. This page is not legal, medical, or financial advice. For decisions that affect your family, consult a licensed professional in your state.
Frequently asked questions
Why is home care sometimes more expensive than assisted living?
Assisted living spreads staffing across many residents. One-on-one home care for 8+ hours a day pays for one caregiver dedicated to one person, which is usually a higher hourly cost.
Does Medicare pay any of this?
Only short-term skilled care (up to 100 days) after a qualifying hospital stay. Medicare does not pay for long-term custodial care.
How much does memory care cost on top of assisted living?
Typically $1,500–$2,500/month more than the same facility's standard assisted living rate. The premium pays for higher staffing, secured units, and dementia-trained caregivers.
Are these costs tax-deductible?
Some are. Long-term care expenses for someone meeting the IRS's 'chronically ill individual' standard can be deductible as a medical expense above 7.5% of AGI. Long-term care insurance premiums are partially deductible up to age-based caps.
Will costs keep rising?
Yes. Long-term care costs have grown faster than overall inflation for two decades, driven by labor shortages and rising demand. A good LTC insurance policy includes a 3-5% compound inflation rider for that reason.