How Much Assisted Living Costs and How to Pay

Aging isn’t just hard on your health — it can be hard on your wallet too.

Senior care can cost more than $500,000 per lifetime, according to various estimates. But as we age, many of us need additional assistance with daily activities and health care.

Here, we’ll unpack how much that might cost and the ways families can manage this big expense later in life.

How Much Does Assisted Living Cost?

The national average monthly cost for assisted living is about $5,350, according to Genworth Financial’s 2023 Cost of Care Survey (the most recent data available).

That’s a lot of money, but compare that to the average monthly fees for nursing homes:

Semi-private nursing home room: $8,669 per month

Private nursing home room: $9,733 per month

This means that assisted living, when medically appropriate, is still expensive but a more economic option than a nursing home.

Aging in place at home may save you some money over assisted living. In-home care costs typically start at about $33 per hour, depending on the requested services and location. That amount may be more affordable if you only need a few hours of care at a time, but full-time care can add up quickly and may be difficult to staff appropriately.

If any of these potential expenses have you considering moving your loved one to a lower-cost-of-living area for their care, check in with them and the rest of the family first. Discuss which family member is most likely and willing to visit them often and if it might be worth having your senior relocate to be near that family member.

[READ How to Determine if Your Aging Parent Needs Additional Support]

How much does assisted living cost for a couple?

Assisted living for couples costs are often based on individual living situations. For instance, if one spouse is in assisted living and paying $5,350 per month, while the other is maintaining the family home, costs add up fast. In that scenario, it may be more cost-effective for both spouses to live in assisted living or to both remain at home and pay for in-home care for the spouse who needs it.

If a couple is living together in assisted living, they may be able to share the rent cost. However, depending on the services each requires, additional costs may vary widely.

[READ Understanding the Different Elder Care Options]

What Is and Is Not Included in Assisted Living Costs

Assisted living costs include:

— Room and board

— Housekeeping services

— Social, educational and physical activities at the facility

Depending on the community, costs may also include assistance with activities of daily living, such as:

— Dressing

— Toileting

— Hygiene and bathing

— Medication management

— Transportation (to doctor appointments, grocery stores and other destinations)

— Laundry services

— Meal preparation

Assisted living costs often do not include:

— Phone and internet services

— Personal supplies, such as incontinence care and toiletries

— Some personal grooming, such as hairstyling or salon-like services, including nail care

[Read: The Highest Medical Costs to Expect in Retirement.]

Does Medicare Pay for Assisted Living?

No, Medicare — the government-run health care insurance plan primarily designed for people ages 65 and older — does not cover the costs of long-term care. That includes most assisted living, nursing home or long-term care facility costs.

Specifically, Medicare doesn’t cover custodial (or nonmedical) care, such as bathing and other activities of daily living, which are the very tasks most people need help with in assisted living.

What Medicare does cover, to some degree, is home health and aide services, such as physical or occupational therapy or skilled nursing services ordered by a physician after a hospital stay.

Medicare Advantage, offered through private insurers, may help cover some custodial care costs, but you will need to explore specific plans.

How to Finance Assisted Living

Steve Jorgenson, CEO and president of Solterra Senior Living in Scottsdale, Arizona, recommends that you research all the available payment options, including:

— Financing

— Medicaid

— Long-term care insurance

— Private health insurance

— Social programs, such as PACE, SHIP, Veterans Affairs or Social Security Disability Insurance

You may also want to consult with a financial advisor, an attorney who specializes in elder law or a geriatric care manager about how to pay the hefty costs of assisted living.

How to Pay for Assisted Living With No Money

The costs of elderly care can be an enormous burden on seniors and their families. With the median stay at about 22 months, according to the American Health Care Association and the National Center for Assisted Living, and that average cost of $5,350 per month, assisted living costs could come out to more than $117,700. If your loved one fares better than average, you could be looking at an exponentially higher total care cost.

Assisted living residents typically pay at least some assisted living costs out of pocket with their own savings and retirement income or with financial assistance from their adult children.

Selling your home will help, but you will have to pay off any remaining mortgage on the house first. You could also consider a reverse mortgage, which involves selling your home back to the bank and collecting monthly payments while you continue to live there. This property needs to be your principal residence, and you can’t be delinquent on any payments or taxes. You will also need to comply with eligibility requirements, such as a credit check. (Read more on this in the FAQs below.)

Factors That Determine the Cost of Assisted Living

The three main factors that go into the price of assisted living are:

— How much assistance the individual requires

— The types of amenities or luxury experiences

— The location of the facility

When you’re deciding on a community, some questions to ask about pricing include:

— How much does pricing vary by room type or floor plan?

— Are there pricing tiers structured around the level of care?

— Are there annual pricing increases, and how much are the increases?

— Which services and activities are included, and which cost more?

— Are there upfront fees, such as deposits or community or move-in fees?

— What notice do I need to provide if I choose to move out?

— Can my loved ones stay indefinitely, or would they ever be asked to move to a community that offers a higher level of care?

There are three primary ways in which assisted living facilities structure fees:

All-inclusive: If you have a lot of needs, selecting an all-inclusive option might be your best bet. With these plans, everything is covered under one monthly bill, so you’re not adding services as you go and not having to think about every dime you spend.

A la carte: With a la carte pricing, residents select only the services they want or need, such as meals, one-on-one caregiving and medication management, and pay for those as individual line items. In some cases, you can add or remove services from month to month, depending on the contract with the community. While this approach can save you money initially, as your care needs increase, so can your costs.

Levels of care: This pricing structure is the most common among assisted living communities. Essentially, this option specifies upfront how the community charges for care services based on the resident’s abilities and the amount of time needed to assist the resident with tasks. Because a resident’s care needs can change as they age, this structure is often tiered; you might start at a lower tier but progress to a higher tier, with associated costs, as you require more assistance.

How Care Costs Are Billed

Exactly how much a service costs and how it’s billed to the resident depend on how the operator runs the business. Many assisted living communities are run as for-profit companies. That means the business needs to make a profit, which could mean a higher price tag.

Personal care services, such as those offered in an assisted living facility, are usually a labor-based cost, rather than materials- or equipment-driven, so the hourly wage of the caregiver, plus any profit margin, are typically used to calculate care costs.

When choosing the right assisted living community, it’s important to do your research and be careful to compare apples to apples. This isn’t always an easy task, given the variety of billing models in the industry.

For example, if you’re considering an assisted living community that costs $4,000 per month, but it offers add-on services a la carte, you might end up spending closer to $6,000 per month for what you need. How does that then compare to the $6,100-per-month facility up the street that’s using an all-inclusive model?

Some communities also charge a one-time upfront “community fee,” and most bill for room and board on a monthly cycle. Other a la carte or ancillary services are also typically billed as additional fees on a monthly basis.

There’s currently no comprehensive database for assisted living community costs through the Centers for Medicare and Medicaid Services or, so you may need to ask for a quote at your top communities to get specific numbers for a comparison. Another option is to visit a commercial site like Genworth Financial to compare senior care costs in your geographical area.

Bottom line: Develop a budget and be sure to plan 12 to 24 months in advance each time you reassess your financial situation, and be sure you understand what you’re on the hook for before you sign any contracts.

Lowering the Cost of Assisted Living

If you’re looking to lower the cost of assisted living, Casey Allen, head of product and co-founder of SeniorLytics, a Vancouver, Washington–based SaaS analytics platform for senior living, recommends looking for a facility that “offers assistance with activities for daily living but doesn’t provide nursing care or specialized medical services.”

It’s important to remember that each facility and its offerings are different, so be sure to do your research on assisted living facilities.

“If you find that a particular facility is charging too much for its services, you may be able to negotiate a lower rate,” Allen says.

Larger families can also consider caring for seniors in their own home before hiring outside caregivers or moving them to assisted living, says Joanna Fuller-Crawford, CEO of Perfect Care Nursing, an in-home care provider offering skilled and unskilled support in and around metro Atlanta.

If you’re looking to go this route, however, it’s important to be realistic about the cost versus the benefit of senior care services. For instance, you might need to cut your work hours to take care of your aging parent.

But some seniors could benefit from the care that assisted living communities provide: help with daily tasks, on-site medical staff, socialization and three nutritious meals every day. Having the peace of mind that comes with balancing care needs with other financial and family priorities may be priceless.

More from U.S. News

When to Move From Assisted Living to Memory Care

Long-Term Care Facilities: Types and Costs

Home Safety Checklist for Seniors

How Much Assisted Living Costs and How to Pay originally appeared on

Update 06/13/24: This story was previously published at an earlier date and has been updated with new information.

Federal News Network Logo
Log in to your WTOP account for notifications and alerts customized for you.

Sign up