What will nursing home or memory care actually cost — and how long will your money last?

Medicaid covers long-term nursing home care, but only after you've spent down most of your assets to your state's threshold — typically around $2,000 in countable assets. A family with $300,000 in savings must spend approximately $298,000 on care before Medicaid begins paying. Some assets are exempt — including your primary home (in many situations), one vehicle, and personal property. An elder law attorney can help you legally protect assets before the spend-down period begins.

When you apply for Medicaid nursing home coverage, the state reviews all asset transfers made in the 5 years before your application. If you gave money to family members, transferred property, or made large gifts during this window, Medicaid can impose a penalty period — a period of time during which you're ineligible for coverage even if you've met the asset threshold. The penalty period is calculated based on the value of transferred assets divided by the average monthly nursing home cost in your state. Consult an elder law attorney before transferring any assets.

Medicare covers nursing home care only in limited circumstances. After a qualifying hospital stay of at least 3 days, Medicare covers 100% of skilled nursing facility costs for the first 20 days. From days 21–100, you pay a $217/day copayment (2026). After 100 days, Medicare pays nothing. Medicare does not cover custodial care — the daily help with bathing, dressing, and eating that most nursing home residents need. Medicare also does not cover memory care facilities at all. Medicaid is the primary payer for long-term custodial nursing home care.

Memory care is a specialized form of assisted living specifically designed for people with Alzheimer's or dementia. It features secured units to prevent wandering, staff trained in dementia care, and programming for cognitive engagement. Memory care costs approximately 20–30% more than standard assisted living but less than a nursing home in most states. A nursing home provides the highest level of medical care — skilled nursing, physician oversight, and rehabilitation services — for people with complex medical needs. Many families transition from memory care to nursing home care as dementia progresses.

The family home is often exempt from the Medicaid asset calculation — you generally don't have to sell it to qualify. However, after the Medicaid recipient passes away, the state can make a claim against the estate to recover what Medicaid paid. This is called Medicaid Estate Recovery. Strategies to protect the home include placing it in an irrevocable trust (must be done 5+ years before applying), transferring it to a spouse or certain dependents, or other legal structures. An elder law attorney specializing in Medicaid planning is essential for this — these strategies must be implemented before the 5-year look-back window opens.

This calculator provides estimates based on state median costs. It does not include: state-specific Medicaid rules beyond the basic asset threshold, spousal protection rules (a community spouse can keep more assets), long-term care insurance benefits, VA benefit calculations, tax deductions for medical expenses, Medicaid Estate Recovery implications, or facility-specific pricing (which can vary 30–60% from state medians). The Medicaid spend-down timeline is a simplified estimate — actual eligibility depends on many state-specific factors. This tool is for educational planning only and is not legal, financial, or medical advice.