$10,798
Median private nursing home room/month (CareScout 2025 data)
$7,750
Median memory care facility/month (estimated, 2025)
70%
Of people over 65 who will need long-term care
$2,000
Medicaid asset limit before coverage begins (most states)
Calculate Your True Care Costs & Medicaid Timeline
6 inputs · Results in under 30 seconds · No email required
1
Where does your family member live?
Care costs vary enormously by state — we use the latest CareScout 2025 median data for all 50 states
Medicaid typically only covers semi-private rooms. Private rooms require private pay or long-term care insurance.
2
What level of care is needed?
Select the care type that best fits current or anticipated needs — costs shown are for your selected state
3
Total savings and assets available for care?
Include savings, investments, and home equity if the home will be sold — this drives your Medicaid timeline
4
Is there a spouse still living at home?
This significantly changes the Medicaid asset threshold — married couples can keep much more
5
Monthly income available? (Social Security, pension, etc.)
This reduces your monthly out-of-pocket cost and slows the Medicaid timeline
Note: The 2026 average Social Security benefit is $2,071/month. Once on Medicaid, most of your monthly income goes toward care costs — Medicaid allows only a small Personal Needs Allowance (typically $30–$200/month depending on state).
6
How many years are you planning for?
Average nursing home stay is 2.5 years. Memory care and dementia can require 5–10+ years.
Your Cost Comparison & Medicaid Timeline
Based on your inputs and 2026 state median data
Option 1
Home Health Aide
State hourly rate—
44 hrs/week—
Monthly cost—
—
Option 2
Assisted Living
Base monthly rate—
Care add-ons~$500
Monthly cost—
—
Option 3
Memory Care
Secure unit rate—
Dementia staff premium
Monthly cost—
—
Option 4
Nursing Home
Room type selected—
All care includedBundled
Monthly cost—
—
Your Medicaid Spend-Down Timeline
—
Monthly out-of-pocket cost
—
Time until Medicaid eligibility
—
Estimated Medicaid start date
⚠ 5-Year Look-Back Rule: Medicaid reviews all asset transfers made within 5 years of your application. Gifts, property transfers, or large withdrawals during this period can delay eligibility. Consult an elder law attorney before moving any assets.
What This Means For Your Family
Total Cost Over 4 Years
* Applies 5% annual cost increase (LTC inflation average — higher than general CPI). Out-of-pocket = care cost minus monthly income. Row highlighted purple = year Medicaid eligibility is reached.
What to Do Next
Use these results as a starting point — then verify with professionals before making any decisions.
🔍 Medicare Care Compare
Rate and compare nursing homes and memory care facilities in your area using official CMS quality and inspection data.
⚖️ Find an Elder Law Attorney
Essential if Medicaid is in your future. An elder law attorney can protect assets legally through trusts, spend-down strategies, and Medicaid planning — before the 5-year look-back window closes.
🎖 VA Aid & Attendance
If your family member is a wartime veteran or surviving spouse, this benefit pays up to $1,558–$2,874/month tax-free toward nursing or memory care costs. Massively underused.
📞 Eldercare Locator (free)
Call 1-800-677-1116 to connect with local Area Agencies on Aging, Medicaid counselors, and other free senior care planning resources.
These are gross costs before benefits. VA Aid & Attendance, long-term care insurance payouts, and tax deductions for medical expenses can significantly reduce what your family actually pays. An elder law attorney can help you apply every benefit before spending down assets toward Medicaid.
National cost comparison
All care options side by side — national medians from the CareScout 2025 Cost of Care Survey, released March 2026
| Care Type | Monthly Median | Annual Cost | Medicaid Covers? | Avg Duration |
|---|---|---|---|---|
| Home Health Aide (44 hrs/wk) | $5,339 | $64,068 | Partial (HCBS waivers) | Varies |
| Assisted Living | $6,200 | $74,400 | Some states only | 2–3 years |
| Memory Care (estimated) | $7,750 | $93,000 | Limited | 5–10 years |
| Nursing Home (private room) | $10,798 | $129,575 | ✓ After spend-down | 2.5 years avg |
| Nursing Home (semi-private) | $9,581 | $114,975 | ✓ After spend-down | 2.5 years avg |
Common Questions
What is the Medicaid spend-down and how does it work?
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.
What is the 5-year Medicaid look-back period?
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.
Does Medicare pay for nursing home or memory care?
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.
What is the difference between memory care and a nursing home?
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.
Can I protect my house from the Medicaid spend-down?
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.
What does this calculator NOT include?
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.
How long will my savings last in a nursing home?
It depends on your savings, monthly income, and state. At the national median of $10,798 per month for a nursing home private room, someone with $200,000 in savings and $3,000 per month in retirement income covers the gap for roughly 26 months before reaching Medicaid asset limits of approximately $2,000. The calculator above shows your exact spend-down timeline based on your state's median costs, your savings, your income, and a 5% annual LTC cost inflation rate. High-cost states like Oregon ($18,448/mo private room) and Connecticut ($16,729/mo) burn through savings roughly twice as fast as low-cost states like Texas ($7,604/mo) and Missouri ($7,604/mo).
What is the difference between assisted living and a nursing home?
Assisted living provides help with daily activities like bathing, dressing, and medication management — with a national median of $6,200 per month per CareScout 2025. A nursing home, also called a skilled nursing facility, provides 24-hour medical care with licensed nurses and averages $10,798 per month for a private room. Memory care sits between them at approximately $7,750 per month and specializes in dementia care with higher staff ratios and secured environments. The transition from assisted living to a nursing home typically happens when someone needs 24-hour medical supervision, has advanced dementia with wandering or aggression, is recovering from a stroke or major surgery, or has equipment needs that assisted living staff cannot manage.
When should someone move from assisted living to a nursing home?
Typical triggers for a move from assisted living to a nursing home include: needing 24-hour medical supervision, advanced dementia with wandering or aggression that cannot be safely managed, recovery from a stroke or major surgery, chronic incontinence that requires constant care, or feeding tubes or other medical equipment that assisted living staff cannot manage. Assisted living facilities will typically give the family 30 days notice when they determine they can no longer safely provide care. Memory care is an intermediate option for someone with dementia who doesn't yet need skilled nursing but has outgrown assisted living.
Does VA Aid & Attendance cover nursing home costs?
Yes, for eligible wartime veterans and surviving spouses. For benefits effective December 1, 2025 through November 30, 2026, the maximum monthly Aid & Attendance benefits are: $2,424 for a single veteran, $2,874 for a married veteran, and $1,558 for a surviving spouse. These funds can be used for nursing home, memory care, assisted living, or in-home care. To qualify, the veteran must have served at least 90 days of active duty with at least one day during an official wartime period, require assistance with activities of daily living, and meet income and asset requirements. Apply through VA.gov or with help from an accredited VA benefits attorney.
Nursing home costs by state
Current median costs for all 50 states — private room, semi-private, memory care, Medicaid asset limits, and spend-down timelines.
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Data sources: State and national median costs are from the CareScout 2025 Cost of Care Survey, released March 2, 2026, conducted between July and November 2025 (carescout.com/cost-of-care). Medicaid Community Spouse Resource Allowance (CSRA) maximum of $162,660 and Federal Benefit Rate of $994/month are 2026 federal figures published by CMS. VA Aid & Attendance pension rates are the maximums for benefits effective December 1, 2025 through November 30, 2026, published by the U.S. Department of Veterans Affairs. Memory care is estimated as a 25% premium over assisted living (NCAL industry standard) — CareScout does not publish a dedicated memory care median. Long-term-care cost inflation (modeled at 5%/year) is the 10-year compound average of Genworth/CareScout nursing home medians 2015–2025. All figures are medians — actual local costs vary widely and most facilities do not match the median exactly. This tool is for educational planning and does not constitute legal, financial, or medical advice. Consult an elder law attorney and a financial advisor before making major care or asset decisions.