Methodology

Every figure on this site traces to a primary source. Here is what we use, where it comes from, and how we calculate the rest.

Cost data

Nursing home, assisted living, and home care

State and national median costs come from the CareScout 2025 Cost of Care Survey, released March 2, 2026, and based on data collected from long-term-care providers nationwide between July and November 2025.^[1] CareScout is a wholly owned subsidiary of Genworth Financial and has conducted this survey annually since 2004 — formerly published under the Genworth name, now under the CareScout brand. The 2025 survey collected more than 25,000 rates across all 50 states and the District of Columbia.

The survey reports rates at the Metropolitan Statistical Area (MSA) level. We use the state median figure on each state page. State medians can mask significant city-level variance: in California, for example, the San Francisco Bay Area median can run 30% above the state median, while inland counties run 20% below.

Memory care (estimated)

CareScout does not publish a dedicated memory care median. We estimate memory care as a 25% premium over assisted living, applied to the state's assisted living median and rounded to the nearest $50. This premium reflects the industry-standard differential reported by the National Center for Assisted Living (NCAL) and consistently observed in publisher surveys: memory care typically runs 20-30% above standard assisted living because of higher staff-to-resident ratios, secured environments, and specialized dementia-care training.^[2]

National example: $6,200 (AL) × 1.25 = $7,750/month estimated memory care median.

Medicaid figures

Federal asset and income limits (2026)

The Community Spouse Resource Allowance (CSRA), Federal Benefit Rate (FBR), and nursing home Medicaid income cap are 2026 federal figures published by the Centers for Medicare & Medicaid Services (CMS).^[3] States may set their own limits within the federal range; the figures we use are the federal maximums that most states adopt.

Some states use different figures — California's individual asset limit is $130,000, Illinois uses a $135,648 standard CSRA, South Carolina uses a $66,480 standard CSRA, and several states have their own minimum monthly maintenance needs allowance schedules. State-specific figures are noted on each state page where they materially differ from the federal default.

5-year look-back and penalty divisor

Medicaid reviews all asset transfers made within 60 months (5 years) of the application date. Transfers below fair market value during this period trigger a penalty period of ineligibility, calculated by dividing the transferred amount by the state's penalty divisor — the state's average daily nursing home cost. State penalty divisors are updated annually by each state Medicaid agency and are typically published in the state's Medicaid eligibility manual.^[4]

Medicare

Medicare Part A covers up to 100 days of skilled nursing facility (SNF) care per benefit period after a qualifying 3-day inpatient hospital stay. The 2026 cost-share figures published by CMS are:^[5]

• Days 1-20: $0 per day (Part A covers in full)
• Days 21-100: $217 per day coinsurance
• Days 101 and beyond: $0 Medicare coverage; resident pays full cost

Medicare does not cover custodial long-term care (the daily help with bathing, dressing, and eating that most nursing home residents need). Medicare does not cover memory care facilities at all. Medicaid is the primary payer for long-term custodial care.

VA Aid & Attendance pension

VA pension rates are the maximum monthly amounts (Maximum Annual Pension Rate, or MAPR, divided by 12) for benefits effective December 1, 2025 through November 30, 2026. These figures reflect the 2.8% cost-of-living adjustment applied at the start of the benefit year.^[6]

The actual pension paid is the MAPR minus the recipient's countable income. Long-term-care expenses can be deducted from countable income, often reducing it to zero and allowing the recipient to receive the full MAPR. The 2026 net worth limit for eligibility is $163,699.

Social Security

The 2026 average Social Security retired-worker benefit of $2,071/month reflects the SSA's January 2026 estimate following the 2.8% cost-of-living adjustment.^[7] This is the figure used in the calculator's income slider as a reference point. Individual benefits vary based on lifetime earnings, claiming age, and marital status.

Calculator formulas

Spend-down timeline

The calculator estimates how many months a family's savings will last before reaching the Medicaid asset threshold:

Where:

• monthly_care_cost = the state's median for the selected care type and room type, escalated annually
• monthly_income = the income figure entered (Social Security + pension + other)
• medicaid_threshold = $2,000 (single) or $162,660 (married, using the CSRA federal max)

Cost escalation

The calculator applies a 5% annual cost increase to long-term care costs in multi-year projections. This figure is the approximate compound annual growth rate of nursing home medians in the CareScout/Genworth survey series from 2015 through 2025. Year-to-year growth has varied between 1% and 10% depending on inflation and labor market conditions, but 5% is a defensible long-run average for planning purposes.

What the calculator does not do

To be honest about the model's limits, the calculator does not account for:

• State-specific Medicaid waivers (HCBS, Aged & Disabled, etc.) that may pay for assisted living or in-home care before nursing-home eligibility
• Long-term care insurance benefits
• VA Aid & Attendance reductions to countable income (which can substantially extend the spend-down timeline)
• Asset-protection trusts established before the 5-year look-back window
• Tax deductions for medical expenses (which can offset some out-of-pocket costs)
• Medicaid Estate Recovery rules (which vary significantly by state)
• Facility-specific pricing variance (which can run 30-60% above or below the state median)

Update cadence

• Cost data: Updated annually each March when CareScout publishes the new survey
• Federal Medicaid figures: Updated each January when CMS publishes new spousal-impoverishment limits
• Medicare cost-shares: Updated each January when CMS publishes the annual Part A/B cost fact sheet
• VA pension rates: Updated each December when the COLA-adjusted rates take effect

Sources

1. CareScout (a Genworth company), "Cost of Care Survey 2025 — Median Cost Data Tables," released March 2, 2026. www.carescout.com/cost-of-care
2. National Center for Assisted Living (NCAL), industry data on memory care premium pricing. The 20-30% premium over standard assisted living is consistent across NCAL data and the AHCA/NCAL annual industry reports.
3. Centers for Medicare & Medicaid Services, "2026 SSI and Spousal Impoverishment Standards." Federal CSRA min/max, MMNA range, and home equity limits effective January 1, 2026.
4. State Medicaid agency manuals (50 separate publications). Penalty divisors are recalculated annually by each state's Medicaid agency. Current values are published in each state's eligibility manual or HCBS waiver documentation.
5. Centers for Medicare & Medicaid Services, "2026 Medicare Parts A & B Premiums and Deductibles" fact sheet, released November 14, 2025. cms.gov
6. U.S. Department of Veterans Affairs, "Current pension rates for Veterans" and "Current Survivors Pension benefit rates," effective December 1, 2025 through November 30, 2026. va.gov/pension
7. Social Security Administration, "Average monthly Social Security retirement benefit," January 2026 estimate following the 2.8% COLA. ssa.gov

This methodology page was last reviewed in April 2026. For background on the editorial team and funding model, see the About page.