October 3rd 2025
By Ari Parker
Learn how to pay for assisted living with Medicare, Medicaid, insurance, and other financing options. Get cost breakdowns and money-saving strategies.
By Jordan McElwain
Planning for assisted living costs can feel overwhelming when coupled with managing the emotional aspects of transitioning to senior care. The average monthly cost of assisted living has risen significantly, but understanding your payment options can help make quality care more affordable than you might expect.
Whether you're planning for yourself or helping a loved one navigate their care options, knowing about Medicare coverage, Medicaid assistance, private insurance options, and alternative financing strategies helps you make informed decisions. The key is understanding which resources apply to your situation and creating a comprehensive payment plan that works within your budget.
Early financial planning can make a significant difference in your care options and reduce stress during an already challenging time.
Assisted living costs range from $4,500 to $6,000 per month nationally, with significant regional variations based on location and amenities.
Multiple financing options exist, including Medicare coverage for medical services, Medicaid assistance programs, and long-term care insurance.
Early planning and understanding all available resources can expand your care options and reduce financial stress.
Understanding current assisted living costs helps you plan realistic budgets and explore appropriate financing options for your situation.
Assisted living costs vary dramatically across the United States, with monthly expenses ranging from approximately $4,000in rural areas to nearly $8,000 in major metropolitan markets. The national median falls between $5,000 and $6,000 per month for basic assisted living services.
Regional differences reflect the local cost of living, real estate values, and labor costs. States like Vermont, Alaska, and New Jersey typically have the highest monthly fees, while states in the Midwest and South with a lower cost of living may offer more affordable options.
Luxury facilities with resort-style amenities, premium dining options, and extensive activity programs can cost $8,000 to $12,000 per month or more. Standard facilities focusing on essential care services and basic amenities typically fall within the national median range.
Base monthly fees typically cover costs like:
Meals
Rent & Utilities
Basic housekeeping
Medication management
Social activities
Emergency response
Assistance with one or two activities of daily living (ADLs)
Additional services that may incur additional costs (which may increase your bill by $200-$1,000 per month) include:
Specialized medical care
Transportation
Guest meals
Laundry services
Personalized meals
There are multiple factors that ultimately impact the price you pay. These include:
Level of care needed: Residents requiring basic assistance with one or two daily activities pay standard rates, while those needing extensive help with multiple activities of daily living face surcharges of $500-$1,500 monthly.
Memory care services: Specialized Alzheimer's and dementia care may add $1,000-$4,000 to monthly fees due to enhanced security, specialized staff training, and structured programming. In many cases, you may need to relocate to a specialized memory care facility.
Room type and size: Studio apartments offer the most affordable option, while one-bedroom units typically cost $300-$800 more monthly, and two-bedroom or companion suites command premium pricing.
Facility amenities: Communities with swimming pools, fitness centers, multiple dining venues, and extensive activity programs charge higher rates than basic facilities.
Geographic location: Facilities in major metropolitan areas and desirable neighborhoods generally cost more than those in smaller towns and rural communities.
Medicare does not cover assisted living, including room and board and non-medical care, and custodial care, including assistance with activities like bathing and dressing. However, Medicare continues paying for eligible medical services you receive while living in an assisted living facility.
Medicare covers eligible costs like skilled nursing stays, physical therapy, medical equipment (such as wheelchairs and oxygen), and doctor visits when provided in assisted living.
Supplemental policies may offer more benefits, but it depends heavily on the plan. For instance, Medicare Advantage plans may offer limited additional benefits, but coverage varies significantly between plans.
Medigap policies don't cover assisted living, but they can reduce your medical expenses, freeing up more money for care costs.
For those who are eligible, Medicaid covers some assisted living services in over 40 states through waiver programs, which include the Home and Community Based Services (HCBS) waivers and the Aged, Blind, and Disabled (ABD) Medicaid.
Medicaid pays for personal care services and case management, but not room and board costs.
To qualify, you must meet strict income limits (typically under $2,000-$3,000 monthly) and asset limits (usually under $2,000 for individuals). You may also have to demonstrate your need for a nursing home level of care. You'll contribute your Social Security and pension income toward housing costs while Medicaid covers care services.
Many states offer additional programs, including supplemental payments to low-income seniors, subsidized senior housing, and prescription assistance programs. Learn more about assisted living options to understand how these programs work.
Long-term care insurance can cover a significant portion of assisted living costs (often up to 50%-100%) after a waiting period. Policies purchased at younger ages offer better coverage and lower premiums than those purchased once you’re older and may have additional health risks.
Unlike Medicare, long-term care insurance is designed to cover the costs of essential supportive care, making it a good option for those who are concerned about the costs of needing support as they age.
Many families rely on personal resources to fund assisted living, making it essential to understand the most effective strategies for accessing and preserving wealth.
401(k) and IRA withdrawals count as income and may increase your tax liability. However, required minimum distributions (mandatory withdrawals subject to retirement) after age 73 provide a consistent income. On the other hand, Roth IRA withdrawals aren't taxed in most cases, offering more flexibility.
Withdrawing from your retirement savings can help you fund the costs of assisted living.
You can leverage your home equity to help cover the costs of assisted living:
Selling your home: Provides immediate, substantial funds, though it may leave a partner without a longstanding home if they aren’t joining you in assisted living.
Reverse mortgages: Access equity without monthly payments. This option is available for those 62 and older. This may only be practical for people considering a short-term stay in an assisted living facility (under six months) or in cases where the primary homeowner continues living in the home.
Home equity loans: You can take out a home equity loan to receive a lump sum, which you can use to pay for costs. However, it will come with a monthly payment.
Family members can contribute through monthly payments, shared costs among siblings, or trust arrangements. When possible, written agreements can help prevent misunderstandings about financial responsibilities and reduce tension down the line.
However, there should always be a backup plan for contingencies, such as when a family member can’t contribute due to hardship, like an illness or a layoff.
Beyond traditional insurance and government programs, several alternative resources can help make assisted living more affordable.
VA Aid and Attendance benefits provide monthly, tax-free payments that can be used toward assisted living costs. To qualify for this benefit, you should be on a VA pension and be unable to perform your daily activities without help. This benefit may help cover some costs for a veteran or their spouse.
Veterans-specific assisted living facilities offer specialized care for military service members and may accept VA benefits directly. These communities often provide military-focused programming and staff trained in veteran-specific needs and challenges.
Selling life insurance policies can provide between 10% and 60% of the death benefit value, depending on your age, health, and the policy itself. This option works best for policies with substantial death benefits, especially when immediate care funding needs outweigh inheritance planning goals. The proceeds from life settlements are usually taxable.
Viatical settlements for individuals with terminal diagnoses may provide 50%-80% of the policy value. These settlements provide immediate access to tax-free funds for care while eliminating future premium payments.
Faith-based organizations, Area Agencies on Aging, and some assisted living facilities offer financial assistance or sliding scale payments for qualifying seniors. Many religious communities maintain emergency assistance funds specifically for helping members afford necessary care.
Nonprofit organizations may provide grants, sliding scale payment facilities, or connections to other community resources. Some facilities offer charity care programs with limited availability, making early inquiry important.
Effective planning helps maximize your resources and create sustainable funding for long-term care needs.
Plan for a minimum of three to five years of care costs, including inflation adjustments.
Combine multiple funding sources, such as long-term care insurance and retirement savings.
Consider lower-cost geographic areas while maintaining family and healthcare access, if that’s an option. (If one child lives in a lower cost-of-living area with good healthcare, for example, you may want to relocate near them.)
Budget for increasing care needs over time as health conditions change; you may eventually need more support or additional services from the assisted living community.
Several approaches can reduce assisted living expenses without compromising care quality or safety.
Look for move-in incentives, first-month discounts, and negotiate rates.
Consider shared rooms or companion arrangements to split housing costs.
Explore companion care services or Papa Pal that might delay the need for facility care.
Research adult day programs that provide supervision at lower costs than residential care.
Understanding common pitfalls helps families make better financial decisions when planning for assisted living costs.
Don't deplete all assets quickly; spread costs across multiple resources.
Avoid waiting until care is needed to explore financing options; early planning can be essential, especially since some benefits programs may have long application or waiting periods.
Consider the tax implications of retirement account withdrawals and asset liquidation.
Don't choose facilities based solely on cost without considering care quality and your overall experience.
Paying for assisted living may require you to combine multiple financing options. Medicare covers medical services but not room and board. Medicaid may cover some services in assisted living facilities in over 40 states, but has strict requirements on eligibility. Long-term care insurance, retirement savings, home equity, and family contributions can fill the gaps.
Early planning provides more options and reduces stress. Start by researching local costs, then inventory your resources, including insurance, retirement accounts, and government program eligibility. Professional guidance from financial advisors helps maximize available benefits.
Medicare does not pay for assisted living room and board or custodial care services. However, Medicare continues to cover eligible medical services, doctor visits, medical equipment, and skilled nursing care when you’re living in an assisted living facility. Some Medicare Advantage plans may offer limited additional benefits, but coverage varies significantly between plans.
Medicaid covers assisted living services in over 40 states through waiver programs, though coverage varies significantly. Moreover, not all facilities accept Medicaid. Medicaid typically covers personal care services and case management, but not room and board costs. Eligibility requires meeting strict income and asset limits that vary by state.
Long-term care insurance specifically covers assisted living, nursing home, and home care costs that other types of insurance may not cover. Policies purchased at younger ages offer better coverage at lower premiums. Whether you should consider it depends on the availability of other assets, your family situation, and risk tolerance for potential care costs.
A Place for Mom. (2025, Feb 18). Cost of assisted living. Retrieved from https://www.aplaceformom.com/caregiver-resources/articles/cost-of-assisted-living
CareScout. (n.d.). Cost of care. Retrieved from https://www.carescout.com/cost-of-care
Centers for Medicare & Medicaid Services. (n.d.. Long term care coverage. Retrieved from https://www.medicare.gov/coverage/long-term-care
Federal Trade Commission. (n.d.). Home equity loans and home equity lines of credit. Retrieved from https://consumer.ftc.gov/articles/home-equity-loans-and-home-equity-lines-credit
National Council on Aging. (2025). A guide to reverse mortgages for older adults. Retrieved from https://www.ncoa.org/article/a-guide-to-reverse-mortgages-for-older-adults/
U.S. Department of Veterans Affairs. (2025, Mar 17). Long-term care. Retrieved from https://www.va.gov/health-care/about-va-health-benefits/long-term-care/
