What senior care costs
Every family arrives at one question — can she stay at home, and for how long — and almost nobody answers it in public, because the honest answer often is she can stay at home for less, and a site paid a placement fee loses money by saying so. Here is the national picture. The arithmetic that answers it is per state, because the answer is.
The national medians
What the survey measured across the country, per month unless it says otherwise.
| A caregiver at home | $35 an hour |
|---|---|
| Assisted living | $6,200 a month |
| A nursing home, semi-private room | $9,581 a month |
| Adult day services | $95 a day |
CareScout (Genworth) Cost of Care Survey, 2025. 211,985 long-term-care providers surveyed, July–November 2025
Where we have the real arithmetic
A national median is the weakest figure on this page. Care is priced market by market, and the spread inside one state is routinely wider than the gap between that state and the country — which is why the page that answers can she stay at home is a page about one state, region by region, with its own crossover point.
What senior care costs in Nevada
Assisted living $6,241 a month statewide, a caregiver at home $37 an hour, a nursing home $11,786 a month semi-private. At about 39 hours a week of help at home, the caregiver alone costs what the whole assisted-living bill costs.
4 measured markets inside the state, each with its own figure.
What senior care costs in Oregon
Assisted living $6,875 a month statewide, a caregiver at home $40 an hour, a nursing home $16,760 a month semi-private. At about 40 hours a week of help at home, the caregiver alone costs what the whole assisted-living bill costs.
9 measured markets inside the state, each with its own figure.
Everywhere else has no page here at all, deliberately — a median we have not checked against its source is not a number we will print. The coverage map is the whole list.
Who pays for any of this
Start here, because it changes the arithmetic more than any figure above. Medicare does not pay for long-term care. That is not our summary of it; it is the heading Medicare itself puts on the page, over the words “Not Covered. You pay all costs” — and the examples it gives of what it will not pay for are help with dressing and bathing, home-delivered meals, adult day health care and transportation. Which is to say: nearly everything a family is trying to price. None of this is state law, which is why it is here rather than repeated on each state's page.
| Medicare | Not long-term care. It does cover home health — a nurse or therapist, and an aide alongside them — if she is “homebound” and needs skilled care part-time or intermittently, which Medicare defines as up to 8 hours a day and 28 hours a week. You pay nothing for covered visits. It will not pay for round-the-clock care at home, meal delivery, or housekeeping unrelated to the care plan. (Medicare, Long-term care; Home health services) |
|---|---|
| Medicaid | The one payer that does cover long-term care, including care at home through home- and community-based services, once she qualifies financially. What it pays is a state rate on a published schedule rather than a market price, and it differs by state — it is on each state's page above, where the schedule has been read. What to do about it. |
| The VA | Aid and Attendance adds to a pension for a veteran or surviving spouse who needs help with daily activities. It is money, so it can pay for any line above. The eligibility tests. |
| Long-term care insurance | If she has a policy, read the benefit trigger and the elimination period before you plan around it — most pay a daily maximum after a waiting period, not a percentage of the bill. |
| The Older Americans Act | Free or donation-based, no means test: meals, volunteer drivers, respite, and the ombudsman. This is why several lines on the stack are marked unpriced rather than expensive — for a lot of families the right first call is the free public agency for her county, not a vendor. |
| This site | Nothing, from you or from anyone else, for anything on this page. |
What no survey prices, and why we say so
Each state's stack leaves lines empty on purpose. A monthly total that quietly treats a missing figure as zero is worse than no total, because it is the lines a family did not budget for that end the plan in month four. The survey measures care; it does not measure meal delivery, pendants, housekeeping, rides or a care manager, and neither do we.
Two of the missing figures we can bound rather than guess. ADA paratransit fares are capped by federal rule at twice the fare for the same trip on a regular bus (49 CFR 37.131), and the Older Americans Act meal program charges no fee at all — a suggested donation, and she may not be refused for declining it. Both are in the menu of needs, area by area, with what to ask.
The figure no national survey publishes
Memory care has no national published private-pay median: no national survey publishes memory care as its own category, so every figure you will find is an estimate built from someone's own sample. Estimates in circulation for 2025–26 run from about $6,690 to $8,019 a month — a spread of nearly a fifth — and at least one widely-repeated number is credited to the very survey that does not measure it. So this site carries no national figure. What some states do publish is what Medicaid pays for an endorsed memory-care unit — a real, checkable rate with an effective date, though a state rate rather than a market price. Where a schedule has been read, it is on that state's page above.