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Cost of care by state · 2024 cost survey · 2026 Medicaid limits
Nursing Home Cost & Medicaid Spend-Down Calculator
See what nursing home, assisted living, memory care, or home care costs per month in your state, how long savings will last, and when Medicaid may begin to pay.
1 yr 9 mountil the Medicaid asset limitAssets last about 1 yr 9 moAround Jun 2028, after $148,000 in private pay.
- Private pay from income and assets
- Under the Medicaid asset limit
$9,277Monthly costNational median
$6,877Monthly gapPaid from assets each month
$148,000Assets to spend down$2,000 allowance kept
$148,000Private pay until thenFrom income and assets
- Year 1$9,277/mo$67,476Private pay
- Year 2$9,741/mo$2,000Medicaid eligible
- Year 3$10,228/mo$2,000Medicaid eligible
- Year 4$10,739/mo$2,000Medicaid eligible
- Year 5$11,276/mo$2,000Medicaid eligible
Medicaid reviews 60 months of transfers; gifts in that window create a penalty period.
Costs: CareScout Cost of Care Survey (2024), national median. Medicaid limits: federal standards (source); exempt assets and spousal rules vary by state.
How the spend-down estimate works
- Pick the setting and your state. Costs start from the 2024 CareScout medians, or the rate you were quoted.
- Each month, income and any other help pay first. Whatever is left comes out of countable assets.
- We count the months until assets fall to the Medicaid limit ($2,000 for a single applicant in most states), raising the cost each year by the increase you choose.
- With a spouse at home, half the couple’s assets within the federal band, plus an income allowance, are protected before anything is spent.
Not modeled: exempt assets (the home up to the equity limit, one vehicle, prepaid funeral, some annuities), transfer penalties inside the look-back window, income-cap states that need a Miller trust, and facility rate increases beyond the slider. This is an educational estimate using published medians and federal standards, not legal or financial advice. Medicaid eligibility is decided by your state; an elder-law attorney or your state Medicaid office can confirm the rules that apply to you.
What long-term care costs, and who pays
National medians from the CareScout Cost of Care Survey (2024). Your state and facility can differ by thousands of dollars a month; a quoted rate always beats a median.
| Setting | Median monthly cost | Basis | Medicare | Medicaid |
|---|---|---|---|---|
| Nursing home, semi-private room | $9,277 | Daily rate × 30.4 days | Up to 100 days after a hospital stay | Yes, once eligible |
| Nursing home, private room | $10,646 | Daily rate × 30.4 days | Up to 100 days after a hospital stay | Yes, once eligible |
| Assisted living community | $5,900 | Monthly rate, base care level | No | Some states, via waivers |
| Memory care community | $7,500 | Assisted living median + 27% | No | Some states, via waivers |
| Home health aide, 44 hours a week | $6,483 | Hourly rate × 44 hours × 4.33 weeks | Skilled visits only, not aide hours | Some states, via waivers |
| Adult day health care, 5 days a week | $2,167 | Daily rate × 5 days × 4.33 weeks | No | Some states, via waivers |
Frequently asked questions
How much does a nursing home cost per month?
The national median is about $9,300 a month for a semi-private room and $10,600 for a private room (CareScout Cost of Care Survey, 2024). States range from roughly $6,000 to more than $15,000 a month. Assisted living runs about $5,900, memory care about $7,500, and a home health aide 44 hours a week about $6,500.
How does the Medicaid spend-down work?
Medicaid pays for long-term nursing home care once countable assets fall to the state limit, typically $2,000 for a single applicant. Income goes toward the cost first, then assets are spent on care until the limit is reached. The calculator estimates the month that happens, with an annual inflation assumption.
What can the spouse at home keep?
Federal spousal-impoverishment rules protect half of the couple's countable assets for the community spouse, between a floor and a ceiling that CMS updates each January (about $31,600 to $157,900 in 2025), plus a monthly income allowance. The home, one car, and personal belongings are generally exempt.
Does Medicare pay for nursing home care?
Only short-term skilled care: up to 100 days per benefit period after a qualifying 3-day hospital stay, with days 1–20 covered in full and a daily coinsurance for days 21–100. Long-term custodial care is private pay, long-term care insurance, or Medicaid.
What is the Medicaid look-back period?
Most states review 60 months of financial transfers before the application. Gifts or below-market transfers in that window create a penalty period during which Medicaid will not pay, calculated from the state's average nursing home cost.
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