In short
Nationally, assisted living runs a median of $6,200 a month and full-time home help about $80,000 a year, and Medicare pays for none of it — it only covers short rehab stays and intermittent home health. The five sources families actually use: Medicaid (the largest payer of long-term care, with income and asset limits that vary by state), VA Aid and Attendance for wartime veterans and surviving spouses, long-term care insurance if a policy exists, the proceeds of the house, and family contributions. Call (800) 614-8388 and we'll tell you which of the five is realistic for your parent.
What care actually costs
Start from the real numbers, because every decision downstream depends on them. These are 2025 national medians from the CareScout Cost of Care Survey:
| Type of care | National median, 2025 | What that means per year |
|---|---|---|
| Home care (non-medical aide) | $35 an hour; about $80,080 a year at 44 hours a week | Varies hugely with hours — a few hours a week is affordable; full-time is not |
| Adult day program | $95 a day (about $2,058 a month) | Often the most cost-effective daytime option |
| Assisted living | $6,200 a month, private one-bedroom | $74,400 a year |
| Nursing home, semi-private | $9,581 a month ($315 a day) | $115,000 a year |
| Nursing home, private room | $10,798 a month ($355 a day) | About $129,600 a year |
Two things those medians hide. First, geography: the same assisted living apartment can cost twice as much in one state as another — our state and city pages carry local medians. Second, slope: care costs tend to rise over time as needs deepen, so a plan that works this year needs a second act. Plan for the version of your parent two years from now, not the version from last spring.
The Medicare gap
If you want the detail behind that — the 3-day rule, the $217-a-day coinsurance, the observation-status trap — our guide to what Medicare covers goes through it line by line.
Medicaid: the big one, with the fine print
Medicaid is the primary payer for long-term care in the United States — federal and state Medicaid spending on long-term services and supports runs to hundreds of billions a year. For families whose savings can't sustain $6,000 to $10,000 a month for long, Medicaid is usually the answer. The fine print is the catch, and it comes in three parts:
- It's needs-based. Medicaid requires meeting income and asset limits, and each state sets its own within federal bounds. A single person's countable assets generally need to be very low; retirement accounts, a second car, and cash all count in various ways.
- The home is treated differently. In most circumstances a primary residence is exempt or partially exempt from the asset count, especially if a spouse or certain family members live in it — which is why "keep the house" and "qualify for Medicaid" are often compatible. The details are genuinely complicated; this is where an elder law attorney earns their fee, and we'd rather you talked to one than guessed.
- What it buys varies by state. Nursing home care is covered everywhere. Home- and community-based services — aides, adult day, sometimes assisted living through a waiver — are covered in most states but with waitlists and program names that change at the border. Florida, Arizona, Kansas, Ohio, Texas, and the others each run their own version; our state pages name yours.
The practical starting point is free: every state's Area Agency on Aging will screen your parent for programs at no cost. Find yours at eldercare.acl.gov or by calling the Eldercare Locator, 1-800-677-1116.
Not sure which of the five applies to your parent?
Veteran or not, homeowner or not, which state, how much care needed — tell us and we'll tell you the two or three sources worth pursuing, in order.
VA Aid and Attendance
If your parent served during a wartime period, or is the surviving spouse of someone who did, this is the most overlooked money in the system. Aid and Attendance is a monthly payment added to a VA pension for veterans and survivors who need help with daily activities — bathing, dressing, feeding — or who are in a nursing home because of lost mental or physical ability.
The numbers, effective December 1, 2025 through November 30, 2026: a veteran with no dependents can receive up to $29,093 a year (about $2,424 a month) with Aid and Attendance; with one dependent, up to $34,488 a year. There's a net worth limit ($163,699 for 2026) and an income test, but unreimbursed medical expenses — including the assisted living rent your parent is already paying — count against income for VA purposes. That's what makes it work for so many families.
Two cautions we give every family: first, pension requires wartime service, not combat — the dates matter, not the theater. Second, anyone who charges a fee to "find" these benefits should be treated with suspicion; VA-accredited representatives file for free. We can help you figure out whether your parent plausibly qualifies before you spend an afternoon on paperwork.
Long-term care insurance
If your parent bought one of these policies in the 1990s or 2000s, find the policy before you do anything else. Many pay for assisted living, home care, and nursing homes after a waiting period (often 30 to 90 days of needing care), with a daily or monthly benefit cap. The reasons families leave this money unclaimed are mundane: nobody can find the policy, or the paperwork feels intimidating, or the parent bought it and never told anyone.
Where to look: old mail and bank records for premium payments, the safe deposit box, the folder with the will. If you find a policy, call the insurer's claims line and ask what it covers, what the elimination period is, and what documentation they need to start a claim. If your parent is already in care, claims can often be filed retroactively for the waiting period. If there is no policy, don't buy one now for a parent already needing care — underwriting won't have them.
The house
For most American families, this is the plan — and it's usually a good one. The house a parent bought in 1985 for $60,000 is often worth several years of excellent care today. The honest questions to work through:
- Sell, or rent? Selling is simple and liquid. Renting preserves the asset and produces income, and in markets like Florida's Gulf Coast, seasonal rentals can cover a startling share of assisted living. Renting also means being a long-distance landlord from a hospital waiting room, which not every family wants.
- Medicaid interplay. A home handled the wrong way can affect eligibility, and a recovery claim against an estate is possible in some states after a parent on Medicaid dies. This is squarely elder law attorney territory — an hour of their time before the sale can be worth five figures.
- The emotional side is real. Selling the house your mother raised you in is a grief event, not just a transaction. Families who name that openly tend to make faster, calmer decisions than families who pretend it's just paperwork.
Family money
It's common — adult children chipping in monthly, sometimes invisibly. If it's going to happen, our only advice is to write it down: who pays what, to whom, starting when. Unrecorded generosity curdles into resentment at the probate table. And a sibling who can't drive Mom to dialysis but can cover $400 of home care is participating; let money be a contribution, not a substitute for showing up.
One more honest note: we are a referral service, and the communities and agencies in our network pay us when they serve a family we introduce. You never pay us, and a partner's price is the same whether you found them through us or on your own. We mention it because families doing money math deserve to know who's paid by whom.
Questions families ask
Will Medicare or my parent's health insurance pay for assisted living?
No. Medicare covers custodial care only in narrow situations (short skilled rehab, intermittent home health, hospice). Assisted living is paid privately or through Medicaid waiver programs, VA benefits, or long-term care insurance when someone qualifies.
Will my parent have to sell the house to qualify for Medicaid?
Often no — a primary residence is treated differently from other assets, particularly when a spouse or certain relatives live there. But the rules are intricate and state-specific, and mistakes here are expensive. This is the one question on this page we'd route to an elder law attorney before you sign anything.
My father was in the Army in Korea but never saw combat. Does the VA benefit still apply?
Wartime service, not combat, is the requirement — service during a recognized wartime period. Many veterans of peacetime posts within wartime windows qualify. An accredited VA representative can confirm his dates for free before you build a plan around it.
How long will my parents' savings last in assisted living?
Divide their invested savings by the monthly cost. At the national median of $6,200 a month, $200,000 lasts roughly 32 months, less if costs rise with care needs. When the projection gets short, that's the moment to talk to your Area Agency on Aging about Medicaid screening — not the month the account hits zero.
Are those "Medicaid planning" companies that advertise on the radio legitimate?
Some are, some aren't. Be wary of anyone charging large upfront fees to "protect assets" or pushing annuities before understanding your parent's situation. Free screening exists: Area Agencies on Aging, and legal aid elder programs in most states. If you want a paid planner, an elder law attorney (NAELA members, in most states) is the credential to look for.
What's the first call I should make?
If it's about finding or choosing care, call us at (800) 614-8388 — it's free and we'll map the paying sources against your parent's actual situation. If it's purely about public benefits screening, the Eldercare Locator at 1-800-677-1116 connects you to your local Area Agency on Aging at no cost. You can do both; plenty of families do.
Sources: CareScout Cost of Care Survey 2025 (carescout.com/cost-of-care); Medicaid.gov, Long-Term Services and Supports (medicaid.gov/medicaid/long-term-services-supports); U.S. Department of Veterans Affairs, Pension Rates effective Dec. 1, 2025 and Aid and Attendance/Housebound (va.gov/pension/veterans-pension-rates, va.gov/pension/aid-attendance-housebound); Medicare.gov, Long-term care (medicare.gov/coverage/long-term-care); Eldercare Locator, U.S. Administration for Community Living (eldercare.acl.gov).