Long-Term Care Costs: What to Expect and How to Plan

National Median Costs by Care Type (2023)

The following figures are from the Genworth Cost of Care Survey 2023, one of the most widely cited sources for long-term care cost data. They represent national medians — half of providers charge more, half charge less.

Source: Genworth Cost of Care Survey 2023. Memory care estimate from SeniorLiving.org.

What Affects the Actual Cost

The national median is a starting point, not a budget. These factors significantly affect what you will actually pay:

• Location: costs in major metropolitan areas and high cost-of-living states can be 50–100% above the national median
• Room type: private rooms cost more than semi-private rooms in nursing homes
• Care level: assisted living communities charge additional fees based on how much personal assistance a resident needs — these can add $500–$3,000 or more per month to the base rate
• Service hours: in-home care costs scale directly with the number of hours of care per week
• Specialized services: memory care, specialized rehabilitation and other services carry premium pricing
• Community amenities: newer, higher-amenity communities typically charge more

Costs That Are Often Overlooked

The advertised base rate is rarely the full cost. Ask about these additional charges before making a decision:

• Community fee or move-in fee (often $1,000–$5,000 and non-refundable)
• Care-level assessment fees
• Medication management charges
• Incontinence supply charges
• Transportation fees beyond scheduled routes
• Personal laundry charges
• Guest meal charges
• Cable, telephone and internet fees
• Annual rate increases — ask for the history of rate increases over the past 3–5 years

Creating a 24-Month Care Budget

A 24-month planning horizon gives families time to arrange finances, explore payment options and avoid crisis decision-making. Steps to build a realistic budget:

• 1. Get written estimates from at least three providers, including all care-level charges
• 2. Add 10–15% for incidentals and unexpected cost increases
• 3. Identify all available payment sources: personal savings, Social Security, pension, investments, long-term care insurance, VA benefits
• 4. Determine how long current resources will cover projected costs
• 5. Explore Medicaid eligibility if resources may be exhausted within 2–3 years
• 6. Consult a certified elder-law attorney before transferring assets — Medicaid has a look-back period for asset transfers