Long-Term Care Costs in 2026: What Every Type of Care Really Costs
Updated
Long-term care is one of the largest expenses in retirement — and one that most people drastically underestimate. A single year in a nursing home costs more than the median American household earns in two years.
Quick answer: In 2026, the national median costs are: nursing home private room $116,000/year, nursing home semi-private $104,000/year, assisted living $64,000/year, home health aide $68,000/year (44 hrs/week), and adult day care $22,000/year. The average person who needs care uses it for about 3 years, making the total cost $192,000–$348,000 depending on care type. About 70% of people turning 65 will need some form of long-term care.
National Average Long-Term Care Costs (2026)
Care Type
Monthly Cost
Annual Cost
3-Year Total
5-Year Total
Adult day care
$1,850
$22,200
$66,600
$111,000
Homemaker services (44 hrs/week)
$5,100
$61,200
$183,600
$306,000
Home health aide (44 hrs/week)
$5,700
$68,400
$205,200
$342,000
Assisted living (private, 1-bedroom)
$5,350
$64,200
$192,600
$321,000
Memory care (specialized)
$6,000–$8,000
$72,000–$96,000
$216,000–$288,000
$360,000–$480,000
Nursing home (semi-private room)
$8,700
$104,400
$313,200
$522,000
Nursing home (private room)
$9,700
$116,400
$349,200
$582,000
Costs by State
Most Expensive States for Nursing Home Care (Private Room)
State
Annual Private Room
Annual Semi-Private
Annual Assisted Living
Alaska
$192,000+
$172,000+
$78,000+
Connecticut
$175,000+
$160,000+
$72,000+
Massachusetts
$165,000+
$148,000+
$78,000+
New York
$160,000+
$140,000+
$68,000+
New Jersey
$155,000+
$138,000+
$72,000+
California
$148,000+
$130,000+
$66,000+
Hawaii
$145,000+
$130,000+
$60,000+
Vermont
$140,000+
$125,000+
$65,000+
Washington
$138,000+
$122,000+
$72,000+
Rhode Island
$135,000+
$120,000+
$64,000+
Least Expensive States for Nursing Home Care (Private Room)
State
Annual Private Room
Annual Semi-Private
Annual Assisted Living
Oklahoma
$70,000
$62,000
$44,000
Louisiana
$72,000
$64,000
$42,000
Missouri
$74,000
$62,000
$38,000
Texas
$76,000
$65,000
$48,000
Mississippi
$78,000
$68,000
$40,000
Arkansas
$78,000
$66,000
$42,000
Alabama
$80,000
$70,000
$42,000
Kansas
$80,000
$68,000
$50,000
Iowa
$82,000
$72,000
$48,000
Georgia
$84,000
$74,000
$42,000
Mid-Range States
State
Annual Private Room
Annual Semi-Private
Annual Assisted Living
Florida
$110,000
$96,000
$52,000
Illinois
$96,000
$84,000
$55,000
Michigan
$108,000
$98,000
$50,000
Minnesota
$126,000
$112,000
$56,000
Ohio
$100,000
$88,000
$52,000
Pennsylvania
$128,000
$112,000
$55,000
Virginia
$108,000
$96,000
$62,000
Wisconsin
$116,000
$102,000
$56,000
Colorado
$120,000
$106,000
$58,000
North Carolina
$96,000
$84,000
$48,000
How Costs Have Changed Over Time
Year
Nursing Home (Private)
Assisted Living
Home Health Aide (44 hrs/wk)
2010
$76,000
$39,000
$44,000
2015
$92,000
$48,000
$52,000
2020
$106,000
$54,000
$58,000
2025
$112,000
$62,000
$66,000
2026
$116,000
$64,000
$68,000
Projected 2030
$132,000
$73,000
$77,000
Projected 2035
$153,000
$85,000
$89,000
Projected 2040
$177,000
$98,000
$103,000
Long-term care costs have grown at roughly 3–5% annually — faster than general inflation.
Cost Comparison: Home Care vs. Facility Care
Hours of Care Needed Per Week
Home Care Annual Cost
Assisted Living Annual Cost
Nursing Home Annual Cost
10 hours
$14,000–$17,000
N/A (facility is 24/7)
N/A
20 hours
$28,000–$35,000
N/A
N/A
30 hours
$42,000–$52,000
$64,000
N/A
40 hours
$55,000–$68,000
$64,000
N/A
44 hours (standard)
$61,000–$68,000
$64,000
$104,000–$116,000
60 hours
$83,000–$95,000
$64,000
$104,000–$116,000
24/7 (live-in)
$144,000–$175,000
$64,000
$104,000–$116,000
Key insight: Home care is cheaper at under 40 hours/week. Once care needs require more than 40–50 hours weekly, assisted living becomes more cost-effective. For 24/7 skilled care, a nursing home is often cheaper than full-time home nursing.
Hidden Costs Most People Miss
Hidden Cost
Typical Amount
Home modifications (grab bars, ramps, stairlift)
$5,000–$50,000
Medical equipment (hospital bed, wheelchair)
$1,000–$5,000
Transportation to appointments
$100–$500/month
Medication management systems
$50–$200/month
Incontinence supplies
$100–$300/month
Special dietary needs
$100–$400/month
Companion/social engagement
$50–$300/month
Care management coordination
$100–$200/hour (geriatric care manager)
Respite care for family caregivers
$150–$350/day
Legal/financial planning updates
$200–$500/hour (elder law attorney)
What’s Included in Facility Costs
Assisted Living: Typically Included vs. Extra
Included
Often Extra
Room/apartment
Medication management ($200–$500/month)
Meals (usually 3/day)
Higher level of personal care
Housekeeping/laundry
Physical/occupational therapy
Social activities
Beauty/barber services
Basic personal care (bathing, dressing)
Private transportation
24/7 staff availability
Additional companion services
Emergency response system
Incontinence care ($300–$700/month)
Nursing Home: Typically Included vs. Extra
Included
Often Extra
Room and board
Private telephone ($30–$50/month)
All meals and snacks
Cable television
24/7 skilled nursing care
Personal barber/beauty services
Medication administration
Additional private-duty aide
Physical/occupational therapy
Specialized wound care supplies
Social activities
Personal clothing laundering
Laundry/housekeeping
Non-formulary medications
The Real Cost of Care: Common Scenarios
Scenario 1: Gradual Decline (Most Common)
Phase
Duration
Care Type
Annual Cost
Phase Total
Phase 1
18 months
Home care, 20 hrs/week
$31,000
$46,500
Phase 2
12 months
Home care, 40 hrs/week
$62,000
$62,000
Phase 3
18 months
Assisted living
$64,000
$96,000
Phase 4
12 months
Nursing home
$116,000
$116,000
Total
4.5 years
$320,500
Scenario 2: Sudden Event (Stroke, Fall)
Phase
Duration
Care Type
Annual Cost
Phase Total
Phase 1
3 months
Hospital → skilled nursing
$29,000 copay
$29,000
Phase 2
24 months
Nursing home
$116,000
$232,000
Total
2.25 years
$261,000
Scenario 3: Alzheimer’s/Dementia (Longest & Most Expensive)
Phase
Duration
Care Type
Annual Cost
Phase Total
Phase 1
24 months
Home care, 20 hrs/week
$31,000
$62,000
Phase 2
24 months
Memory care facility
$84,000
$168,000
Phase 3
36 months
Nursing home
$116,000
$348,000
Total
7 years
$578,000
Who Pays for Long-Term Care
Source
What It Covers
Percentage of LTC Spending
Medicaid
Nursing home, some home care (for those who qualify)
~42%
Out-of-pocket
Any care (self-funded)
~25%
Private insurance (LTC, hybrid, life)
Any care (per policy)
~11%
Other public sources
VA, state programs
~11%
Medicare
Short-term skilled nursing only (up to 100 days)
~8%
Other private
Health insurance, charities
~3%
The stunning reality: Despite being the largest single payer, Medicaid only covers people who have spent down nearly all their assets to qualify.
How to Estimate Your Costs
Factor
How to Estimate
1. Your state’s costs
Look up Genworth Cost of Care Survey for your area
2. Expected care type
Home care is most likely first need; nursing home for severe decline
3. Duration estimate
Average is 3 years; 20% need 5+ years; dementia averages 7+ years
4. Inflation factor
Add 3–5% per year from now until likely care age
5. Spouse needs
Both spouses may need care (not simultaneously usually)
6. Existing resources
Medicare (100 days max), VA benefits, family caregiving
Quick Estimation Formula
Estimated cost = Monthly cost × Months of care × Inflation factor
If you need care in…
Inflation multiplier (at 3%/year)
5 years
1.16
10 years
1.34
15 years
1.56
20 years
1.81
25 years
2.09
30 years
2.43
Example: 55-year-old estimating assisted living at 80: $5,350/month × 36 months × 2.09 = $402,000
Bottom Line
Long-term care costs are staggering — $192,000–$580,000 for a typical care journey — and they’re growing 3–5% annually. Medicare doesn’t cover custodial care. Medicaid requires near-poverty to qualify. The earlier you plan, the more affordable your options. Whether you choose insurance, self-funding, or Medicaid planning, the worst strategy is hoping you won’t need care — because statistically, you probably will.