How Much Does a Nursing Home Cost?

It's Expensive

Nursing homes cost anywhere from $7,000 to $15,000+ per month depending on where you live and what level of care you need. That's $84,000 to $180,000+ per year. Most families can't afford this out-of-pocket for long.

Location Matters

Urban areas and states with high costs of living (California, New York, Massachusetts) are way more expensive than rural areas or states like Texas, Florida, or the Midwest.

Private Rooms Cost More

A semi-private room (sharing with a roommate) is the standard rate. If you want a private room, expect to pay $1,000-$3,000 more per month.

Short-Term Rehab Only

Medicare covers nursing home care ONLY if you're recovering from a qualifying hospital stay (3+ days) and need skilled nursing or therapy. This is short-term rehab, not long-term care.

Up to 100 Days

Medicare covers: Days 1-20 at 100% (no cost to you). Days 21-100 require a copay (around $200/day as of 2024). After 100 days, Medicare stops covering—even if you still need care.

You Must Be Improving

To qualify, you need to be making progress in therapy. If you plateau or stop improving, Medicare will stop coverage even if you haven't hit 100 days.

Long-Term Care? No Coverage

If you need to live in a nursing home long-term because you can't take care of yourself, Medicare does NOT cover it. This is the biggest misconception about Medicare.

The Main Payer for Long-Term Care

Medicaid covers about 60% of nursing home residents. It pays for long-term care if you meet income and asset requirements. This is the safety net for most people who can't afford to pay privately.

You Have to Qualify

To qualify, you must "spend down" your assets to around $2,000 (varies by state). Your income also must be below your state's limit. Your home, car, and personal belongings usually don't count.

Not All Facilities Accept Medicaid

Some nursing homes don't take Medicaid at all. Others only accept Medicaid after you've paid privately for a certain period (6 months to 2 years). Ask about this upfront.

Medicaid Beds May Have a Wait

Facilities often have limited "Medicaid beds." Even if you qualify, you might have to wait for an opening. Some facilities prioritize private-pay residents.

Application Takes Time

Applying for Medicaid can take 2-3 months. Start the process early. Many facilities will let you move in and work on the application after admission.

When You Pay Privately

If Medicare doesn't cover it and you don't qualify for Medicaid (or the facility doesn't accept it), you pay the full monthly rate out-of-pocket.

How Long Can You Afford It?

At $10,000/month, $100,000 lasts about 10 months. $500,000 lasts about 4 years. Most people eventually spend down and transition to Medicaid.

You Can Use Retirement Funds

IRAs, 401(k)s, pensions, Social Security, savings—all can be used to pay. Talk to a financial advisor about the tax implications of withdrawing from retirement accounts.

If You Have a Policy

Long-term care insurance can cover nursing home costs if you bought a policy years ago (usually in your 50s or 60s). Check your policy—most have a waiting period (90 days) and a maximum daily or lifetime benefit.

File Your Claim Early

Don't wait to file a claim. Insurance companies can take weeks to process it. Submit paperwork as soon as you know you'll need nursing home care.

It Won't Cover Everything

Most policies have a cap—like $150/day or a $200,000 lifetime maximum. If your nursing home costs more, you pay the difference out-of-pocket.

If You Don't Have Insurance

It's probably too late (and too expensive) to buy long-term care insurance once you're already elderly or sick. Focus on Medicaid planning instead.

VA Aid and Attendance

Veterans and surviving spouses may qualify for VA Aid and Attendance benefits—up to $2,000-$2,500/month to help pay for nursing home care.

Who Qualifies

You must be a wartime veteran (or widow/widower), meet income/asset limits, and need help with daily activities. Apply through the VA—it can take 6-12 months to get approved.

VA Nursing Homes

The VA operates its own nursing homes (called Community Living Centers). These are free for eligible veterans but often have waiting lists.

Talk to an Elder Law Attorney

An elder law attorney can help you protect assets, apply for Medicaid, understand the "look-back period" (5 years in most states), and avoid penalties.

Don't Give Away Assets Too Late

Medicaid has a 5-year "look-back" rule. If you gave away money or property in the last 5 years, Medicaid can penalize you. Don't do this without legal advice.

Protect Your Spouse

If you're married, Medicaid has rules to protect the spouse still living at home—they can keep the house, a car, and some savings. Don't let the nursing home tell you otherwise.

Get Everything in Writing

Before signing a nursing home contract, understand all costs, what happens if you run out of money, and the discharge policy. Some facilities try to kick people out when they switch to Medicaid.