Understanding the Cost of Assisted Living

According to our data, the national average for assisted living costs in 2019 is $4,468 per month. This is closely aligned with the Genworth’s 2019 Cost of Care Survey reporting of a national average of $4,051 per month. To see a breakdown of assisted living costs according to Genworth and Seniorly families, take a look at the table below to find the average costs for some of the most expensive and inexpensive states across the United States. 

Highest Average Monthly Assisted Living Costs by State (2019)

*Genworth data as of their 2019 Cost of Care Survey.

Lowest Average Monthly Assisted Living Costs by State (2019)

*Genworth data as of their 2019 Cost of Care Survey.

When evaluating the cost of assisted living remember that you, or your loved one, can expect room, three meals per day, 24-hour supervision, housekeeping, and daily non-medical assistance as part of your monthly fee. Once you add up housing, meals, healthcare, social activities, and other amenities included in the monthly fee, the cost of assisted living can actually be comparable to at-home care. Our partner, Holiday Retirement has a very useful calculator to compare the costs of living at home.

Common assisted living pricing terminology

Before diving deeper into the cost of assisted living, it’s helpful to first understand that assisted living pricing can be complicated. Let’s start with some common pricing terms:

• Community Fee: The community fee is a one-time fee charged by most communities. Typically this fee is used to cover the administrative costs of residents moving in. (Tip: Our local senior living experts have informed us that they are often able to negotiate this or even get it waived.)
• All-Inclusive Pricing: This is the most straight forward form of pricing in assisted living communities. It is one price to cover all monthly expenses. (Tip: It is typical to find this type of pricing in small or family-owned communities often called “board and care homes.”)
• Monthly Rent plus Care Fees: This is sometimes a way that sales and marketing professionals will explain how their communities charge residents. The rent for the room and board is separate for the monthly cost of care services. There are two common types of Care Fees: (1) Levels of Care Fees and (2) Points System Pricing. In both cases, the communities assess the level of care and use the applicable level or a number of points to establish the monthly cost. (Tip: Communities will reassess the level of care often, so be sure to understand what the monthly price ranges might be.)

How do assisted living communities differ?

The pricing of assisted living communities can differ based on what type of amenities and services they offer. Assisted living communities often choose to focus on delivering services focused on hospitality or healthcare. For example, some communities will cater more towards senior residents that don't need higher levels of care and are more interested in living a maintenance-free and social lifestyle. Other assisted living communities focus on healthcare services to provide higher acuity and/or memory care services. Within both of these categories, the communities can then be divided up into three different pricing levels: basic, boutique, and luxury.

Basic assisted living community

To many seniors, a no-frills lifestyle is perfect. Choosing an assisted living community with fewer amenities at a lower cost shouldn’t equal sub-par health care or comfort levels. It simply means not paying for what you or your loved one doesn’t need. For example, board and care homes are great options for seniors who are in need of senior care but don’t want to pay the fees of a large community.

Why spend extra for social activities, pools, larger living spaces, or extensive on-site health care if you prefer watching television and only need minimal health care and supervision?

Basic assisted living communities often have limited options when it comes to food and activities. Housing units are small, sometimes shared, studio-sized spaces. But even with a lower price, any community worth considering will have impeccably clean facilities, friendly, well-trained staff, and up-to-date certifications. Be sure to research user reviews on Google, Yelp, Facebook, and other sites.

Boutique assisted living community

If you’re searching for that perfect balance of price, amenities, and comfort, this is the sweet spot.

Boutique assisted living communities usually offer:

• Comfortable, private living studios
• 24/7 certified medical staff
• High-quality meal options
• Exercise classes and facilities
• Enrichment classes
• Regular social activities

Choosing a boutique assisted living community is also ideal if you or your loved one has increased medical care needs. The higher cost often includes specialized staff trained in geriatric health. Nurses certified in memory care, nutrition, mobility, medication management, etc. are often on-hand to support your loved one anytime.

Luxury assisted living community

Perfect for the senior who wants it all, or has increased care needs. Luxury assisted living communities offer a resort-style lifestyle combined with top-notch, around-the-clock medical care.

Expect a luxury community to provide:

• Gourmet, restaurant-quality meals
• Beautifully manicured grounds
• Modern multi-room apartments with kitchenettes
• High-quality classes and social events
• All-day chartered excursions
• Premier exercise amenities like pools or yoga studios
• Concierge services

Customized, premium health care is also a priority. Overall, expect more personalized care with a lower staff to resident ratio vs. basic or mid-level facilities. Full-time nurses, nutritionists, memory care experts, physical therapists, etc. are always on-hand for every senior residents’ needs.

In addition, many luxury level senior living communities have on-site support options in the event of an illness or medical emergency. With the increased price comes the increased comfort of knowing you or your loved one is in incredible hands no matter what.

Assisted Living Cost Breakdown

No matter the level of luxury you choose, any good community should feel safe and secure, with certified, caring staff members. No bargain is worth risking the well-being of your loved one.

How much does assisted living cost couples?

The pricing structure will vary at each assisted living community when it comes to balancing the appropriate care and wants of couples. Often, when only one spouse needs assistance with activities of daily living (ADLs), they will pay for those services and the other partner will only be charged for room and board. In other cases, it might be that both partners require care services, and they live in different units appropriate for their care needs (for example, one is in assisted living while the other is in memory care).

With over 30,000 assisted living communities across the United States (according to the CDC) there are many different types of housing options at different costs. So, be confident that balancing cost and exceptional care for your loved one is possible to attain.

How do I know what assisted living I can afford?

To get a better understanding of what you or your loved can afford, sit down and carefully discuss where money for all living expenses goes every month. Review bills, receipts, transactions, etc. This includes (but isn’t limited to):

• Housing Costs
• Monthly Bills
• Taxes
• Transportation
• Food
• Medical Costs
  • +Non-Medical Costs including any assistance with activities of daily living (ADLs)
• Classes & Activities

Then, look into the costs of various assisted living options. This cost of living calculator is also a great tool to give you a better ballpark estimate of costs. Make sure to take into consideration the living expenses that will now be included in monthly assisted living fees. That initial sticker shock may subside once costs like transportation, food, bills, cleaning services, and medical care are rolled into one.

Ensure you thoroughly discuss with each community exactly what is included in your monthly fees. Also, ask what additional fees you should expect, like initiation fees, grooming & bathing, medication management, housekeeping, etc.

Adding up all current expenses against the expenses of at-home care vs. assisted living should provide valuable insight into choosing the best care for you or your loved one.

Does insurance cover assisted living costs?

Standard health insurance does not cover daily, extended care services at assisted living facilities. Programs like Medicaid will only cover short-term stays under very strict conditions. 

Does long-term care insurance cover assisted living costs?

In general, most long-term care insurance policies are designed to work across the continuum of care and will cover expenses at approved assisted living facilities. It’s important to carefully review your policy to determine if the facility you want to move into meets the insurance company’s requirements. While assisted living facilities generally accept private long-term care insurance, sometimes an insurance company will refuse to pay because an assisted living community doesn’t meet its standards.

How much does assisted living insurance cost?

Long-term care insurance premiums vary widely depending on location and coverage type. The average is about $2,700 a year, according to AARP.

Your rates will depend on a variety of things, including:

• Your age and health
• Gender
• Marital status
• Amount of coverage

Is there government assistance for assisted living?

Depending on your circumstances, government aid might be available to help with the costs of long-term care. Below we’ve answered a few frequently asked questions concerning this.

• Does Medicare cover assisted living? For many over 65 years of age, Medicare may be able to temporarily cover some of your loved one's daily skilled care. However, there are limitations.
• How much does Medicare pay for assisted living? It will depend on how many days of your benefit period you have used and what services are required.
• Does Medicaid cover assisted living? Each state has different qualifications and benefits for helping seniors afford quality assisted living. Go to the Medicaid website to find out about potential eligibility.
• Does Tricare cover assisted living costs? Currently, Tricare doesn't cover assisted living facility care or routine personal care associated with assisted living. They do offer coverage for skilled nursing care, however.
• Can Social Security pay for assisted living? Social Security Benefits can be used to pay for assisted living.
• Does Veterans Assistance cover assisted living? The VA offers many benefits, services and financial assistance for seniors or their spouses who have served more than one day during a designated war. To see what your loved one may be eligible for, visit our Veterans Benefits for Assisted Living resource page.

You can learn more in our comprehensive resource on assisted living payment assistance. Based on their income, some seniors and their families may be eligible for additional assisted living options. To see if you qualify, visit this page to view your state’s requirements.

Also, don’t hesitate to talk to a local senior living expert who knows all the nuances of paying for assisted living within each major city. The professionals have relationships with all the local retirement living communities and staff, allowing them to understand the unique programs or strategy at any property you might be interested in. A senior living expert is also often able to negotiate rent on your behalf, allowing you or your loved one to live in the perfect assisted living community.

Are assisted living expenses deductible?

The cost of housing and meals at assisted living is not tax-deductible, but the money spent on care may be.

Generally, for assisted living care expenses to be tax-deductible, the total out-of-pocket medical costs must be greater than 10 percent of gross adjusted income. The resident must also be considered "chronically ill." This means a doctor or nurse has certified that the resident either:

• Cannot perform at least two activities of daily living, such as dressing, eating, toileting, or transferring; or
• Requires supervision due to cognitive impairment (such as dementia).

A licensed healthcare professional must have recommended the care service is part of a formal care plan. For example, if the resident’s doctor recommends assistance with bathing and continence, these services may be deducted. However, costs associated with medication management or dressing can’t be deducted, since they’re not considered part of the care plan. Visit the IRS website for more information.