It’s a seemingly straightforward question… one that we’re often asked at myLifeSite… but unfortunately, there is no one simple answer to the query, “What is the cost of assisted living? And how much will I pay for it?”

Assisted living center: A senior living option for people needing daily assistance with regular activities of daily living (ADLs).

As older adults or their family members begin to research various assisted living facilities, they will inevitably see statistics from sources like Genworth’s cost of care calculator showing the average monthly cost of assisted living and other types of care. This is an excellent tool for getting a ballpark idea of assisted living expenses nationally, regionally, or even by zip code.

But keep in mind that the cost can vary drastically from location to location, and even among different residents within an assisted living center.

>>Related: Distinguishing Between Types of Retirement Communities

Assisted living fees you can expect to pay

People who are researching assisted living communities for themselves or a family member should understand how pricing works. It is important to know that most assisted living providers charge a la carte, as described in the fee breakdown below, but others are all inclusive.

An upfront fee (one time)

Most assisted living facilities will charge future residents a reservation deposit. Sometimes referred to as a “community fee,” this deposit may be a couple thousand dollars or so and reserves the accommodations of your choice for a certain period of time. Typically, this deposit is not applied to any other charges and is sometimes refundable only if the would-be resident is unable to move into the facility for health reasons.

Base monthly fee 

In short, this is your monthly “rent” once you live in the assisted living facility. The cost varies depending upon the size of the residential unit and whether you live alone or have a companion. Most base fees are inclusive of most utilities, basic housekeeping, maintenance, and some meals. The base fee is also based on the type of services you need; i.e. independent living, assisted living, or memory care. Note: Some assisted living providers may not offer independent living options.

Care services fee 

The care services fee typically uses a tiered approach based upon the level of care you need (or want), and it gets added to the monthly base fee. The level of care is usually based on the number of ADLs (activities of daily living) for which a resident requires regular assistance. ADLs include activities such as bathing, eating, dressing, toileting, etc. The monthly cost of assisted living care services may range from a few hundred dollars for tier one and could go up to a few thousand dollars per month for tier five assisted living care. Accurately assessing the amount of care needed is one of the most important aspects of the decision process and also one of the more difficult to understand. The more thorough, clinical, and detailed the assessment, the better the plan of care and understanding of the cost.

To accurately compare the cost at different assisted living providers, it’s important to understand how much the additional care services fee could add to the total monthly cost at each location rather than comparing only the base monthly fee.

Medication management & other ancillary services (monthly)

Many seniors need assistance with remembering to take medicines at the right time and in the right dosage, so most assisted living communities provide medication management services for an additional fee­–usually a few hundred dollars per month, depending on the complexity of the medicine administration. If needed, additional ancillary services like physical or occupational therapy would also be charged on a monthly basis, as well as non-care related services, possibly including parking, additional meals, and some activities. Each of these can add to the cost so be sure to get a listing of ALL services and the corresponding cost so there are no surprises later. 

All-inclusive assisted living pricing

An assisted living provider that operates under an all-inclusive pricing model spreads the total cost of services for the entire facility across all residents. In theory, some residents would pay more than they might pay in a la carte facility and others will pay less, depending on the amount of care they are receiving. The advantage, however, is that residents can more accurately plan for their monthly cost over the long term, regardless of the level of care received.

Yet, some all-inclusive facilities may also have a cap on the level of services they can provide under the all-inclusive price. They may also charge for other ancillary expenses on occasion so be sure to inquire about all of the potential costs or limits.

Affordable living options

For those who qualify, a government-supported assisted living facility will provide services at a lower overall monthly cost. You can contact the specific agency in your state to learn more about affordable senior living options in your state and qualification guidelines.

Many assisted living centers may also be Medicaid-certified. Medicaid eligibility requirements vary by state but suffice it to say that, except for a few allowances, qualifying for Medicaid requires that you have exhausted most of your financial resources and your income must be close to the federal poverty level.  (Most states allow the cost of care to be deducted against income when determining if income eligibility requirements are met.) Medicaid is only applicable if your provider, either the facility or a home care provider, is Medicaid-certified.

Under the Affordable Care Act, eligibility requirements tend to be less strict in states that have expanded Medicaid coverage compared to states that have not expanded under the ACA. As of 2024, 41 states have expanded Medicaid coverage under the ACA. This is up from just 12 states in 2016 when the last edition of this book was released.

There are many middle income senior adults who ultimately end up on Medicaid only because they exhausted their assets paying for long-term care.

Veterans benefits

U.S. Veterans and spouses of Veterans may have access to long-term care benefits to help offset the cost of care. Qualification is not dependent on service-related injuries and can provide as much as $32,000 or more in annual benefits, which caps somewhere around $1,500 to $2,700 per month, depending on income levels and whether the recipient is married, single, or a surviving spouse of a veteran. Learn more about Veterans long-term care benefits.

Medicare doesn’t cover long-term care

As you can see, the monthly costs associated with assisted living vary widely and can really add up, so it is important to plan ahead for this potential expense. A major misconception is among consumers is that Medicare will cover the cost of assisted living but this is not the case. Medicare only covers skilled nursing care, and for a temporary period of time, if you meet certain requirements, including a preceding three-day hospital stay (observation days DO NOT count towards the total) and admittance to the skilled nursing center must take place within 30 days of the hospital stay.

Assisted living and long-term care insurance

If you have a long-term care insurance policy that was purchased within the past 20 years you are likely covered for some or all of your assisted living expenses, depending on the amount of coverage. In the early days of long-term care insurance, most policies were considered pure nursing home policies, meaning they only covered the cost of care in a nursing home. But modern policies typically cover nursing homes, assisted living communities, and even in-home care.

Assisted living within a continuing care retirement community

A continuing care retirement community, also commonly referred to as a CCRC or “life plan community,” often provides a full continuum of care for residents, ranging from independent living for those who are still healthy and active all the way through to assisted living, memory care, and skilled nursing care.

The cost of assisted living within a CCRC will depend on the type of CCRC residency contract, but similar to what is described above it may be included in your monthly fee at the CCRC or it may be provided at an additional cost.

Revised Sept 9, 2024

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