The average monthly cost of a nursing home in the United States is between $8,669 for a semi-private room and $9,733 for a private room. However, costs vary by location, the level of care, and the type of room and amenities.
Factors affecting cost
Location: The cost of nursing homes varies greatly by state, with the Midwest and the South generally having the lowest median prices.
Room type: The type of room you choose, whether it’s private or semi-private, affects the cost.
Amenities: The luxury amenities and services you choose can impact the cost.
Level of care: The level of care you need, such as 24-hour care, affects the cost.
As of July 2024, 63% of nursing facility residents in the United States paid for their care primarily through Medicaid.
Medicaid is the primary source of funding for most nursing home services in the U.S. As a joint federal and state health insurance program, it helps low-income individuals afford long-term care.
Many Medicaid-covered nursing home residents are also eligible for Medicare, which typically covers the initial portion of a nursing facility stay, while Medicaid pays for the remainder. Additionally, Medicaid plays a vital role in funding home- and community-based care, allowing seniors to remain at home with their families rather than moving into institutional care.
Medicaid eligibility, benefits and coverage vary by state. While some individuals use long-term care insurance to cover nursing home expenses, relatively few people have such policies. If you meet Medicaid’s eligibility requirements, the program typically covers 100% of nursing home costs. However, the exact amount depends on the state and facility.
Eligibility requirements
You must require long-term care
Your income and assets must fall below certain state-established levels
Factors that affect Medicaid payments
Income: Monthly income limits vary by state
Assets: Countable resources, such as bank accounts, stocks, bonds and property, must be below certain state-established levels
Facility: The nursing home must be Medicaid-certified and have designated Medicaid beds
Additional considerations
You may be allowed to keep a monthly allowance and receive deductions for medical expenses, depending on your state’s Medicaid rules, living arrangements and type of nursing facility. Additionally, certain assets—such as your home, car, personal belongings and funeral savings—may be exempt from Medicaid’s asset limits.
More than 7 million seniors rely on Medicaid for nursing home care, according to Justice in Aging, making it the primary payer for over 60% of nursing home residents. As a public health insurance program, Medicaid provides both health care and long-term care services to low-income individuals. It is especially crucial for older adults who need assistance with daily activities like eating, dressing and bathing.
Beyond nursing home care, Medicaid helps millions of seniors cover Medicare cost-sharing and provides benefits that Medicare does not, including dental, vision, hearing and non-emergency medical transportation. While state and federal governments jointly fund the program, it is administered at the state level, leading to variations in coverage and eligibility across the country.
With all the good Medicaid does for millions of Americans, there is most likely some abuse and fraud in the system. An acquaintance of mine owned a nursing home many years ago. His nursing home falsely billed Medicaid hundreds of thousands of dollars. He was caught and put in prison for over four years. Because there are many who aren’t caught, millions of tax dollars are stolen. The Department of Government Efficiency hopefully can provide oversight that will eliminate or stop most of the fraud and abuse.
However, this is a critical service for millions of Americans that would be difficult if not impossible for most to be without.
Sources KFF.com and SeniorLiving.com.
Dr. Glenn Mollette is the author of Nursing Home Nightmares, America’s Disgrace: A True Story of Abuse, Neglect and Corporate Greed.