How much does assisted living cost? What drives the price and how to compare

Assisted living has no single price. What you pay depends on the community and the level of care the person needs, and Medicare does not pay for it. We do not quote an average, because no federal source we read publishes one and a made-up number would help no one.

What sets the price

MedlinePlus gives the basic rule: residents pay more for higher levels of care. It also says assisted living usually has several levels of care, which vary by state. That means two people in the same building can pay different amounts.

The services a community lists show what the base rate might cover. MedlinePlus says assisted living services may include:

• up to three meals a day
• help with medicines
• housekeeping and laundry
• transportation
• 24-hour supervision, security and on-site staff

Each community decides which of these are in the base rate and which cost extra. That is where quotes that look alike often differ. We have no federal source that says which fees are common, so the section on comparing quotes below lists what to get in writing instead.

Who pays

• You, your family or your savings. Medicare.gov says you pay all costs for non-covered services, including most long-term care.
• Medicare does not pay. Medicare.gov says Medicare does not pay for long-term care, whether in a nursing home or in the community, and lists assisted living as a place to get non-medical long-term care.
• Medicaid, in some states, for some services. Medicare.gov says Medicaid may pay if you meet your state's requirements. For home and community-based waiver services, the federal rule in 42 CFR 441.310 excludes the cost of room and board, except in narrow cases such as respite care in a state-approved facility. The state sets the rest. Read does Medicaid pay for assisted living and our Medicaid guide.
• VA benefits, for some veterans and survivors. VA says Aid and Attendance is an increase to a monthly VA pension for qualified veterans and survivors, for example when you need another person's help with daily activities such as bathing, feeding and dressing. The page we read does not mention assisted living by name. Use the VA Aid and Attendance calculator and our VA guide and then ask VA how your situation fits.
• Private long-term care insurance. Medicare.gov says you can buy it. Policies differ, so read yours. See long-term care insurance.

How to compare quotes

Ask every community for the same things, in writing, on the same day:

1. The base monthly rate, and exactly what it includes.
2. The cost of each level of care, and how the community decides which level a resident needs.
3. Every one-time fee, such as an entry or community fee.
4. How and when rates can rise, and how much notice you get.
5. What happens if care needs grow beyond what the community provides, and how much notice you get before a move.
6. What happens to the rate if the resident is in the hospital.
7. Whether it accepts Medicaid, and how a resident who runs out of private money is treated.

These are questions, not findings. The answers belong in the contract. If you can, have an elder law attorney read the contract before you sign. The Eldercare Locator, a public service of the Administration for Community Living, can help you find help in your community. Its number is 1-800-677-1116.

A simple table keeps the quotes honest. Make one row per community and fill it in from the written quotes:

Item	Community A	Community B	Community C
Base monthly rate
Added cost for the person's current level of care
Added cost for the next level of care
One-time fees
Extra charges
Notice before a rate change

Add the base rate, the added cost for the current level and the one-time fees to get a first-month figure, and use the next-level row to see what happens if needs rise.

Put the quotes side by side

The care cost comparison lets you enter a monthly assisted living bill next to a home care schedule and see them together. It uses your numbers and sends nothing to Carevo. If home care is also on the table, the home care hours and cost calculator works out weekly, monthly and yearly cost from hours and an hourly rate.

What catches people out

• A low base rate with many add-ons. Compare total monthly cost at the level of care the person needs today and at the next level.
• Room and board. Even where a state program pays for care services, federal waiver payment does not cover rent and meals.
• Moving between levels. MedlinePlus says residents pay more for higher levels of care, so a resident whose needs rise can face a higher price. Ask how the community handles that.
• Medicaid and your savings. If you plan to apply for Medicaid later, talk to your state Medicaid agency or a qualified elder law attorney before you move or give away any money. Transfers for less than fair market value can lead to a penalty period. See the Medicaid look-back explained.

Next step

Make a short list of three communities that serve the person's current level of care. Ask each for the seven items above, in writing. Then compare the totals in the care cost comparison. For a wider view of the options, see assisted living and assisted living vs nursing home.

Carevo does not give financial or legal advice and does not vouch for any community.