Assisted living is housing and daily help for people who cannot manage everything on their own but do not need the round-the-clock medical care of a nursing home. Medicare does not pay for it. Most residents pay privately, and some get help from Medicaid in some states, long-term care insurance or a VA benefit.
This guide explains what the service includes, who it suits, how it differs from the options next to it and how to compare communities. For the numbers, read how much assisted living costs, which goes deeper on price. For the Medicaid question, read does Medicaid pay for assisted living.
What assisted living is and how it works
MedlinePlus describes assisted living as housing and services for people who need some help with daily care but who do not need the medical care a nursing home provides. The idea is to let people live more independently than they could in a nursing home.
Names vary. MedlinePlus says assisted living facilities sometimes go by other names, such as adult care facilities or residential care facilities. Size varies as well, from about 25 residents to 120 or more. A federal compendium from HHS notes that states regulate residential care and define assisted living differently, and says that creating a single standard definition is unlikely. That is why the same word can mean a hotel-style apartment complex in one state and a licensed group home in another.
Who assisted living is designed for
MedlinePlus says residents usually need help with tasks such as dressing, bathing, medicines and cleaning. They are usually older adults, including people with Alzheimer's disease or another dementia. In some cases younger residents live there too, for example people with mental illnesses, developmental disabilities or certain medical conditions.
It tends to fit someone who is safe most of the time but who cannot keep up with meals, medicines, housekeeping or personal care, or who is lonely or isolated at home. It fits less well when someone needs frequent skilled nursing, or needs a secure environment because of wandering. See memory care and nursing homes for those cases.
What assisted living includes and leaves out
Services vary by state and by community. MedlinePlus lists these as typical:
- Up to three meals a day
- Help with personal care, such as bathing, dressing and eating
- Help with medicines
- Housekeeping and laundry
- 24-hour supervision, security and on-site staff
- Social and recreational activities
- Transportation
Facilities usually offer several levels of care, and residents pay more for higher levels. So the first question is never "how much is the apartment?" It is "which level will I be assigned, how is that decided, and what does it include?"
Ask about the things that are usually add-ons or limits: incontinence care, two-person transfers, medication management beyond reminders, overnight checks, therapy visits and help after a hospital stay. If the answer is "it depends," ask for the written assessment criteria.
Assisted living vs nearby care options
- Nursing homes. Nursing homes provide 24-hour nursing care and are federally certified, with CMS ratings. Assisted living is state-licensed housing with help. Read assisted living vs nursing home.
- Memory care. A secure setting with staff trained for dementia. Some assisted living communities have a memory care unit, and some do not.
- Board and care homes. Smaller residential homes, often in a house. State definitions overlap. The ASPE compendium notes that some states folded several residential care categories into one general set of assisted living rules.
- Home care. Help comes to your own home, by the hour or around the clock. Use the care cost comparison to compare the cost of your own hours with a community's fees.
- Adult day care. A daytime program. It does not include housing.
Who pays for assisted living
Medicare. Medicare.gov says Medicare does not pay for long-term care, which most commonly means help with basic personal tasks of everyday life. It names assisted living as one place where this care can be received. You pay all costs for non-covered services. Read what Medicare pays for.
Medicaid. Rules differ widely by state. The ASPE compendium says Medicaid home and community-based services waivers can serve residential care residents who meet each state's nursing home criteria. Medicaid.gov says waivers can cover services such as case management, personal care, homemaker help, adult day health and respite, and that states choose how many people each waiver serves. The federal rule at 42 CFR 441.310 generally bars federal matching funds for room and board, with exceptions for respite in an approved facility and for some live-in caregivers. That usually means a resident pays for housing and meals from their own income even where a waiver pays for care services. Check your state on the programs page and read Medicaid, plus the look-back period.
VA. Aid and Attendance adds a monthly payment to a VA pension. You may qualify if you need another person to help with daily activities like bathing, feeding and dressing, you have to stay in bed or spend a large part of the day in bed because of illness, you are a patient in a nursing home, or your eyesight is severely limited. You must also qualify for the pension. For a Veteran with no dependents who qualifies for Aid and Attendance, the maximum annual pension rate is $29,093, effective December 1, 2025. VA's page does not say how recipients may spend the money, so ask VA. VA also lists assisted living facilities as community residential options it inspects and approves for Veterans. See VA benefits.
Long-term care insurance. Some policies pay toward assisted living. The terms vary, so ask the insurer what triggers benefits and what the policy counts as assisted living. See long-term care insurance.
Private pay. Most residents pay from savings, income, home sale proceeds or help from family. Get every charge in writing. See private pay.
What drives the cost of assisted living
We do not publish an average price because the sources available to us do not give a figure that fits every state. The factors that change the bill are:
- The state and the metro area
- The apartment type and whether it is shared
- The care level assigned at move-in and any reassessment later
- A one-time community or move-in fee, where charged
- Charges for services outside the base price, such as medication management, incontinence supplies, transportation or extra meals
- A memory care unit, if the person needs one
- The rate increase policy and how often it applies
Read how much assisted living costs for a longer treatment, and ask each community for a written fee schedule and the last three years of rate increases.
Who oversees assisted living communities
CMS publishes star ratings for nursing homes, home health agencies and hospices. We have no CMS rating for assisted living, and our listings carry none, because CMS does not publish one for this category. The ASPE compendium says states have the responsibility for regulating residential care settings, with different licensing categories and thresholds. So you check the state: its licensing agency, inspection reports and complaint records. For help finding local resources, call the Eldercare Locator, a public service of the Administration for Community Living, at 1-800-677-1116.
Our care ratings by state research and methodology explain which CMS data we use and where there is none.
How to choose an assisted living home
- List what help you need now and what you may need in two years.
- Shortlist communities by location, so family can visit.
- Visit at least twice, once at a mealtime and once in the evening.
- Ask for the contract, the fee schedule and the assessment form before you decide.
- Check state licensing and inspection records.
- Have someone you trust read the contract. For an elder law question, speak to an attorney.
Questions to ask on every tour
- What does each care level include, and how is my level set?
- What happens if my needs go beyond what you can provide? Who decides, and how much notice do I get?
- How many staff are on duty at night, and what are their qualifications?
- Who manages medicines, and is there a nurse on site?
- What are the exact charges outside the base price?
- How often have rates gone up in the last three years?
- What is your policy if I run out of money?
- Can I see the last state inspection report?
What to check before you sign a contract
Assisted living contracts decide most of what happens later, so read the whole document at home. Ask for these items in writing:
- The base fee, the fee for each care level and every add-on charge
- How and when care needs are assessed and who decides the level
- Notice you must give to leave, and notice the community must give you
- The conditions under which the community can ask you to move out
- What happens to fees if the person moves to a hospital or nursing home for a stay
- The refund policy for deposits and prepaid fees
- Who is responsible for medicines, and the charges for that service
- Rules about visitors, pets, outings and personal belongings
If anything is unclear, ask the community to explain it in plain words and to write the answer in the margin. For a legal review, speak to an elder law attorney. Do not sign the same day as your first tour.
Red flags when you visit a community
- No written fee schedule, or a contract you cannot take home
- Evasive answers about discharge or what happens when needs increase
- Staff who cannot say who is on duty overnight
- Pressure to sign the same day
- A community that will not show its latest state inspection
- Residents who look unattended, or call bells that go unanswered during your visit
About the communities listed below
Carevo is a directory and connection platform. It does not place residents, assess whether someone needs assisted living or vouch for any community. The lists below come from public data. Check each community yourself, and use get matched if you want help finding options near you.