Nursing Home vs Assisted Living vs Home Care: 2026 Cost Comparison
When a parent or loved one needs care, families face a decision that can cost $70,000–$300,000+ per year — and most make it under time pressure without fully understanding the options. This guide compares all four major care types using the latest CareScout (Genworth) Cost of Care Survey, fielded July–November 2025 across roughly 16,000 providers.
What changed since the older figures you may have seen: costs have moved sharply. Assisted living's national median is now $6,200/month — up from about $4,500 in the 2023 survey, roughly 38% higher in two years. If your plan is built on 2023 numbers, it is materially under-funded. CareScout has also merged "homemaker" and "home health aide" into one non-medical caregiver category, because their prices converged.
The 4 Types of Senior Care & Their Costs
1. In-Home Care (Most Flexible)
A non-medical caregiver provides assistance in the person's own home. This covers bathing, dressing, meals, and companionship — but not skilled nursing or medical care.
National median: $35/hour, $80,080/year (44 hours/week — full-time). Part-time (20 hrs/week) runs roughly $36,400/year.
2. Adult Day Services (Lowest Cost)
Structured daytime programs at a community center provide supervision, meals, and activities. The care recipient goes home each evening — ideal for working family caregivers.
National median: $95/day — about $24,700/year at five days a week. Still the cheapest formal option by a wide margin, at roughly a third of assisted living.
3. Assisted Living (Most Common)
Residential communities offering housing, meals, personal care, and social activities. Residents live semi-independently in their own apartment. Staff provides help with activities of daily living (ADLs).
National median: $6,200/month ($74,400/year). Memory care (Alzheimer's/dementia) units typically run $1,000–1,500/month more.
4. Nursing Home (Highest Care & Cost)
24/7 skilled nursing care for those with serious medical needs. A nursing home is a medical facility, not a residence — meals, medications, physical therapy, and nursing care are included.
Private room: $355/day — $129,575/year (about $10,800/month). Semi-private: $315/day — $114,975/year (about $9,580/month). Sharing a room saves roughly $14,600 a year.
Side-by-side: the annual bill
| Care type | Unit rate | Annual (national median) |
|---|---|---|
| Adult day health care | $95/day | ~$24,700 (5 days/wk) |
| In-home care, part-time | $35/hour | ~$36,400 (20 hrs/wk) |
| Assisted living | $6,200/month | $74,400 |
| In-home care, full-time | $35/hour | $80,080 (44 hrs/wk) |
| Nursing home, semi-private | $315/day | $114,975 |
| Nursing home, private room | $355/day | $129,575 |
Source: CareScout (Genworth) Cost of Care Survey, fielded July–November 2025. National medians — your state will differ substantially.
The crossover most families miss: full-time in-home care ($80,080) now costs more than assisted living ($74,400). Staying at home stops being the cheap option once round-the-clock help is needed — the maths flips somewhere around 40 hours a week.
State-by-State Cost Comparison
| State | Home Health (Annual) | Assisted Living (Annual) | Nursing Home Private (Annual) |
|---|---|---|---|
| California | $68,640 | $60,000 | $136,160 |
| New York | $73,008 | $60,000 | $160,025 |
| Texas | $50,232 | $42,000 | $71,175 |
| Florida | $52,624 | $48,000 | $101,660 |
| Illinois | $55,016 | $48,000 | $92,345 |
| Georgia | $46,904 | $42,000 | $82,125 |
| Mississippi | $44,616 | $34,800 | $63,875 |
Vintage note (read this): the state table above is still on the 2023 Cost of Care Survey, because that release is the last one we hold verified state-level detail for. National medians have risen roughly 30–40% since. Use these rows for relative ranking between states — Mississippi cheap, New York expensive — and use the current national medians in the table above it for the actual dollar planning. We will replace this table when we have verified state-level figures from the 2025 survey. Home health = 44 hrs/week; assisted living = one-bedroom standard; nursing home = private room.
The Medicare myth: Most families assume Medicare will cover assisted living or nursing home costs. It doesn't. Medicare covers limited skilled nursing facility care only after a 3+ day qualifying hospital stay, and only for up to 100 days with significant co-pays after day 20. For ongoing custodial care, families pay out of pocket — or qualify for Medicaid after spending down assets.
What Pays for Senior Care?
- Private pay (out-of-pocket) — most families start here. Median assisted living resident has $100,000–150,000 saved; this lasts 2–3 years.
- Long-term care (LTC) insurance — purchased before age 65, typically pays $150–200/day for 3–5 years. Increasingly expensive and difficult to qualify for.
- Medicaid — covers nursing home costs once assets are spent down to ~$2,000 (rules vary by state). Medicaid does not typically cover assisted living in most states.
- VA benefits — veterans may qualify for Aid and Attendance ($2,200+/month) through the VA.
- Bridge loans / life settlements — converting life insurance to cash to pay for care.
The Caregiver Career Impact (Often Ignored)
AARP research shows the average family caregiver provides 24 hours per week of unpaid care. Over a 4-year caregiving journey, this represents $100,000–250,000 in foregone earnings, lost 401(k) contributions, and reduced Social Security credits — costs that never appear in any senior care cost comparison.
See your state's care costs + caregiver impact
Enter your parent's state, care type, and your own situation to see the full financial picture.
Open Aging Parent Planner →Frequently Asked Questions
Planning the wider picture? See the Later Life financial guide for care funding, health coverage and pension claiming, the state pension comparison across 6 countries, and run your own numbers in the Aging Parent Planner.
Sources: CareScout (Genworth) Cost of Care Survey, fielded July-November 2025 (national medians) and the 2023 survey (state-level table, labelled as such); Medicare.gov coverage rules; AARP Public Policy Institute Caregiver Economic Impact Study; Centers for Medicare & Medicaid Services.
Cite this article
Randive, A. (2026). Nursing Home vs Assisted Living vs Home Care: 2026 Cost Comparison. DecisionsCalc. https://decisionscalc.com/articles/nursing-home-vs-assisted-living-cost/