Private assisted living had a national median of $6,200 per month ($74,400 per year) in 2025, according to CareScout in its 2025 Cost of Care Survey. Qualifying adults pay little or nothing for Medicaid-approved home-care hours, far less than private facility care.
Assisted living means private housing with meals plus daily help and supervision. Private full-time home care at 44 hours per week cost about $6,483 per month in 2024. Part-time care at 20 hours cost about $2,947 per month, reports WhatIf Labo using Genworth/CareScout rates in its elder-care cost comparison.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Official resource:
- Check eligibility on Medicaid’s official study page — Use this page to check the study’s participation requirements.
Table of Contents
- What does assisted living charge?
- Why do home-care hours decide the math?
- What does Medicaid home care cover?
- Does Medicaid pay for assisted living?
What does assisted living charge?
CareScout reported a 2024 national median of $5,900 per month ($70,800 per year) for a private one-bedroom unit. Its newer survey reports $6,200 per month for 2025, a 5% rise. The figure is private-pay, not what Medicaid pays. The facility rate is flat.
It bundles rent, meals, staff supervision, and daily help. Families compare that single monthly price against home-care hours that rise with need. For dementia care, the flat rate matters. Night waking, wandering, and prompts for meals add hours at home. In a facility, those needs fall inside the monthly charge.
Why do home-care hours decide the math?
The 2024 national median rate for a home health aide was about $34 per hour. At that rate, 20 hours per week cost about $2,947 per month, well below assisted living. At 44 hours per week, the cost reached about $77,792 per year, or $6,483 per month.
Part-time help for meals, bathing, and rides often keeps home cheaper. Full-day supervision, common in mid-stage dementia, flips the math. Count real weekly hours before choosing.
- 20 hours per week at home: about $2,947 per month
- Assisted living facility median in 2024: $5,900 per month
- 44 hours per week at home: about $6,483 per month
What does Medicaid home care cover?
Medicaid covers home-care services for qualifying low-income older adults through Home and Community-Based Services. Medicaid.gov explains on its HCBS 1915(c) authorities page that 1915(c) waivers serve people who would otherwise need institutional care. Each state sets eligibility and covered hours. Medicaid is the dominant long-term-care payer. KFF reports it paid 61% of U.S.
long-term-care spending in 2023, including most home-care spending. Families who qualify do not face the private medians above for approved services. Medicaid pays providers less than private rates. KFF's 50-state survey completed April-July 2025 found medians of $26 per hour to personal-care agencies, $51 per hour to home-health agencies, and $19 per hour to direct personal-care providers. Low rates can limit which local agencies accept Medicaid.
Does Medicaid pay for assisted living?
Medicaid generally does not pay room and board in assisted living. Eldercare Resource Planning notes that where a state covers assisted living, it pays care services such as personal care and medication support. The resident still owes rent and meals.
National medians also hide wide state variation plus Medicaid wait lists and hour caps, reports CareScout in its assisted living versus home care comparison. A state may cap daily hours, cover fewer tasks, or maintain a waiver waiting list. Dementia behaviors that need overnight watch may exceed approved hours.
- Get two local facility quotes and one local home-care hourly quote
- Multiply the hourly quote by true weekly hours, including evenings
- Ask your state Medicaid office whether its waiver covers services in assisted living and what hours you qualify for
