How to pay for nursing home care

Nursing home care is the most expensive form of long-term care. Most families combine several payment sources over time — almost nobody pays the whole bill from one place.

What it costs

CareScout's 2025 Cost of Care Survey puts the national median at $315 a day for a semi-private room — about $9,581 a month or $114,975 a year — and $355 a day for a private room ($10,798 a month, $129,575 a year). Costs vary widely by state and city; the 14,690 facilities in this directory show the spread, and a facility's own admissions office is the only authoritative quote.

The payment sources, in the order families usually use them

1. Private pay. Savings, pension income, the proceeds of selling a home, and family contributions. This is how most people start. A facility will ask for a financial disclosure and may require a deposit.

2. Medicare — short-term skilled care only. Part A can pay for up to 100 days per benefit period of skilled nursing facility care after a qualifying hospital stay, with coinsurance after day 20. Medicare does not pay for custodial long-term care. See does Medicare cover nursing home care.

3. Medicaid — the long-term-care payer of last resort. For people who meet their state's income and asset limits, Medicaid covers long-term custodial nursing home care in certified facilities. It is means-tested and state-specific; see Medicaid and nursing homes.

4. Long-term care insurance. If a policy was bought years ago, it may pay a daily or monthly benefit after an elimination period. Check the policy's benefit period, inflation protection and whether it pays for nursing home care only or also home care.

5. Veterans benefits. The VA has community living centres, state veterans homes and the Aid & Attendance allowance for eligible wartime veterans and surviving spouses. Apply through the VA, not the facility.

6. Other assets. Life insurance with a long-term care rider, hybrid life/LTC policies, annuities with LTC benefits, a reverse mortgage, or the sale of a home. Get independent financial advice before cashing in policies — the tax and benefit consequences matter.

How to choose the order

Start with what the person needs clinically (skilled rehabilitation versus custodial care), then check Medicare eligibility for the short term, then plan the long term with Medicaid/insurance/VA in mind. Ask the facility's admissions director which payers they accept — most accept Medicaid, but bed availability for Medicaid patients can differ. Apply for Medicaid before the money runs out; retroactive coverage is limited.

Watch out for

Facilities are not allowed to require a "Medicaid bed" deposit in most states, but they can ask for a private-pay commitment for a period. Get every commitment in writing. Keep records of every payment, policy and application — appeals are common and documentation wins them.

Written and maintained by the US Nursing Homes data team · last reviewed 2026-10-24 · sources and methodology.