Nursing Home Costs by State

Nursing homes vary more by state than any other kind of care. Texas is the least expensive at $72,708 a year. Connecticut is the most expensive of the lower 48 at $187,848, more than two and a half times Texas. Alaska sits far outside everything else at $298,594.

Twenty-eight states and the District of Columbia are above the national average of $115,988. The least expensive cluster in the south and lower midwest: Texas, then Missouri at $79,264, Oklahoma at $81,087, Louisiana at $85,747 and Arkansas at $89,035. The most expensive are in the northeast and on the west coast.

Assisted Living Costs by State

Assisted living runs from $52,971 in Arkansas to $134,550 in the District of Columbia. Hawaii is the most expensive state at $119,003, followed by Alaska at $106,064, New Jersey at $102,669 and Massachusetts at $101,559.

The national average is $70,349. Twenty-five states and the District of Columbia sit above it. The lowest are Arkansas, Mississippi at $54,159, Utah at $56,366, Georgia at $56,628 and Alabama at $58,925.

Home Care Costs by State

Home care prices are the most consistent in the country. Between the cheapest state and the most expensive, the difference is about $48,000 a year. For nursing homes that gap is more than $115,000, even leaving Alaska out.

South Dakota has the highest home health aide costs in the country at $102,313 a year, which is unexpected given its nursing homes run below the national average. Washington follows at $100,669, then Minnesota at $96,950, Colorado at $96,430 and New Hampshire at $95,957. Louisiana is the least expensive at $54,539.

The pattern is worth noticing. The more institutional the care, the more your state matters. Home care is priced close to local wages, and wages vary less than the cost of running a licensed facility.

Does LTC Insurance Cost More in Some States?

Two different things get called cost here, and they behave differently.

The rate per dollar of coverage barely moves. Carriers price from your age, your health, the benefit amount, how long benefits last, the elimination period and whether you add inflation protection. Those rates are filed with each state, but the pricing behind them is often national. A $6,000 monthly benefit costs about the same in Texas as in Connecticut.

What you actually spend is a different question. Coverage only protects you if it is sized to local care costs. A nursing home runs $72,708 a year in Texas and $187,848 in Connecticut. Buying meaningful coverage in Connecticut means buying a much larger benefit, and paying a much larger premium for it.

Most people do not insure the whole bill. A common approach is to cover 70 or 80 percent of local costs and pay the rest from income and savings. Either way, the benefit you need is driven by where you live. So your state affects what you spend, even though it barely affects the rate.

What These Numbers Mean for Planning

Three years is a common planning assumption. At the national average, three years in a nursing home costs $347,964. Three years of assisted living costs $211,047. Three years of home care at 44 hours a week costs $235,263.

Medicare pays for almost none of it. It covers a short skilled nursing benefit after a qualifying hospital stay and nothing once the need becomes daily help. Medicaid pays only after you have spent down nearly everything you own, and the rules differ in every state.

How These Figures Are Measured

The figures come from the Nationwide Financial 2026 Cost of Care Survey, conducted by HealthView Services. Nursing home rates are average daily rates multiplied by 365 days. Assisted living rates are based on costs per metropolitan region. Home health aide costs assume 44 hours of care a week.

Regions follow Metropolitan Statistical Areas as defined by the US Office of Management and Budget, so a few cross state lines.

These are estimates. What you actually pay varies by facility, by level of care and by how much help you need.