Paying for senior care by state
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- Independent, not a care agency
Will Medicaid, the VA or your state help pay for assisted living or care at home? Here's how each option works, what care costs in your state, and official places to apply.
Quick answer
Medicare does not pay for long-term custodial care. Medicaid can pay for home care through state home and community-based services (HCBS) programs, and can help with services in assisted living in some states, but federal waiver rules don't cover room and board (rent and meals). Some veterans can get extra monthly VA pension money through Aid and Attendance or Housebound benefits, or care through VA programs. Eligibility depends on income, assets, care needs and your state.
Choose your state
| State | Assisted living (monthly) | Home care, 44 hrs/week (monthly) | Home care (hourly) |
|---|---|---|---|
| U.S. median | $6,200 | $6,673 | $35 |
| Alabama | $4,425 | $5,148 | $27 |
| Alaska | $9,882 | $7,245 | $38 |
| Arizona | $6,250 | $7,245 | $38 |
| Arkansas | $4,637 | $4,767 | $25 |
| California | $7,000 | $7,627 | $40 |
| Colorado | $6,584 | $7,913 | $42 |
| Connecticut | $9,118 | $6,864 | $36 |
| Delaware | $7,600 | $6,673 | $35 |
| District of Columbia | Not reported | Not reported | Not reported |
| Florida | $5,610 | $6,101 | $32 |
| Georgia | $5,300 | $6,101 | $32 |
| Hawaii | $12,096 | $7,817 | $41 |
| Idaho | $5,175 | $7,341 | $39 |
| Illinois | $6,219 | $6,864 | $36 |
| Indiana | $5,639 | $6,673 | $35 |
| Iowa | $5,381 | $7,836 | $41 |
| Kansas | $5,975 | $6,435 | $34 |
| Kentucky | $5,528 | $6,197 | $33 |
| Louisiana | $5,163 | $4,957 | $26 |
| Maine | $8,205 | $8,485 | $45 |
| Maryland | $7,173 | $6,673 | $35 |
| Massachusetts | $9,600 | $7,627 | $40 |
| Michigan | $5,818 | $6,626 | $35 |
| Minnesota | $6,573 | $8,389 | $44 |
| Mississippi | $4,369 | $4,576 | $24 |
| Missouri | $5,400 | $6,292 | $33 |
| Montana | $6,075 | $7,245 | $38 |
| Nebraska | $6,350 | $6,864 | $36 |
| Nevada | $6,241 | $7,055 | $37 |
| New Hampshire | $8,025 | $7,627 | $40 |
| New Jersey | $8,710 | $7,245 | $38 |
| New Mexico | $5,950 | $5,720 | $30 |
| New York | $7,110 | $6,673 | $35 |
| North Carolina | $6,496 | $5,720 | $30 |
| North Dakota | $4,729 | $6,483 | $34 |
| Ohio | $6,103 | $6,483 | $34 |
| Oklahoma | $6,150 | $6,292 | $33 |
| Oregon | $6,875 | $7,627 | $40 |
| Pennsylvania | $6,480 | $6,483 | $34 |
| Rhode Island | $7,781 | $7,627 | $40 |
| South Carolina | $5,350 | $5,982 | $31 |
| South Dakota | $4,900 | $8,437 | $44 |
| Tennessee | $5,845 | $5,911 | $31 |
| Texas | $5,666 | $5,720 | $30 |
| Utah | $5,475 | $7,484 | $39 |
| Vermont | $8,597 | $8,580 | $45 |
| Virginia | $6,945 | $6,673 | $35 |
| Washington | $7,600 | $8,580 | $45 |
| West Virginia | $6,340 | $5,720 | $30 |
| Wisconsin | $6,540 | $6,912 | $36 |
| Wyoming | $5,325 | $8,771 | $46 |
"Home care" here is CareScout's non-medical caregiver category (homemaker and home health aide). Assisted living is a private one-bedroom. These are survey medians, not quotes.
Medicare: usually not for long-term care
Medicare doesn't pay for long-term custodial care, at home or in a facility (Medicare.gov). It may cover short-term skilled home health or skilled nursing care that meets its rules. PACE, offered in some areas to people who qualify, combines Medicare and Medicaid services to help people stay at home.
Medicaid: home care waivers and assisted living
States use home and community-based services (HCBS) waivers to pay for care at home or in the community instead of a nursing home. Covered services can include case management, homemaker, home health aide, personal care, adult day health and respite. To qualify, a person usually has to meet the state's income and asset limits and need a nursing-home level of care. States can cap enrollment, so waitlists are common.
Assisted living: some states pay for care services in assisted living through a waiver or their state plan. Federal rules don't let states use federal waiver money for room and board (42 CFR 441.310), so the resident usually still pays rent and meals from income or other money.
Many waivers also let the person hire their own caregiver, sometimes a family member. See getting paid as a family caregiver, by state.
VA: Aid and Attendance, Housebound and VA care
Aid and Attendance and Housebound are add-ons to the VA pension for wartime veterans and surviving spouses who meet income, net worth and care-need rules (VA.gov). VA pays the gap between your countable income and a yearly limit. For December 1, 2025 to November 30, 2026, VA lists these limits:
| Veteran's situation | Basic pension | Housebound | Aid and Attendance |
|---|---|---|---|
| No dependents | $17,441 | $21,313 | $29,093 |
| 1 dependent spouse or child | $22,839 | $26,710 | $34,488 |
Yearly maximums, not what you'll get. Net worth limit: $163,699. Source: VA pension rates.
VA care programs: enrolled veterans may get Homemaker and Home Health Aide care or Veteran-Directed Care, a budget to hire their own helpers. For assisted living, VA says it does not pay rent but may pay for some extra services. Ask the VA social worker at your medical center. Caring for a veteran? See VA programs that pay family caregivers.
State and local help
Your Area Agency on Aging can tell you about state-funded in-home programs, respite and caregiver support that aren't Medicaid. Find yours through the Eldercare Locator or call 1-800-677-1116. Paying for help at home? Read how to pay for in-home care. Changing the home instead? See home modification grants for seniors.
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Frequently asked questions
Does Medicare pay for assisted living or long-term home care?
No. Medicare.gov says Medicare doesn't pay for long-term (custodial) care such as help with bathing and dressing, whether at home, in assisted living or in a nursing home. Medicare may cover short-term skilled care that meets its rules.
Will Medicaid pay for assisted living?
It depends on the state. Medicaid waivers can pay for services such as personal care, but federal rules (42 CFR 441.310) don't allow federal waiver money for room and board, so rent and meals in assisted living usually have to be paid another way. Ask your state Medicaid agency whether it covers services in assisted living and whether there's a waitlist.
Will Medicaid pay for home care?
Nearly all states run HCBS waivers that can cover services like personal care, homemaker and home health aide help at home for people who meet the state's financial rules and need a nursing-home level of care. Spots can be limited and waitlists are common.
How much is VA Aid and Attendance?
It's not a fixed amount. VA pays the difference between your countable income and a yearly limit (MAPR). For December 1, 2025 to November 30, 2026, the MAPR for a veteran with no dependents who qualifies for Aid and Attendance is $29,093 a year, according to VA. Unreimbursed medical costs, such as care costs, may lower countable income.
Does the VA pay for assisted living?
VA says it does not pay the veteran's rent in an assisted living facility, but it may pay for some extra services the veteran needs there. Aid and Attendance pension money can be used toward care costs.
How much does senior care cost?
In CareScout's 2025 Cost of Care Survey, the national median was $6,200 a month for assisted living and $6,673 a month for a non-medical caregiver at home (44 hours a week, $35/hour). Costs vary a lot by state and city.
Sources
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