Long-Term Care Costs by State in 2026

Long-term care is one of the largest potential expenses in retirement, and what you will pay depends heavily on where you live. A private room in a nursing home can cost as little as $6,000 per month in Oklahoma or as much as $36,000 per month in Alaska. Understanding these state-by-state differences is essential for planning how much coverage you need, whether through insurance, savings, or a combination of strategies. This guide breaks down 2026 long-term care costs across different states and care types to help you plan effectively.

National Average Costs in 2026

Before looking at individual states, it helps to understand the national baseline. According to data from the Administration for Community Living and the Genworth Cost of Care Survey, the national average costs for different types of long-term care in 2026 are approximately:

• Nursing home (private room): $10,965 to $11,294 per month ($131,000 to $135,000 per year)
• Nursing home (semi-private room): Approximately $9,500 to $10,000 per month
• Assisted living facility: Approximately $5,900 per month ($70,800 per year)
• Home health aide (full-time): Up to $24,000 per month for 24-hour care; approximately $5,150 per month for 44 hours per week
• Adult day care: Approximately $1,750 to $2,000 per month

These figures represent medians, meaning half of facilities charge more and half charge less. Your actual costs could be higher or lower depending on the specific facility, level of care needed, and location within your state.

High-Cost States for Long-Term Care

Several states consistently rank among the most expensive for long-term care. If you live in or plan to retire in one of these states, you will need to plan for costs well above the national average.

• Alaska: The most expensive state for nursing home care by a wide margin. A private room averages approximately $36,000 per month ($432,000 per year). The high cost is driven by Alaska's remote location, high cost of living, and limited number of care facilities. Home care is also among the most expensive in the nation.
• Connecticut: Nursing home private rooms average approximately $15,000 to $16,000 per month. Connecticut has some of the highest care worker wages in the country, and demand for quality facilities is strong in the densely populated state.
• New York: Costs vary dramatically within the state. New York City and its suburbs can see nursing home costs exceeding $15,000 per month, while upstate areas may be closer to $11,000 to $13,000. Assisted living in the New York metro area also significantly exceeds the national average.
• California: Nursing home costs average around $12,000 to $14,000 per month for a private room, with significant variation between the Bay Area, Los Angeles, and more rural regions. Assisted living averages about $6,500 to $7,500 per month statewide, but can exceed $8,000 in high-cost metro areas.
• Massachusetts and New Jersey: Both states see nursing home costs averaging $13,000 to $15,000 per month for private rooms, driven by high wages, strong regulatory standards, and dense populations.

Lower-Cost States for Long-Term Care

If you live in the South or Midwest, long-term care costs are generally well below the national average. This can make a significant difference in how much coverage you need.

• Oklahoma: One of the most affordable states for long-term care. Nursing home private rooms average approximately $6,000 to $6,500 per month. Assisted living averages around $3,800 per month. Home care is also significantly below the national average.
• Missouri: Nursing home costs average around $5,800 to $6,500 per month for a private room, making it one of the least expensive states in the country. Assisted living is also affordable at approximately $3,200 to $3,800 per month.
• Louisiana: Private nursing home rooms average about $6,000 to $6,800 per month. Home care costs are also below average, making Louisiana an affordable state for aging in place.
• Mississippi and Alabama: Both states have nursing home costs in the range of $6,500 to $7,500 per month. Assisted living averages approximately $3,500 to $4,000 per month.
• Texas and Georgia: Both large states offer costs below the national average, with nursing home private rooms averaging $6,500 to $8,500 per month. Costs within these states vary widely between major metro areas and rural communities.

Why Costs Vary So Much Between States

Several factors drive the wide variation in long-term care costs across states:

• Labor costs: Staffing is the single largest expense for care facilities, typically accounting for 60 to 70 percent of operating costs. States with higher minimum wages, stronger labor markets, and higher costs of living pay more for nurses, aides, and other care staff.
• Real estate and construction costs: Building and maintaining care facilities is more expensive in high-cost states. Land prices, property taxes, and construction labor all factor into the overhead that gets passed along to residents.
• State regulations: Each state sets its own standards for staffing ratios, facility requirements, and licensing. States with more stringent regulations tend to have higher costs but may also have higher quality standards.
• Supply and demand: States with large elderly populations and limited facility capacity tend to have higher costs. Conversely, areas with more facilities and competition may offer lower prices.
• Medicaid reimbursement rates: In states where Medicaid reimbursement rates are low, facilities often charge private-pay residents more to make up the difference, which can drive up costs for people paying out of pocket or through insurance.

How Inflation Affects Future Care Costs

Long-term care costs have been rising at an average annual rate of 3 to 5 percent, which is faster than the general consumer price index. This means that the costs you see today will be significantly higher by the time you might need care, especially if you are still 10, 20, or 30 years away from needing it.

Here is what the national average nursing home cost of $10,965 per month could look like in the future at different inflation rates:

• At 3% annual inflation: $14,700/month in 10 years, $19,800/month in 20 years, $26,600/month in 30 years
• At 4% annual inflation: $16,200/month in 10 years, $24,000/month in 20 years, $35,600/month in 30 years
• At 5% annual inflation: $17,900/month in 10 years, $29,100/month in 20 years, $47,400/month in 30 years

These projections demonstrate why inflation protection is one of the most important features of a long-term care insurance policy. A policy purchased today at a $350 daily benefit will not cover a $500 or $800 daily cost in the future unless it includes an inflation rider that increases benefits over time.

Using Cost Data to Plan Your LTC Insurance Benefits

Understanding your state's costs is the foundation for choosing the right LTC insurance benefit amount. Here is a step-by-step approach to using this data in your planning. For a deeper explanation of how LTC policies work, see our complete guide to long-term care insurance.

1. Identify your likely care state: Determine where you expect to live during retirement. If you plan to move, research costs in your destination state rather than your current state.
2. Look up current costs for your preferred care type: Do you prefer to receive care at home, in an assisted living facility, or would you want nursing home care if needed? Each setting has a different cost profile.
3. Project costs forward: Use a 3 to 5 percent inflation rate to estimate what care will cost when you are most likely to need it. If you are 55 today, project costs 15 to 25 years into the future.
4. Set your daily or monthly benefit: Choose a policy benefit amount that covers most or all of the projected cost. If you plan to supplement insurance with savings, you can choose a lower benefit amount.
5. Add inflation protection: Choose compound inflation protection if you are buying a policy more than 10 years before you expect to need care. This ensures your benefits grow automatically to keep pace with rising costs.
6. Choose your benefit period: Consider how long you want your benefits to last. The average care need is about 2 to 3 years, but some conditions require care for 5 years or more. A longer benefit period provides more protection but increases your premium.

Costs by Care Type: What the Numbers Mean

When comparing costs, it is important to understand what each care type includes and why the prices differ so much:

• Nursing home care is the most expensive option because it provides around-the-clock skilled nursing care, meals, room and board, and medical supervision. This level of care is needed for people with serious medical conditions or advanced cognitive impairment who require constant monitoring.
• Assisted living is less expensive because residents need help with daily activities but do not require constant medical supervision. Assisted living facilities provide housing, meals, social activities, and personal care assistance. Many people start in assisted living and transition to a nursing home only if their needs increase.
• Home care costs vary the most because they depend on how many hours of care you need. Part-time home care of 20 to 30 hours per week is often the most affordable option and allows you to remain in your own home. However, round-the-clock home care can cost more than a nursing home because you are paying for dedicated one-on-one attention.
• Adult day care is generally the least expensive option because it provides supervised care only during daytime hours, typically five days a week. It is a good option for people with moderate care needs whose family members work during the day.

Planning for Your State's Costs

The difference between a $6,000-per-month state and a $15,000-per-month state has a dramatic impact on how much protection you need. A three-year stay in a nursing home could cost $216,000 in Oklahoma but $540,000 in Connecticut. That difference should directly influence your insurance benefit amounts, your savings targets, and your overall financial plan. To understand whether insurance is the right approach for your situation, see our financial analysis on whether long-term care insurance is worth it.

Here are some practical planning tips based on your state's cost level:

• High-cost states: Consider a higher daily benefit amount and a longer benefit period. Inflation protection is critical because costs are already high and rising. If premiums for comprehensive coverage are too expensive, consider a hybrid policy or a combination of insurance plus savings.
• Moderate-cost states: A standard policy with a daily benefit matching your state's current costs and compound inflation protection should serve most people well. Focus on getting a benefit period of at least three years.
• Low-cost states: You may find that premiums for adequate coverage are more manageable. A policy with a moderate daily benefit and inflation protection can provide strong protection at a relatively affordable premium. Consider extending your benefit period to four or five years since the lower cost per month allows your total benefit pool to stretch further.

Long-term care costs are real and rising, but they are also predictable enough to plan for. By understanding what care costs in your state today and how those costs are likely to grow, you can make informed decisions about insurance coverage, savings goals, and retirement planning. The key is to start planning now, while you still have time and options to put a strategy in place that protects both your care and your finances.