What’s the Average Cost of Assisted Living in 2021?

Many people assume that Medicare pays for assisted living, when the reality is that it does not pay for any portion. Medicare only pays for short-term rehab. With the rising costs of assisted living and the growing number of aging adults, families and their loved ones are understandably concerned about the cost of assisted living.

Jump ahead to these sections:

• Overview: What’s Assisted Living? 
• What’s the Cost of Staying in an Assisted Living Facility?
• What Are the Costs of Assisted Living By State?
• 5 Common Ways to Pay for Assisted Living

The average cost of assisted living might come as a shock to some. When budgeting for long-term care, there are many factors to consider. Two of the main ones are how long you will live and where you live. Some states have much higher costs for assisted living than others, and unless you are willing to move (unlikely in most cases), you are stuck with the average pricing in the area. 

As you consider the cost of care over the long term, it is prudent to make certain assumptions. One is that you will live a long time and that you will require some level of care. Meeting with an estate planning attorney can help you assess your assets and income and make decisions to ensure that you can get the help you need when you need it.

In reviewing the average cost of an assisted living facility for 2021, you will feel better prepared for your and your family’s long-term care needs.

Overview: What’s Assisted Living? 

Assisted living is housing for people who need various levels of medical and personal care. Assisted living communities can be set up as individual rooms, apartments, or shared rooms. Some communities are quite large, with several stories and hundreds of rooms. Others are smaller and more homey.

Assisted living facilities, unlike nursing homes, are not managed or licensed by the federal government, so oversight is left to the states. Various state departments or agencies set rules and regulations regarding admissions and discharge criteria. The amenities offered by assisted living communities are generally uniform across the country, with some exceptions. You can expect the following services in most assisted living facilities.

• All meals: Three meals a day in a congregate dining room is standard. Meals are included in the monthly cost of assisted living. Most communities can accommodate special diets, and more and more are offering diverse menu options to cater to changing demands.

• Housekeeping and laundry: You can expect weekly housekeeping and laundry service in assisted living. The cleaning staff won’t necessarily do deep cleaning but will do the basics. 

• Medication management: Medications are kept in a secure place and overseen by a nurse but often administered by a certified nursing assistant (CNA) or med tech. Some assisted living communities prohibit keeping prescribed drugs in your room.

• Nursing and CNAs: A nurse is on staff at assisted living facilities but may not be available 24 hours a day. The involvement of nursing will vary depending on the state regulations and the community itself. In most places, a nurse will develop a plan of care to identify personal care needs and medication management. Nurses do not replace the resident’s primary care provider. CNAs and other personal care staff provide hands-on care like help with dressing, bathing, transfers, and accompaniment to the dining and activities if needed. 

• Activities: Activities take a prominent place in assisted living daily life. One of the reasons many older adults opt for assisted living is for socialization. You can expect a robust calendar of activities including, but not limited to, arts and crafts, movies, cultural outings, exercise classes, and lectures. 

• Transportation: Not every assisted living will offer transportation, but most do because they understand that many seniors no longer drive. Transportation availability will vary, but most places offer scheduled drop-offs and pickups for medical appointments. Vans might be available for group activities. 

• In-house physician: More and more assisted living facilities see the value of in-house physician services so that their residents don’t have to leave. These physician services can be stand-alone companies or physicians that are part of local healthcare entities.

• Emergency Response Systems: Emergency response systems are standard in most communities with pendants and pull cords in the bathroom for 24-hour emergency response.

Who is assisted living typically for? 

Older adults and their families have many reasons for choosing assisted living. Not everyone makes the decision based on the need for help, but most do. It is not unusual for some seniors to resist the idea of assisted living if they don’t have a clear idea of what it is like. They may not want to leave their family home and surrounding friends and familiar places. Often the deciding factor is the level of care someone requires. Let’s take a look at some of the reasons people decide to move to assisted living.

Increasing care needs

When someone has mobility problems or needs lots of assistance with dressing, bathing, cooking safely, managing their home, or taking medications, they consider assisted living. Managing home caregivers and providing family caregiving can become overwhelming. Some states restrict what home care aides can do, and if a family can’t provide the care, assisted living can.

Home care becomes too expensive

Many families start with private home care to assist a loved one, but over time as their needs increase, it is hard to justify the cost. Plus, managing in-home caregivers combined with family caregiving stress encourages families to consider assisted living.

Socialization

Social isolation and loneliness are huge concerns for older adults confined to home with limited options for getting out. Seniors will occasionally opt for assisted living even if they don’t need personal care assistance because they need and want to be around their peers. 

What’s the difference between assisted living, nursing home, and home care?

Assisted living, nursing home, and home care have much in common, but there are distinct differences as well. Some seniors will go through life with just one of these long-term care options, while others may use all three.

Home care

Home care is a logical first step for care in the home. States govern and make regulations for home care companies. Some states permit home care companies to offer medical services, and others will only allow for personal care duties and companionship. The distinction is important since you may expect a caregiver to perform tasks prohibited by state law. 

Home care is flexible, meaning you can ask for as few or as many hours as you need. Some agencies will have a minimum number of hours per week. Overnight or 24-hour care is also available. 

Assisted living

For many seniors, assisted living can provide much of what they need for the remainder of their life. Having a foundation of care and support encourages independence and keeps people safer than they might be in their home.

Nursing home

Most people would prefer to avoid nursing home care for several reasons. One is the cost which is higher than most other types of care. But, nursing home care is unavoidable in some situations. A nursing home is like a hospital in terms of medical support. Assisted living communities, due to state regulations, cannot and will not provide complex medical services. 

Nursing homes are set up to take care of medically complex patients who need 24-hour care. Nursing homes have received a lot of attention due to the disproportionate number of people who died from COVID-19. Long-standing infection control problems and understaffing have plagued the industry. 

Are there different types of assisted living?

There are different types of assisted living, depending on where you live. As the aging demographic changes, so do assisted living communities. The trend seems to be pointing towards a “one-stop shopping” format that can offer someone everything they need for the long term.

Continuing care retirement communities (CCRCs)

CCRCs or life plan communities allow older adults the option of staying in one place throughout their lifespan. Someone may start in independent living and then transition to assisted living, memory care, and eventually nursing home care if they need it. CCRCs have complicated financial arrangements with a substantial buy-in fee along with additional monthly fees.

Memory care

Memory care communities are for people who need special care because they have cognitive impairment. Some memory care facilities are free-standing, but most are in the same building as assisted living. 

Independent living with assisted living

Following the trend of keeping housing options under one roof, some assisted living communities also have independent living. Some of the same amenities are offered for independent residents, such as meals, housekeeping, activities, and transportation.

Board and care

Board and care, sometimes called group homes or residential care, are smaller home-like communities that may fall under assisted living licensure. Board and care facilities are usually in residential neighborhoods and have a smaller number of residents. 

What’s the Cost of Staying in an Assisted Living Facility?

The national average cost of assisted living varies according to what state you live in, the type of assisted living, and even the local within the state. According to Genworth, the monthly median cost of care in assisted living is $4,429.

What Are the Costs of Assisted Living By State?

Below we outline the projected 2021 costs of assisted living by state. You will notice right away the significant differences between states in cost.

How Do Assisted Living Costs Compare to Other Types of Long-Term Care?

The answer to how assisted living costs compare to other types of long-term care is “it depends.” Much of it depends on how much in-home care you need in addition to the cost of assisted living and nursing home care in your community.

Cost of assisted living vs. in-home care

The cost of assisted living versus in-home care depends on how much in-home care you need. For example, if your loved one only requires 10 hours of home care a week at the hourly median cost of $24.72, that would be about $1000 a month, well below the national average for assisted living. But as those hours increase, the cost of care can equal or exceed assisted living costs.

Cost of assisted living vs. nursing home

The monthly median cost of care in a nursing home is $7,756 for a semi-private room. As you can see by the table above, most assisted living community costs are well below that rate, but a few come close. But, as we will discuss, add on charges related to care in assisted living can bring those totals much higher. 

5 Common Ways to Pay for Assisted Living

Paying for assisted living can be a struggle for some families due to the high cost and limited assets. Unfortunately, you either have to have ample financial resources or very few to pay for assisted living. Many older adults in the middle-income brackets can’t afford assisted living and don’t qualify for Medicaid programs that might help.

1. Long-term care insurance

If you have a long-term care policy, it might pay a daily rate towards assisted living costs. An elimination period is typical with many policies.

2. Savings and retirement

If you have savings and stock or another type of retirement account, you can use funds to pay for assisted living. Make sure you factor in any penalties for early withdrawal or tax implications. 

3. Your home

Some older adults sell their home to finance assisted living or use other methods to tap into the equity if they don’t want to sell. Other creative options include renting out their home to combine with additional income to pay for assisted living. 

4. Medicaid programs

Some state programs will pay for assisted living for low-income seniors if they meet a nursing home level of care but wish to stay in an assisted living facility. Criteria are stringent, and there can be waiting lists. 

5. Trusts and annuities

Some older adults have trusts and annuities that can help pay for assisted living. Consider consulting with an attorney or financial advisor about how to access funds from those sources.

Frequently Asked Questions: Costs of Assisted Living

It is reasonable to have questions about assisted living costs since you want to make an informed decision. The last thing you need is to move to an assisted living community and find out that there are costs you were not expecting. 

How does paying for assisted living work for couples?

Paying for couples in assisted living can be tricky if one person needs a higher level of care than the other. In most cases, assisted living communities charge a flat rate for room and board and then add costs for care. Typically, the couple pays for the cost of the room and then additional fees for care for each person. If both need care, the price can go up significantly. 

Can you save money on assisted living costs?

The best way to save money on assisted living costs is to avoid additional costs associated with care. One way to do this is to stay as healthy and independent as possible. The other is to enlist the help of the family to assist with care needs. 

Are there any hidden costs associated with assisted living?

One of the biggest misunderstandings people have about assisted living is the actual cost. Whatever amount you are quoted is just the basic rent and may not cover care or other amenities. It is also rare for the base rent to stay the same. Expect yearly increases. 

The Average Cost of Assisted Living in 2021

Assisted living can be a boon to seniors and their families. Many assisted living communities have reputations for excellent care, but as listed above, the costs can be very high. By assessing your long-term care needs, you can plan to pay for and stay in assisted living as long as you need to.

Sources:

1. “Cost of Care Survey.” Genworth, genworth.com.
2. “How Continuing Care Communities Work.” AARP,  aarp.org.
3. “Paying for Care.” National Institute on Aging, nia.nih.gov.