Assisted Living vs Nursing Home: Costs, Care Levels and How to Choose
Quick answer: Assisted living is for people who need help with daily care but not as much help as a nursing home provides. Nursing homes focus more on medical care, with nursing care and 24-hour supervision. Nursing homes also cost more: CareScout's 2025 Cost of Care Survey puts the national median at $6,200 a month for assisted living, compared with $9,581 a month for a semi-private nursing home room. Medicare does not pay for assisted living, and it generally doesn't cover long-term stays in a nursing home.
Assisted living vs. nursing home at a glance
| Assisted living | Nursing home | |
|---|---|---|
| Who it's for | People who need help with daily care, but less help than a nursing home gives | People who need nursing care and 24-hour supervision |
| Care focus | Personal care, meals, help with medications, housekeeping | More focus on medical care; therapy services are available |
| Living space | Usually a private apartment or room, with shared common areas | Room in the facility (Medicare-covered short stays use a semi-private room) |
| 2025 national median cost | $6,200 a month | $9,581 a month (semi-private room); $10,798 a month (private room) |
| Does Medicare pay? | No | Not for long-term custodial care; Part A may cover a short skilled nursing stay after a qualifying hospital stay |
| Does Medicaid pay? | May cover some parts, depending on the state | May cover some costs for people who qualify based on income and resources |
Sources: National Institute on Aging (care descriptions and payment), CareScout Cost of Care Survey 2025 (costs), Medicare.gov (Medicare coverage).
What is the difference between assisted living and a nursing home?
The main difference is how much medical care each one gives. The National Institute on Aging (NIA) describes assisted living as care "for people who need help with daily care, but not as much help as a nursing home provides." Nursing homes, also called skilled nursing facilities, focus more on medical care than most assisted living facilities do. (NIA)
What assisted living includes
Assisted living residents usually live in their own apartments or rooms and share common areas. According to the NIA, services can include up to three meals a day, help with personal care, help with medications, housekeeping and laundry, 24-hour supervision and on-site staff, and social and recreational activities. Facilities range from as few as 25 residents to 100 or more. Most offer a few levels of care, and residents pay more for extra services or special care. Exact arrangements vary by facility and by state.
What a nursing home includes
Nursing homes provide a wide range of health and personal care services. The NIA lists nursing care, 24-hour supervision, three meals a day and help with everyday activities as typical services. Physical, occupational and speech therapy are also available. Some long-term care facilities also offer special programs for people with Alzheimer's disease and other types of dementia.
Other options you may hear about
- Board and care homes (also called residential care facilities or group homes) usually have 20 or fewer residents. Staff are available around the clock, but nursing and medical care usually are not provided.
- Continuing care retirement communities (CCRCs) offer different levels of care in one place, often independent living, assisted living and skilled nursing on one campus. Most charge a one-time entrance fee and then a monthly fee.
The NIA's guide to long-term care facilities describes both.
How much does assisted living cost compared with a nursing home?
At the national median, a nursing home costs more than assisted living. Here are the 2025 national median costs from CareScout's Cost of Care Survey (CareScout):
| Type of care | 2025 monthly median | 2025 yearly median | 2024 monthly median |
|---|---|---|---|
| Assisted living community | $6,200 | $74,400 | $5,900 |
| Nursing home, semi-private room | $9,581 ($315 a day) | $114,975 | $9,277 |
| Nursing home, private room | $10,798 ($355 a day) | $129,575 | $10,646 |
Based on those medians, a semi-private nursing home room costs about $3,381 more per month than assisted living (our calculation). CareScout ran the survey from July through November 2025, with 4,944 completed surveys from licensed assisted living communities and 4,425 from certified and licensed nursing homes. CareScout notes that the cost at any one provider may differ significantly from the median, and that costs vary widely by location and by the level of care needed. Ask each facility for its full price list in writing.
The NIA adds that assisted living "tends to be more expensive than living independently but less expensive than a nursing home."
Does Medicare pay for assisted living or a nursing home?
Medicare does not pay for assisted living. (NIA) It also doesn't pay for long-term care, also called custodial care, which is mostly help with everyday tasks like dressing, bathing and using the bathroom. Medicare.gov says Medicare and most health insurance, including Medigap, don't pay for long-term care services, including care in a nursing home. (Medicare.gov)
Medicare Part A does cover skilled nursing facility care for a limited time. To qualify, you generally need a qualifying inpatient hospital stay of at least 3 days in a row, you must enter a Medicare-certified skilled nursing facility within a short time (generally 30 days) of leaving the hospital, and your doctor must decide you need daily skilled care, like intravenous medications or physical therapy. Time spent in the hospital under observation or in the emergency room before you're admitted doesn't count toward the 3 days. (Medicare.gov)
In 2026, here is what you pay for a covered skilled nursing facility stay under Original Medicare:
- Days 1 to 20: $0 a day, after the $1,736 Part A deductible for the benefit period
- Days 21 to 100: $217 a day
- Day 101 and beyond: all costs
Part A limits skilled nursing facility coverage to 100 days in each benefit period. Medicare Advantage plans may have different rules, so check with the plan.
Does Medicaid or long-term care insurance help?
It can, if the person qualifies. The NIA says Medicaid may cover some nursing home costs for people who are eligible based on income and personal resources, and may cover some aspects of assisted living, depending on the state. Medicare.gov notes that you may get long-term care through Medicaid if you meet your state's eligibility rules, or you can buy private long-term care insurance. Some long-term care insurance policies partly cover assisted living or nursing home care, so check the policy with the insurer.
Most people still pay the full cost of assisted living themselves, according to the NIA.
Which is right: assisted living or a nursing home?
Start with the care the person needs now and is likely to need later. The NIA suggests asking which services are needed, such as help with everyday activities, physical therapy, nursing care, hospice care, or a special unit for memory problems or dementia. If you're not sure, ask a health care provider which services would help most.
- Assisted living may fit when the person needs help with daily tasks such as meals, medications, housekeeping or personal care, but does not need nursing care around the clock.
- A nursing home may fit when the person needs nursing care and 24-hour supervision, or a level of medical care that assisted living doesn't provide.
- A CCRC may fit when the person wants to stay on one campus as their needs change, and can afford the entrance fee.
Also weigh what matters to the person, such as meals, activities, a religious connection or staying close to family and friends.
How to compare facilities before you choose
The NIA recommends calling each place on your list to ask how many people live there, what it costs and whether there is a waiting list. Then visit several facilities in person and meet the director or nursing director. Make a second visit without calling ahead, on a different day or at a different time, and stop by at mealtime. (NIA)
Questions the NIA suggests asking staff include:
- How many care providers are there per resident, and what training do they have?
- How long have the director and department heads worked there, and how often do key staff turn over?
- Does a doctor check on residents regularly? How often?
- How do residents get to medical appointments?
- Is there a special unit for people with dementia, and what does it provide?
Get detailed information about costs and which services are included, and read the contract carefully before signing. For nursing homes, Medicare's Care Compare tool lets you find and compare facilities. The Eldercare Locator (800-677-1116) can help you find care in your area.
For more on touring and questions to ask, see our guide on what to look for in a care facility. When it's time to move, these may help: tips for transitioning to a care facility and how to pack to move a loved one into assisted living.
If staying at home is still an option
Some families look at more help at home before deciding on a move. Our articles on what to do if aging in place doesn't work and creating a safer home for aging in place cover that side. If getting in and out of bed is the main struggle, you can also read about the best bed height for seniors or browse lift beds.
FAQ
Is assisted living cheaper than a nursing home?
Usually, yes. CareScout's 2025 national medians are $6,200 a month for assisted living and $9,581 a month for a semi-private nursing home room. Prices at individual facilities vary widely.
Does Medicare pay for assisted living?
No. Medicare does not pay for assisted living or for long-term custodial care. Part A may cover a short skilled nursing facility stay after a qualifying hospital stay of at least 3 days.
Is a nursing home the same as a skilled nursing facility?
The NIA says nursing homes are also called skilled nursing facilities. Medicare covers skilled nursing facility care only for a limited time, up to 100 days per benefit period, when you need daily skilled care.
Can someone move from assisted living to a nursing home later?
Yes. Some assisted living facilities are part of larger organizations that offer other levels of care, and continuing care retirement communities often have assisted living and skilled nursing on one campus.
Sources
- National Institute on Aging, "Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care" (content reviewed October 12, 2023): https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes
- National Institute on Aging, "How To Choose a Nursing Home or Other Long-Term Care Facility" (content reviewed October 12, 2023): https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/how-choose-nursing-home-or-other-long-term-care-facility
- CareScout, Cost of Care Survey, 2025 national median values (survey July through November 2025): https://www.carescout.com/cost-of-care
- Medicare.gov, "Long-term care": https://www.medicare.gov/coverage/long-term-care
- Medicare.gov, "Skilled nursing facility care" (2026 costs): https://www.medicare.gov/coverage/skilled-nursing-facility-care
Written by the EzLift Team, EzLift's organizational authorship team. Sources checked November 2, 2026. This guide offers general information; it is not medical, legal or financial advice. Costs and coverage rules change, so confirm details with each facility, Medicare (1-800-MEDICARE) or your state Medicaid office.