As you search for the right senior living option, you may find yourself awash in a wide variety of contracts, services and fees. Weighing your choices carefully is worth the time and research it takes so you can make an informed decision that meets all your objectives.
An Overview of Assisted Living Costs
How does assisted living work, financially?
Many assisted living communities have a community move-in fee. It can be paid up front or prorated monthly. It usually runs between $1,000 and $5,000.
What should you look for in a contract?
Pricing is usually broken down into rent and services. Rent pays for your apartment, the cost of which will vary depending on size and location. Services typically include three meals a day, housekeeping, transportation, activities and some level of personal assistance.
Beth Burnham Mace, chief economist at the National Investment Center for the Seniors Housing & Care Industry (NIC), notes that depending on the community, care services may have an additional fee, on top of base costs. “Sometimes called tiered or à la carte pricing, the amount you pay depends on the level of help you need with ADLs (activities of daily living) and the amount of time it takes to deliver those services,” said Mace. For example, a resident may need 15 minutes of help with medication management, 15 minutes of help with dressing and 30 minutes of help with meals each day. That’s one hour of care per day at the community’s stated rate. Someone needing three hours of care would pay more.
Some assisted living communities provide memory care for their residents with Alzheimer’s disease or other forms of dementia. It’s important you find out about any additional fees associated with memory care.
Which is better: a package or a flat fee?
Some communities will offer a selection of bundled packages based on need, rather than charging for the amount of time it takes to deliver various services. Other communities have a flat fee for the monthly package, which means everyone pays the same, regardless of the amount of services they use.
How Much Does Assisted Living Cost?
The answer depends on the community, the size of your apartment, the number of services you need and what part of the country you live in.
The Genworth Cost of Care Survey 2017 says that the national median cost for assisted living per month is $3,750, which breaks down to around $123 per day (and adds up to $45,000 per year). To put that into some context, the same survey says a private room in a nursing home will cost around $267 per day ($97,455 per year). Home health aide services average $135 per day ($49,192 per year), based on an eight-hour day (more time-intensive care will likely be more expensive).
Source: Genworth Cost of Care Survey 2017.
You can see assisted living costs by state and by metro areas at Genworth. You can also calculate future costs of assisted living and other types of care at the site.
Not surprisingly, areas where the general cost of living is high tend to be more expensive for assisted living residents. The NIC reports that, as of year-end 2016, assisted living is most expensive in San Francisco, New York City, San Jose, Boston and Los Angeles.
How to Pay for Assisted Living
Many people believe assisted living is covered by Medicare. In fact, 57% of people surveyed said they plan to rely on Medicare to help pay for any senior care they might need. However, while your personal health insurance coverage and your pharmaceutical coverage continues after relocating to a community, Medicare typically doesn’t pay for assisted living.
The same survey found that 61% of respondents thought they would rely on Social Security to cover assisted living or other long-term care costs. The reality is, the average monthly Social Security payment only covers a small portion of those costs.
Most assisted living residents pay for assisted living from their personal resources (“private pay”) or with help from the coverage provided by long-term care insurance. Adult children often help with expenses, as well. However, many states offer home and community-based waivers that help low-income residents afford assisted living. Check with your state Medicaid resource to address your situation and needs.
It’s worth noting that in a Life Plan Community (or Continuing Care Retirement Community), your entrance fee helps guarantee you access to all levels of care – including assisted living and memory care – and helps offset the long-term costs of that care. In many cases, a portion of the entrance fee is tax-deductible as a medical expense, so be sure to talk with a tax professional about these savings.
The Value of Assisted Living
When it’s apparent that some type of assistance is needed for day-to-day support, sorting through the finances to pay for assisted living is important. Do your due diligence – look at the Genworth site for costs in your area. As a point of comparison, figure out how much it’s costing you to stay in your house with this Costs Worksheet. (Note: If you haven’t paid off your mortgage, you should add that expense to the worksheet, too.)
It’s also important to factor in the other benefits you get from an assisted living or a Life Plan Community. Social connections, wellness programs, cultural experiences, nutritious meals, opportunities to learn and grow, safety and 24/7 security – they’re all part of what you get on top of personal assistance.
Do the math; consider the value. You may be surprised at how affordable assisted living really is.
- National Investment Center for Seniors Housing & Care
- Long-Term Care in America: Views on Who Should Bear the Responsibility and Costs of Care. AP/NORC Center for Public Affairs Research, 2017.