Senior care is more affordable in these states

When older Americans contemplate retirement, and they consider whether to retire in another state, the regional costs of senior care might not cross their minds.

Yet, more than 80% of Americans will need long-term care at some point, according to the Center for Retirement Research at Boston College. Long-term care delivers help with everyday activities, like dressing and eating.

A recent report from Caring.com, the senior care platform, ranks and rates states on affordability of assisted living, nursing homes and other metrics of long-term care.

The costs of senior care vary dramatically from one state to another. Assisted living costs $52,200 a year in South Dakota, on average, but $107,460 in Connecticut. A private nursing-home room costs $85,045 in Texas, $205,130 in Oregon.

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Long-term care costs can be staggering

Wherever you retire, long-term care costs can be staggering. Assisted living cost $5,900 a month in 2024, on average, according to CareScout, a long-term care network. A private room in a nursing home averaged $10,646 a month.

Many Americans don’t know those costs, and many assume they won’t have to pay them. Most Americans wrongly believe Medicare covers long-term care, according to research by Nationwide.

“I think the first thing they’re surprised about is that Medicare doesn’t pay for it,” said Doug Robertson, senior director of government affairs at Right at Home, an in-home care provider. “The sticker shock is something they don’t plan for, and it’s sudden.”

Much of the data in the Caring.com report comes from CareScout, which publishes median prices by state for long-term care. Here are a few standouts:

The least expensive state for assisted living is South Dakota, with annual costs of $52,200. Mississippi and Alabama rank second and third.
Texas has the lowest costs for a private room in a nursing home, $85,045 a year. Missouri and Oklahoma rank second and third.

Mississippi is the most affordable state for senior care

The Caring.com analysis identifies Mississippi as the most affordable state overall for senior care, followed by Texas and Arkansas.

The least affordable states: Hawaii, followed by Connecticut and Rhode Island.

“Different states definitely have different cost levels,” said Susann Crawford, senior vice president of sales at Caring.com. “I don’t think anybody back in the ‘50s thought they would be spending $13,000 a month for assisted living, or how to prepare for that.”

Of course, when it comes to senior care, cost isn’t the only quality to consider.

AARP published a State Scorecard on long-term care in 2023, rating states not just on affordability but also on access, consumer choice, safety and quality, among other factors.

The AARP Scorecard identified the top-tier states as Colorado, Massachusetts, Minnesota and Washington state, along with the District of Columbia. None of them rank near the top in the Caring.com report, which considers only affordability.

“I think quality is a huge aspect here,” said Lindsay Theodore, a certified financial planner at T. Rowe Price and coauthor of another recent report on long-term care.

“Moving to a lower-cost state or a lower-tax state, you have to think about, for the affordability, what are you giving up?” she said.

The 10 most affordable states for senior care

Here are profiles of the 10 most affordable states for senior care, according to Caring.com:

Mississippi. Caring.com awards Mississippi a score of 8.98 out of 10 for affordability. The state has the second-lowest annual cost for assisted living, $55,343, behind South Dakota. Mississippi also ranks second (in a tie with Alabama) for the costs of a full-time home health aide, at $57,200 a year.
Texas. Texas earns a score of 8.41 out of 10. The state offers the lowest median cost for a private room in a nursing home, $85,045 a year, half the annual cost of New York or California. Texas also spends generously on Medicaid, $9,637 a year per enrollee.
Arkansas. With a score of 8.21, Arkansas offers assisted living at an annual cost of $56,688, and home health aides at $59,488, both relatively affordable.
Louisiana. This state earns a score of 8.16. Louisiana has the most affordable home health aides of any state, with a median annual cost of $50,336. And those costs declined in 2024.
Alabama. Score: 7.59. Alabama ranks high among states for affordable home health aides, with a median annual cost of $57,200. Assisted living costs average $54,870 a year.
Missouri. Score: 7.58. This state ranks second-lowest for the annual cost of a private room in a nursing home, $85,775. Assisted living costs $61,800 a year.
Kansas. Score: 7.42. Medicaid spending per enrollee is relatively generous at $10,089 per enrollee. Assisted living costs $71,400 a year.
Oklahoma. Score: 6.89. Assisted living costs only $57,870 a year, one of the lowest rates in the nation. A private room in a nursing home averages $91,250, also relatively low.
Wyoming. Score: 6.82. Assisted living costs a mere $56,400 a year. Home health aides average $74,360 a year.
Georgia. Score: 6.81. Assisted living costs $59,280 a year, and home health aides cost $66,352.

The 10 least affordable states for senior care

And here are the 10 least affordable states for senior care:

Hawaii. A private room in a Hawaii nursing home will run you $196,370.
Connecticut. Assisted living in Connecticut costs a median $107,460 a year.
Rhode Island. Home health aides in Rhode Island average $96,096 a year.
Maine. Assisted living in Maine costs $95,850 a year.
Massachusetts. Assisted living costs average $108,696 a year.
Oregon. A private nursing-home room in Oregon costs $205,130 a year.
California. Assisted living in California costs a median $88,200 a year.
Washington. Home health aides in Washington average $96,096 annually.
New Hampshire. A private room in a nursing home in this state costs $157,680 a year.
Colorado. Home health aides in Colorado average $96,096 a year.