A nursing home in Illinois runs about $99,645 a year for a shared room, well below the national median but still a steep bill to carry out of pocket for long. The thing that makes that bearable is that Illinois Medicaid can pay for nursing-home care for those who qualify.

This guide walks through what a nursing home is, how to check a facility's quality before you choose one, what it actually costs in Illinois, and how Illinois Medicaid pays for long-term nursing-facility care.

In This Guide

What a Nursing Home Is

A nursing home, also called a skilled nursing facility, provides nursing care, 24-hour supervision, meals, and help with everyday activities, and rehabilitation services such as physical, occupational, and speech therapy are also available. Its services focus more on medical care than most assisted living facilities, and the federal Administration for Community Living describes nursing facilities as the most service-intensive housing option, providing skilled nursing services and therapies as needed.

People arrive at a nursing home along two different paths, and it's worth keeping them straight because they're paid for differently. The first is short-term rehabilitation, often after a hospital stay for a stroke, a fall, or surgery, where the goal is to recover and go home. Medicare helps with that short rehab stay under specific conditions, covering up to 100 days per benefit period, generally after an inpatient hospital stay of at least three days, with a $217 daily coinsurance for days 21 through 100 in 2026. The second path is long-term custodial care, where someone needs ongoing nursing and supervision they can't safely get at home. Medicare does not pay for that long-term custodial stay. That is the care families worry about affording, and it's where Medicaid can step in for those who qualify.

How to Check a Facility's Quality

Quality differs from one nursing home to the next, and you have several free tools to vet a place before you commit. Use more than one. Each shows you something the others don't.

Start with state oversight. The Illinois Department of Public Health (IDPH) licenses and inspects every nursing home in the state through its Bureau of Long-Term Care, under the Nursing Home Care Act, and IDPH says it conducts approximately 1,300 full, on-site licensure inspections a year. If you see something that worries you, IDPH says to call its toll-free hotline at 1-800-252-4343 to complain about an Illinois nursing home. Federal rules require a facility to post the results of its most recent inspection and to let anyone review its reports from the past three years on request. When you tour, ask to see them and look for a pattern of repeat deficiencies rather than reacting to a single old citation.

Next, check the federal star rating on Medicare Care Compare. For every Medicare- and Medicaid-certified nursing home, the Centers for Medicare & Medicaid Services publishes an overall rating from 1 to 5 stars. Medicare's own advice is that the ratings can help you compare nursing homes but aren't a substitute for visiting. That overall rating combines three things: health inspections, staffing, and quality measures, and each of the three gets its own star rating too. That lets you look at the staffing score on its own instead of relying on the overall number.

Finally, know who to call for help. The Illinois Long-Term Care Ombudsman Program, administered through the Illinois Department on Aging, advocates for nursing-home residents and investigates complaints. Its services are free, and an ombudsman works to resolve a resident's complaint to the resident's satisfaction.

What a Nursing Home Costs in Illinois

Nursing-home care is expensive, but Illinois costs run well below the national midpoint. According to the CareScout (Genworth) Cost of Care Survey, the 2025 statewide medians were about $99,645 a year (roughly $8,304 a month) for a semi-private room and about $110,595 a year (roughly $9,216 a month) for a private room. That semi-private figure runs below the national median of about $114,975. Those are medians from an industry survey, not government rates and not maximums. CareScout cautions that actual costs vary with individual care needs, provider availability, and local market conditions.

Room type Illinois (year) Illinois (month) National (year)
Semi-private room $99,645 $8,304 $114,975
Private room $110,595 $9,216 $129,575

To put that in context, the same 2025 survey put Illinois assisted living at a median of roughly $72,645 to $74,628 a year, depending on which CareScout publication you read. A semi-private nursing-home room costs noticeably more than that. The gap is why it's worth asking whether assisted living or in-home care could meet the need before moving to a nursing home, and why Medicaid matters so much to a family facing a long stay.

Does Illinois Medicaid Pay for Nursing Homes?

Yes, and this is the single most important thing to understand about paying for an Illinois nursing home. The Illinois Department of Healthcare and Family Services (HFS) administers Medicaid long-term care in the state, and Medicaid can pay for nursing-home care for those who qualify. Financial eligibility is determined by the Illinois Department of Human Services (DHS), so to have the state pay, a person applies for medical benefits through DHS and gets a needs screening through the Department on Aging or DHS.

Qualifying turns on an asset test and an income contribution, plus a needs screening for nursing-home care. Here is how the money side works.

Assets. Illinois's countable-asset limit for long-term care is $17,500, up from the former $2,000 for an individual and $3,000 for a couple, and that single $17,500 limit applies whether one person or more is in the household. That limit isn't a line you have to get under before applying. Illinois treats extra assets the way it treats extra income: an applicant with more countable assets than the limit is approved as a spend-down case, unless they say in writing that they don't want spend-down. Equity in a home is protected while it remains the principal residence of the recipient or certain close relatives, subject to Illinois's 2026 home-equity limit of $752,000. A married couple with one spouse staying in the community gets spousal-impoverishment protections: in 2026, Illinois lets that community spouse keep a resource allowance of $143,172 and a monthly income allowance of $4,066.50.

Income. A nursing-home resident on Medicaid applies their countable monthly income to the cost of care after allowable deductions, keeping a $60-a-month personal needs allowance. Countable assets above the $17,500 limit are added to that income and go toward the cost of care as well. Medical coverage for a month can't begin until medical expenses, with nursing-home charges counted at the private rate, equal the resident's countable income plus those excess assets. Medicaid then pays for the nursing-home care beyond what the resident contributes.

The five-year look-back. Illinois applies a five-year (60-month) look-back to transfers of resources or income, measured from the request for the state to pay for long-term care. A non-allowable transfer, such as gifting money or property away in that window, can trigger a penalty period during which Medicaid won't pay for nursing-home care, supportive living facility care, or Department on Aging home and community-based waiver services. If otherwise eligible, the person stays entitled to other covered medical services. That's why giving assets to family in a rush to qualify can backfire.

Estate recovery. After death, Illinois pursues Medicaid estate recovery against recipients who were 55 or older when they received Medicaid, or who were determined permanently institutionalized at any age, and who were not survived by a spouse or certain other dependents with a deserving claim on the estate. Once a home is no longer the principal residence of the recipient or certain close relatives, the state can count its equity or recover Medicaid spending from it, and its liens protect that right before the property can be sold.

Frequently Asked Questions

How much does a nursing home cost in Illinois?

The CareScout 2025 Cost of Care Survey put Illinois's median at about $99,645 a year (roughly $8,304 a month) for a semi-private room and about $110,595 a year (roughly $9,216 a month) for a private room. Those are statewide medians from an industry survey, not maximums, and Illinois runs well below the national median.

Does Medicaid pay for nursing home care in Illinois?

Yes. Illinois Medicaid, administered by HFS, can pay for nursing-home care for those who qualify. You apply for medical benefits through the Department of Human Services and get a needs screening through the Department on Aging or DHS.

What is the asset limit for nursing-home Medicaid in Illinois?

The countable-asset limit is $17,500, and that single limit applies whether one person or more is in the household. Having more than that doesn't rule someone out: Illinois approves the applicant as a spend-down case, and the excess goes toward the cost of care. Home equity is protected while the home remains the principal residence of the recipient or certain close relatives, and a married couple with one spouse staying at home gets spousal-impoverishment protections for that community spouse.

What happens to my income once Medicaid pays?

A nursing-home resident on Medicaid applies countable monthly income to the cost of care after allowable deductions, keeping a $60-a-month personal needs allowance, and Medicaid pays for the care beyond that contribution. Illinois also applies a five-year look-back to transfers of resources or income, so gifting assets away shortly before applying can trigger a penalty period during which Medicaid won't pay for nursing-home care, though other covered medical services continue if the person is otherwise eligible.

How do I check whether an Illinois nursing home is good?

Check the facility's 1-to-5-star overall rating on Medicare Care Compare, paying attention to the staffing component, and review its IDPH inspection results. You can report concerns to IDPH's toll-free hotline at 1-800-252-4343, and the Illinois Long-Term Care Ombudsman, a free advocacy program, investigates residents' complaints.

Learn More

Care TypesNursing Homes by State: Costs, Medicaid Coverage, and How to ChooseWhat a nursing home costs, how Medicaid pays for it, and how facilities are rated all share a federal floor but vary by state. See yours, with a 50-state guide. Care TypesAssisted Living in IllinoisAssisted living in Illinois runs about $72,645 to $74,628 a year. What it is, whether the Medicaid Supportive Living Program pays, and how to vet a facility. Care TypesMemory Care in IllinoisMemory care in Illinois isn't a separate license. Learn the settings it lives in, what the Special Care Disclosure Act requires, and what it costs. Care TypesHome Care vs. Home Health in IllinoisHome care vs. home health in Illinois: home health is skilled, Medicare-covered care; home care is non-medical help Medicare won't pay for at home. Care TypesMemory Care vs. Nursing Home in IllinoisMemory care vs. a nursing home in Illinois: skilled-nursing need, cost and who pays. A semi-private nursing-home room runs about $8,304 a month. MedicaidMedicaid Estate Recovery, ExplainedMedicaid estate recovery can claim a home after death, but not while a spouse or a child under 21, blind or disabled survives. See your state's rules. MedicaidMedicaid Personal Needs Allowance, ExplainedHow the Medicaid Personal Needs Allowance works in 2026: the $30 federal floor, what the states set, and how patient liability is calculated. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.

Find personalized help comparing nursing homes in Illinois at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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