A nursing home provides around-the-clock skilled nursing care, and it is the most expensive setting in senior care. If you are comparing nursing homes by state, what it costs, who pays, and how facilities are rated all share a federal floor but come down to where you live: Medicaid covers nursing-home care everywhere and is the primary payer, while the income and asset limits to qualify are set state by state. This guide walks the rules that hold nationwide, then points you to a full guide for your state.

In This Guide

What a Nursing Home Costs

Nursing-home care is the most expensive setting in senior care. As of 2026, a nursing home runs about $9,581 a month for a semi-private (shared) room and about $10,798 a month for a private room, or roughly $115,000 to $130,000 a year. For comparison, assisted living runs about $6,200 a month in 2026, so a nursing home costs roughly one and a half times as much. Those are national figures; the actual price where you live can run well above or below them, which is one reason the who-pays question below matters so much.

Who Pays: Medicaid and Nursing Homes

For most nursing-home residents, the answer is Medicaid. Under federal law, nursing-facility care is a mandatory Medicaid benefit, so Medicaid covers nursing-home care in every state, and it is in fact the primary payer for nursing-home care in the country. This is different from most other long-term care: home and community-based services are an optional Medicaid benefit each state chooses whether to offer, but a nursing home is the one setting Medicaid must cover everywhere.

Qualifying is where your state comes in. Nursing-home Medicaid has an income test and an asset test, and both are set within a federal frame but with state-specific numbers. Many states cap income at the special income limit, which is 300% of the SSI federal benefit rate, or about $2,982 a month for an individual in 2026. A single applicant generally must also have no more than about $2,000 in countable assets in 2026, a limit drawn from the federal SSI resource standard, though the exact figure is set by each state. Because those thresholds and how a state applies them vary, your state's guide is where the real numbers live.

How Nursing Homes Are Regulated and Rated

Here the news is reassuring: nursing homes answer to a single federal standard. Under Social Security Act sections 1819 and 1919, every Medicare- or Medicaid-certified nursing home in the country must meet the same federal health-and-safety requirements, and Medicare and Medicaid jointly survey and certify facilities against those standards, publishing the results, including quality ratings, on Medicare's Care Compare. That gives every family the same national yardstick for comparing facilities, wherever they live.

That uniform federal standard is the opposite of assisted living, which has no federal standard and is licensed and regulated state by state. When you are comparing nursing homes, start with Care Compare for the federal ratings, then check your state's guide for local costs, a facility's inspection history, and how oversight works where you live.

Is a Nursing Home the Right Setting?

A nursing home is a clinical setting for someone who needs 24-hour skilled nursing, and it is easy to confuse with lighter settings. A nursing home, also called a skilled nursing facility, provides round-the-clock licensed nursing and medical oversight. Medicare pays for skilled nursing only on a short-term, post-acute basis, such as recovery after a hospital stay, and does not pay for long-term custodial care. That is the misconception that sends the most families to the wrong page.

If the person mainly needs help with daily activities such as bathing, dressing, and meals rather than constant medical care, that is custodial or personal care, the kind of support assisted living provides, not a nursing home. Matching the setting to the level of care needed comes first; the cost and coverage above follow from it.

What Varies by State

The federal floor is the same everywhere: nursing-home care is covered by Medicaid, facilities meet one federal standard and are rated on Care Compare, and Medicare pays only for short skilled stays. What differs is the detail that decides an individual case, such as the exact income and asset limits, how your state applies them, local costs, and how state inspections and complaint investigations work. That is why the smartest next step is not to learn all fifty sets of rules but to read the one that applies to you.

Find Your State

Pick your state for a full nursing-home guide: local costs, your state's Medicaid income and asset limits, and how to find and compare facilities where you live.

Find Your State's Nursing Home Guide

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Frequently Asked Questions

How much does a nursing home cost?

As of 2026, a nursing home runs about $9,581 a month for a semi-private room and about $10,798 a month for a private room nationally, or roughly $115,000 to $130,000 a year. Local costs vary widely, so check your state's guide.

Does Medicaid pay for nursing homes?

Yes, in every state. Nursing-facility care is a mandatory Medicaid benefit, and Medicaid is the primary payer for nursing-home care nationally. You must meet your state's income and asset limits to qualify.

What is the income limit for nursing home Medicaid?

Many states cap income at the special income limit, 300% of the SSI federal benefit rate, or about $2,982 a month for an individual in 2026, with a countable-asset limit of about $2,000., The exact limits are set by each state, so confirm yours.

Does Medicare pay for a nursing home?

Only for short, skilled, post-acute stays, such as recovery after a hospital admission. Medicare does not pay for long-term custodial nursing-home care. For long-term care, Medicaid is the main payer.

How do I compare nursing homes?

Every certified nursing home is surveyed against one federal standard and rated on Medicare's Care Compare, so start there for the national ratings. Then use your state's guide for local costs and how state inspections work.

Learn More

Care TypesThe Cost of Senior Care by StateThe 2026 national median cost of assisted living, memory care, nursing homes, and in-home care, why your state differs, and your state's own cost guide. Care TypesAssisted Living vs. Nursing Home by StateAssisted living is custodial care; a nursing home is 24/7 skilled care. See what each costs, who pays (Medicaid differs by state), and your state's guide. MedicaidNursing Home Medicaid by StateMedicaid pays for nursing-home care in every state, but the income cap, level-of-care test, and rules vary. The federal floor, what changes, and your state. FinancialHow to Pay for Senior CareHow to pay for senior care: what it costs nationally and how Medicaid, Medicare, VA benefits, and private pay each fit. Who qualifies, what's covered, in 2026.
Your next step Weighing a nursing home for a parent and not sure how to pay for it? Brevy's care navigator can help you understand the costs and Medicaid rules in your state.

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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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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.