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The $130,000 question: Can you afford to get old in America?

$130,000: That number is not a worst-case scenario. It is the 2025 national median annual cost of a private room in a nursing home, according to CareScout’s survey, which has tracked long-term care pricing across the United States since 2004. The figure rose 1 percent this year. It is not going down.

Most Americans have not done this math.

The gap between what families imagine long-term care costs and what it actually costs is where the financial shock lives. A private nursing home room is only one point on a much wider spectrum. The 2025 data maps that spectrum in detail, and the differences between care settings are significant enough to reshape the entire planning conversation.

The in-home care number that surprises people most

The national median hourly rate for non-medical in-home caregiver services rose 3 percent in 2025 to $35 per hour. That figure sounds reasonable. The annual figure does not. Forty-four hours of care per week at that rate totals $80,080 a year. For families who assume keeping a parent at home is the affordable option, this is usually the number that reframes everything.

CareScout also added private duty nursing to its 2025 survey for the first time. The national median for skilled nursing in the home runs $90 per hour, or $160 per visit for brief task-based clinical services.

The assisted living reality

The national median monthly cost for assisted living reached $6,200 in 2025, up 5 percent but well below the double-digit growth reported in 2024. Annually, that is $74,400. Pricing tracks closely with rental housing because room and board form the core of the charges, a pattern independent of analyses.

For families weighing assisted living against in-home care, the annual costs are closer than most expect. The tradeoffs involve supervision, socialization, and clinical support rather than price alone.

The nursing home numbers

A semi-private nursing home room now runs a national median of $315 per day, or $114,975 annually, up 2 percent from 2024. State-by-state data shows costs rose between 2024 and 2025, with some markets seeing dramatically steeper increases. The private room median is $355 per day, totaling $129,575 per year. These figures reflect the higher staffing costs and clinical demands of skilled nursing facilities, where inflationary and workforce pressures have been sustained and show no sign of reversing.

The option most families overlook

Adult day health care services saw a 5 percent decline in rates in 2025, landing at a national median of $95 per day. For families using five days per week, the annual cost is $24,700, the lowest in the dataset. These programs provide supervision, structured activities, and daytime support while allowing the individual to return home in the evening. Medicaid covers adult day care in all 50 states through Home and Community Based Services waivers, making this the care setting with the broadest public funding access.

Wrap up

The cost of long-term care in America is high, it is not declining, and most families encounter it without having planned for it. The 2025 data suggest the pace of increases has eased, but the baseline remains historically elevated. The difference between a family that has mapped these numbers in advance and one that discovers them at a moment of crisis is not just financial. It is the difference between a decision made with options and a decision made without them.

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