A semi-private nursing home room costs a median $333,975 a year in Alaska and $67,525 in Texas, according to CareScout’s state-by-state tables from its 2025 Cost of Care Survey. That is $915 a day in Alaska and $185 a day in Texas, a difference of $266,450 a year for the same kind of room.
CareScout is a Genworth company. It ranks every state from the highest price to the lowest, and Alaska sits first while Texas sits last among the 50 states.
Alaska at the top, Texas at the bottom
Alaska’s yearly price works out to $27,831 a month. Texas comes to $5,627 a month. Alaska’s figure is nearly five times Texas’s, and almost three times the national median of $114,975 a year, or $315 a day, which CareScout put in its March 2 release. The national figure rose 2% from the year before.
CareScout collected the rates from July to November 2025, at the metropolitan-area level, and says the numbers reflect median costs based on provider-reported pricing. Samir Shah, CareScout’s chief executive, said the survey “brings clarity to a moment that can otherwise feel overwhelming for families.”
The question for families is what a nursing home stay would cost where they live, and who pays. Anyone with a parent in or near a nursing home, or a spouse who may need one, should find their state in the table first. The national median can hide a gap of tens of thousands of dollars in either direction.
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Where other states land
Most of the high-cost states are in the Northeast and the Pacific. Connecticut ranks fifth at $182,500 a year, or $500 a day. Massachusetts ranks seventh at $173,375, or $475 a day. Hawaii ranks fourth at $185,679, and Oregon ranks second at $201,115.
The low end is in the South and the Midwest. Louisiana comes in 46th at $91,250, or $250 a day. Missouri is 49th at $80,893, or $222 a day. Mississippi, ranked 30th, lands exactly on the national median at $114,975.
A private room costs more nearly everywhere. Oregon’s private-room price is the highest in the country at $221,372 a year, or $606 a day, according to the same tables. Texas is much cheaper there too, at $91,250 for a private room, which is still below what Connecticut charges for a semi-private one.
CareScout notes that actual expenses depend on individual care needs, provider availability and local market conditions. A facility near a big city can price well above the state figure, and a rural one well below it.
The same release puts the national median for a private nursing home room at $129,575 a year, or $355 a day, up 1%. Assisted living has a median of $6,200 a month, or $74,400 a year, up 5%. An in-home non-medical caregiver costs $35 an hour, or $80,080 a year at 44 hours of care a week, up 3%. Those national numbers give a family a yardstick, but the state tables show how far a local price can sit from it.
What Medicare pays and what it does not
Many families assume Medicare covers a nursing home. Medicare.gov says Part A “may cover short-term nursing home or rehab care (up to 100 days)” in a Medicare-certified facility after a hospital stay, and only when skilled nursing care is medically necessary. Its page on nursing home coverage adds that Medicare “doesn’t cover custodial care” when that is the only care a person needs.
Help with bathing, dressing or eating is generally not covered, and the page says Medicare generally does not cover long-term nursing home stays unless the resident is receiving skilled nursing care. Medicare Advantage plans usually do not pay for nursing home care unless the facility has a contract with the plan. For a long stay at $185 a day or $915 a day, the family or the resident carries the bill until another program steps in.
Medicaid and the five-year look-back
The program that does pay for long stays is Medicaid, and it checks the past. The Centers for Medicare & Medicaid Services says the Deficit Reduction Act lengthened the look-back period to 60 months, or five years, before the date a person applies. States review transfers made in that window.
A transfer can trigger a penalty period during which Medicaid will not pay for nursing home care. For transfers made on or after Feb. 8, 2006, the penalty begins on the later of the transfer date or the date the person enters a nursing home and is otherwise eligible. The agency’s backgrounder also describes a home equity cut-off of $500,000, which states can raise to $750,000, with exceptions for a home that a spouse or a minor, blind or disabled child lives in.
Rules and dollar limits differ by state, so the state Medicaid office is the place to confirm them. The state price list in the CareScout tables sets the scale of what is at stake: at Alaska’s rate, five years of semi-private care would run past $1.6 million, and at Texas’s rate, about $337,625.
What would a nursing home room cost in the family’s own state?
A price of $185 a day in Texas or $915 a day in Alaska can empty a lifetime of savings in a few years, and a gift made inside the five-year window can delay Medicaid help. Families tend to learn those rules after the fall or the diagnosis, when there is little room to plan.
Protect Your Savings From Care Costs is a 10-page guide that covers what Medicare pays for nursing care, and what it won’t, and how the Medicaid look-back works. It also includes a worksheet for a care plan and a large-print edition.
Get the 10-page nursing home cost guide and care-plan worksheet →
This article was produced with AI assistance and edited for accuracy against the sources linked above.
