Elder Care Index 2026

Care costs, Medicaid rules and help paying, state by state

Pick your state for 2026 nursing home and assisted living costs, Medicaid income and asset limits checked against the state agency, and the waivers that pay for care at home. Every state is also graded in the Elder Care Index.

emoji_eventsUtah ranks #1 overall
paymentsA nursing home room runs $5,639/mo in Texas and $31,282/mo in Alaska
fact_checkBuilt from CMS, Census and BLS data. How we grade

A (8)B (16)C (10)D (6)F (11)

Full rankings arrow_forward

Where to start

Pick the question you came with

ABCDF

Researching costs?

State-by-state median pricing for assisted living, nursing homes, memory care, and home aides — every state graded A–F.

See all 51 states ranked

Independent → In-home → Assisted → Memory → Nursing → Hospice

Just starting out?

A plain-English walk-through of the 6 levels of senior care, what each one includes, and how families typically choose.

Read the primer

AL$4,995

NH$9,277

Comparing care types?

Side-by-side monthly cost — assisted living vs. nursing home. What's included, who pays, and when each one fits.

Compare options

SavingsLTC insuranceVA benefitMedicaid

+ 4 more ways families pay

Figuring out how to pay?

The 8 ways families cover assisted living, from savings and long-term care insurance to VA Aid and Attendance and Medicaid waivers.

See all 8 options

Making sense of senior care coverage

We translate opaque state Medicaid policies into actionable, state-specific guides for families figuring out how to pay for care.

account_balance

Policy Clarity

Clear explanations of state-specific asset limits, look-back periods, home equity exemptions, and spend-down rules.

trending_down

HCBS Waiver Detail

Every senior HCBS waiver enumerated — eligibility, covered services, waitlists, self-direction options.

analytics

Data-Driven Rankings

Every state graded across 5 pillars: Medicaid support, quality, staffing, access, and affordability.

Rankings

The best state for what matters to you

Every family weighs things differently. These are the leading states on each part of the index.

See every ranking arrow_forward

savingsMost affordable

Missouri

27% lower

Care costs 27% less, measured against what seniors there earn, than in the typical state. A nursing home room runs $6,548/mo.

Missouri guide arrow_forward

verifiedBest nursing homes

Hawaii

1.73 RN hrs

Registered nurse time per resident each day (typical state: 0.74), and 12.4% of long-stay residents on antipsychotics (typical: 17.1%).

Hawaii guide arrow_forward

diversity_1Easiest to find care

New York

172 aides

Home health and personal care aides per 1,000 seniors (typical state: 45), plus 29 nursing home beds per 1,000.

New York guide arrow_forward

volunteer_activismMost generous Medicaid

Illinois

$17,500

Asset limit for long-term care Medicaid (most states: $2,000). 43% of senior Medicaid long-term care spending goes to care at home (typical state: 37%).

Illinois guide arrow_forward

Washington, D.C. is not included in these cards: as a single city, its per-senior figures are not comparable with states. It appears in all rankings.

Editorial Highlights

View all

A-F

Letter grade per state

Pillar dimensions

Medicaid Report Card pillars per state

24+

CMS metrics ingested

Scoring framework computed from CMS Nursing Home Compare, state Medicaid agency data, Genworth 2024 Cost of Care Survey, and BLS healthcare wage data.

Institutional Trust, Built on Data

Our scoring methodology is developed by independent analysts with public-policy experience, and our data and rankings are never influenced by any commercial relationship. We verify every data point against its primary source.

verified

Verified sources only

We cite state Medicaid agencies, CMS, and federal regulations directly.

sync

Monthly updates

Medicaid figures change. We keep each state page current with the latest rules.

shield_person

Independent & data-first

Every state page is built from current CMS, Genworth, and state Medicaid data.

Read Methodology arrow_forward

Take the first step toward better care

Use our state-by-state guides to see exactly what Medicaid pays for in your parent's state — and what it doesn't.

Browse All 51 State Guides arrow_forward View Rankings