Geography Matters: Location plays key role in long-term care cost

While it’s normal for the cost of long-term care to vary from place to place, location is becoming a more significant part of the conversation when it comes to planning, according to Susann Crawford, SVP of sales for online senior care platform Caring.com.

“Now, geography is a bigger part of the conversation, whether it’s between significant others, spouses or whole families making those decisions, because we often find as seniors decide to downsize, it’s probably some type of a move,” Crawford said in a recent interview with InsuranceNewsNet.

Her organization recently published the findings of a study on the most affordable states for long-term care, with Mississippi claiming the top spot.

However, long-term care insurance specialists Jim Better, president, Essential Plans of Insurance, and Mark Baron, founder, Baron Long-Term Care Planning, said it’s not always as easy as simply moving to a different state to afford care.

They said American seniors have to consider factors such as where children or family members who can help with care reside, and also look at how the quality of care may differ in various locations.

Crawford, Better and Baron all agreed that financial advisors play a crucial role in assessing all the options and helping clients determine the best care for their needs.

Southern states are more affordable

According to Caring.com’s research, southern states tend to be among the most affordable for long-term care. The top five most affordable states for long-term care overall, ranked on a scale of 1-10, were:

• Mississippi: 8.9
• Texas: 8.41
• Arkansas: 8.21
• Louisiana: 8.16
• Alabama: 7.59

The top three most affordable states for assisted living were:

• South Dakota: $52,500/year
• Mississippi: $53,343/year
• Alabama: $54,870/year

The top three most affordable states for home care were:

• Louisiana: $50,336/year
• Alabama: $57,200/year
• Mississippi: $57,200/year

The top three most affordable states for private rooms in a nursing home were:

• Texas: $85,045/year
• Missouri: $85,775/year
• Louisiana: $91,250/year

What’s driving costs up?

Better and Baron said Caring.com’s research seems consistent with their lived experiences in the field. They noted that it’s reasonable to expect states with a higher cost of living like New York and California to also have higher long-term care costs — although this may not always be the case.

“States like Arkansas or Texas, some of these places, a private room in a nursing home is like $9,000 a month, whereas in Massachusetts, it’s $15,000, $14,000 to $16,000 a month for the same exact room,” Baron said.

However, all three professionals said supply and demand also factor into the overall cost.

“So, the wages of your caregivers, the availability of care in an area. You may have a large workforce available to you, or a smaller workforce based on the cost of living, education level, even density,” Crawford said.

“Some of the immigration issues that have been happening in the country have driven up home care prices because there’s a shortage of immigrants that do that kind of work. So, it’s just a market supply and demand thing where fewer home care workers can demand more money per hour,” Baron added.

At the same time, Crawford noted that higher life expectancies also mean retirement is lasting longer than many Americans plan for.

“So, thinking longer range than what maybe families did in the past is very important because those decisions compound,” she said.

Not just about cost

While moving may be an option for some, seniors were urged to think about more than just overall cost.

“Are there caregivers, are there communities available near me to be able to retire into? It might be very affordable, but is there the supply for the demand that may be there as well?... Is it being closer to other family members? Are family members going to come together in a certain area? Does it still afford the opportunities for the younger family members to have a very prosperous and growing future too?” Crawford pointed out.

For Better, quality of care is another crucial consideration that he says can vary by location.

“People don’t generally use buying long-term care insurance as a lever about where they’re going to live; it just happens to work out that way,” Better said. “Really, the significant issue is the quality of care. When you go from one state that has better services as opposed to one that may not have as good of services, that’s really the key issue, not the price of the policy.”

“That’s why a financial planner or a true expert advisor that really understands the inner workings of that senior care industry is a great person to kind of have in your back pocket to ensure that you’re getting all of the options that are available to you, to your family and what’s really going to fit the situation best,” Crawford added.

Caring.com is an online platform dedicated to providing information, resources and tools for senior care planning. The data for its survey was gathered using CareScout (2024) and verified as correct up to May 2025.

Essential Plans of Insurance is an LTC provider founded in 2013 and based out of California.

Baron Long-Term Care Planning is an independent agency founded in 2003 and based out of Massachusetts.

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Rayne Morgan is a journalist, copywriter, and editor with over 10 years' combined experience in digital content and print media. You can reach her at [email protected].