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What Assisted Living Costs in Maryland

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Families looking for a Maryland assisted living price usually want one number. The national survey most quotes trace back to does not publish one: it cuts Maryland into six regions, files the DC suburbs under a Washington heading, and reports a midpoint of a basic-to-heavy-care range. Here is what the 2024 figures actually measure, what sits on top of them, and how to find the line that covers your own county.

Last updated: July 2026

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Why Maryland has six assisted living prices, not one

The 2024 Cost of Care Survey does not report a single Maryland number. It reports Maryland in six pieces: Baltimore, Columbia, Towson; Hagerstown, Martinsburg; Lexington Park; a catch-all called MD Rest of State; and two regions named for cities that are not in Maryland at all — Philadelphia, Camden, Wilmington and Washington, Arlington, Alexandria 1.

That structure is not an accident of formatting. The survey prices care in 431 regions built on 383 federal Metropolitan Statistical Areas, and those boundaries come from the Office of Management and Budget rather than from any state line. In July 2023 the OMB redrew its delineations, and every 2024 figure reflects the new map — one that, as the survey notes in its own methodology, often folds in counties from other nearby states 1.

A statewide Maryland average would blend one of the most expensive labor markets on the East Coast with the Eastern Shore. The survey declines to do that, and a figure that does blend them is describing nobody in particular.

The practical consequence is small and irritating. The number a family wants is filed under a heading they would not think to look for, and a "Maryland average" found on a marketing page has usually been produced by averaging regions that have nothing to do with each other. Six lines is more work to read than one. It is also the only honest shape for a state that runs from the Washington beltway to Garrett County.

What the $5,900 national median is actually measuring

The national median for an assisted living community in 2024 was $5,900 a month, up 10 percent from $5,350 the year before 1. Annualised, that is $70,800 2. Maryland sits in a high-cost corridor and its metro regions would not be expected to land at the national midpoint, but the national figure is still the right place to start, because it is the number whose construction is documented.

And the construction matters more than the total. Surveyors polled 17 percent of licensed assisted living communities, completing 4,610 surveys, and collected the monthly private-pay rate for a one-bedroom unit 1. Three details inside that sentence do most of the damage to family budgets:

  • It is private pay. The survey captures what a family pays out of pocket. It does not capture what a state Medicaid program reimburses.
  • It is a one-bedroom. A shared room prices lower; a two-bedroom or a larger apartment prices higher.
  • It is a midpoint of a range. Surveyors collected rates "as they ranged from basic care to more substantial care," and where a community gave a range, the average of the high and the low was used 1.

The published median is the middle of a basic-to-substantial-care band 1 — which means a resident who needs substantial help is priced above it before anything else is added.

One more piece of context that explains the 10 percent: the survey's publisher identified inflation, rather than labor cost, as the number one driver of the increase for assisted living communities 1.

The Maryland side of the DC metro is priced under a Washington heading

This is the single most common way a Maryland search goes wrong. The survey lists a Washington, Arlington, Alexandria region under Maryland 1. The Maryland suburbs on the DC side of the state are priced there — not under Baltimore, and not under MD Rest of State. A family in Montgomery County reading a Baltimore figure, or a rest-of-state figure, is reading someone else's market.

The same logic runs the other way at the state's edges. Hagerstown, Martinsburg reaches across into West Virginia. Philadelphia, Camden, Wilmington reaches down into Maryland's northeast corner. The survey's methodology says this plainly — the redrawn MSA regions "can often include counties from other nearby states" 1 — but the sentence is buried in a methodology appendix that nobody reads before they read a price.

What this means when comparing quotes. Two communities twenty-five minutes apart, one inside the beltway and one past it, can sit in different survey regions and be measured against different medians. Neither is overcharging relative to its own market. They are simply not in the same market, and the survey is the thing that says so.

The workable move is to find the region that contains the county in question first, and read that line — rather than starting with a statewide figure and trying to adjust it. The survey's own interactive cost-of-care lookup is built for exactly that, and it is where the state and regional figures live; this summary report carries the national medians and the region definitions.

Baltimore, Lexington Park, and the catch-all called MD Rest of State

The other four Maryland regions are worth knowing by name, because they behave differently. Baltimore, Columbia, Towson is the state's large metro line. Lexington Park is a small single-region line in southern Maryland. Hagerstown, Martinsburg straddles the western border. And MD Rest of State absorbs everything else 1.

That last one deserves suspicion, and not because it is wrong. It is a residual. Everything the survey could not assign to a named metro lands there together: the Eastern Shore, the mountain counties in the west, the rural stretches in between. A residual region blends genuinely different markets, and a median drawn from it has more spread behind it than a metro median does.

A residual region — a "rest of state" line — is not a place. It is what is left after the metros are named, and its median is the midpoint of a wider and more mixed set of communities.

Reading the small regions carefully. The survey reports only the regions where data collection actually succeeded 1. A thinly covered region's median rests on fewer completed surveys than a Baltimore or Washington figure does, which is not a reason to disregard it — it is a reason to treat it as a rough centre of gravity rather than a going rate. In practice a family calling four communities in western Maryland will learn more about their real price than any median can tell them, and the median's job is to tell them whether those four quotes are strange.

The base rate is a midpoint, and the care level sits on top of it

Every figure discussed so far is a base rate, and a base rate is not a bill. Assisted living is typically priced as rent plus a care level, and the care level is set by an assessment the community performs — usually before move-in, and again whenever needs change. The published median already sits somewhere in the middle of a basic-to-substantial-care band 1, so a resident assessed at a high care level is starting above it, not at it.

Then there is the fee that arrives before the first month. The survey found that approximately 58 percent of assisted living communities charge a one-time, non-refundable fee 1 — a community fee or entrance fee, typically due at signing and typically not counted in any monthly figure anyone quotes.

Roughly 58% of assisted living communities charge a one-time, non-refundable fee on top of the monthly rate 1.

The questions that surface the rest of the structure are ordinary ones, and they are fair to ask on a tour:

  • What care level would this assessment place them at today, and what does that level add per month?
  • What triggers a reassessment, and how much notice comes before a level changes?
  • Is the one-time fee refundable in any circumstance, including a death or a move within the first month?
  • How much has the base rate risen in each of the last three years?
  • What is billed separately — medication management, incontinence care, transport, a second person in the apartment?

A community that answers all five in writing is describing a real price. A community that answers only the first is describing a starting point.

Medicaid, Maryland, and the limits of a federal rulebook

Two things are true at once, and confusing them is expensive. Medicare does not pay for long-term custodial care — help with bathing, dressing, eating, and moving around — in assisted living, in a nursing home, or at home, when that help is the only care needed 3. That is not a Maryland rule or a gap in a particular plan. It is what the benefit is, nationally, and Medigap does not fill it 3.

Medicaid is the programme that can reach assisted living, and it reaches it sideways. Under Section 1915(c), a state may run a waiver that provides long-term services and supports in the home or community instead of an institution, targeted at people who would otherwise need an institutional level of care 4. Several other authorities exist alongside it, and which ones a state uses — and who qualifies, and what is covered — varies by state 4.

Even where a waiver covers assisted living services, it generally does not cover room and board. The rent is still the family's, and that is the fact that most often breaks a plan built on a waiver alone.

This page will not name Maryland's programme, its current eligibility figures, or its waiting list, because those move and a stale number here would be worse than none. The durable move is to go to Maryland's own Medicaid and aging agencies for the current rules, and to ask two questions specifically: whether the state's waiver covers assisted living services at all, and what the room-and-board arrangement is for someone on it. The survey's private-pay medians are silent on both — it captures private-pay rates, not what a state reimburses 1.

What happens when the money runs out

Most families paying privately are drawing down savings against a rising base rate, and the arithmetic ends somewhere. Naming that date early is the whole of the planning, because the options narrow sharply once the money is gone and widen considerably while it is still there.

If there is a spouse still at home, the rules are more protective than most people expect. Medicaid's spousal-impoverishment provisions protect a portion of a couple's income and assets for the spouse remaining in the community — a Minimum Monthly Maintenance Needs Allowance and a Community Spouse Resource Allowance — when the other spouse needs institutional or waiver long-term care expected to last at least 30 days 5. This is federal structure, it applies in Maryland, and it means the healthy spouse is not required to spend down to nothing.

After a death, the state looks at the estate. States must recover the cost of nursing-facility care, home- and community-based services, and related services from the estates of people who were 55 or older when they received them 6. There are mandatory exceptions — a surviving spouse, a minor or disabled child — and an undue-hardship waiver process 6. Families are frequently blindsided by this, and it is better understood at the start than discovered at the end.

The reason to name the run-out date now is that a move made in a crisis is made from a shorter list. The comparison worth doing while there is still runway is not between two communities in the same region — it is between the private-pay path, the waiver path if the state has one, and staying home with paid help, priced honestly against each other.

Reading a Maryland number against another state's

The Cost of Care Survey applies one method to all fifty states, which is what makes cross-state comparison meaningful at all. Respondents from every state and the District of Columbia completed the survey by phone or online between July and December 2024, and the same one-bedroom, private-pay, range-midpoint rule was used everywhere 1. So a Maryland region and a region in another state are measured the same way even though they are nothing alike.

That is genuinely useful for a family weighing a move — an adult child in another state, a parent willing to relocate. What assisted living costs in Pennsylvania and what assisted living costs in Texas are pulled from the same instrument as Maryland's regions, and the comparison holds. Assisted living cost in Tennessee, likewise. The medians are comparable; the regulation behind them is not.

There is no uniform federal regulatory standard for assisted living. Licensing standards are set state by state, and the survey says so directly 1.

That asymmetry is the thing to carry across a state line. Two regions can post similar medians while their states license, staff, and inspect assisted living on entirely different terms. The survey counts more than 70 different names or designations for facilities licensed as some form of assisted care community, and fewer than 40 percent of them use the words "assisted living" in their formal name or licensure designation at all 1. A family comparing Maryland to another state is comparing two prices drawn the same way, attached to two things that may not be the same thing.

Common questions

Because the survey most figures trace back to does not publish one. It prices Maryland in six regions built on federal metropolitan boundaries, including two named for cities outside the state. A single statewide average would blend the Washington suburbs with the Eastern Shore, producing a number that describes neither. The regional line covering a specific county is the useful one.

No. Published medians are base rates for a one-bedroom unit, and the survey averages the high and low of a community's basic-to-substantial-care range. A care level set by assessment sits on top, roughly 58 percent of communities charge a one-time non-refundable fee at signing, and items like medication management or transport are often billed separately.

No. Medicare does not cover long-term custodial care — help with bathing, dressing, eating, and moving around — in assisted living, a nursing home, or at home when that help is the only care needed. Medigap does not fill the gap either. Medicare's nursing-home coverage is limited to short skilled stays after a qualifying hospital admission, which is a different benefit.

Medicaid can reach assisted living through home- and community-based waiver authorities, which let a state provide services in the community instead of an institution for people who would otherwise need institutional-level care. What a state covers and who qualifies varies. Even where services are covered, room and board generally is not. Maryland's own Medicaid and aging agencies hold the current rules.

The survey builds its regions from federal Metropolitan Statistical Areas, not state lines, and those areas cross borders. The Maryland side of the DC metro sits in the Washington, Arlington, Alexandria region; the northeast corner sits in the Philadelphia, Camden, Wilmington region. The heading names the metro's anchor cities, not the state the resident lives in.

The national median rose 10 percent in 2024, from $5,350 to $5,900 a month, and the survey's publisher pointed to inflation as the leading driver for assisted living. That is a national figure for one year and not a forecast for any community. A specific community's history — its base-rate increase in each of the last three years — is a fair question to ask before signing.

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When the price question is really a care-level question

  • —A fall with a head strike, a suspected fracture, or any fall while taking a blood thinner — and a second fall within a month, which often means the current level of supervision no longer matches the need
  • —New confusion, agitation, or a sudden change in continence appearing over hours to days, which can signal an infection or a medication problem rather than a step down in dementia
  • —Leaving the building unaccompanied and being unable to find the way back, or being found outside at night
  • —Losing weight without trying, or being found to have skipped meals or medications repeatedly despite the care plan covering them

A fall with a head strike, a possible fracture, or any head injury in someone taking a blood thinner is an emergency — call 911 or go to the emergency department rather than waiting for the community's next assessment.

This page explains how assisted living costs are measured and what public data does and does not show. It is general information, not medical, legal, or financial advice, and it is not an assessment of any individual's care needs or eligibility. Costs, Medicaid rules, and state programmes change. Decisions about care and payment are worth working through with a clinician, and with Maryland's own Medicaid and aging agencies for anything eligibility-related.

References

  1. 1.CareScout (Genworth) (2024). Cost of Care Survey 2024. CareScout / Genworth. link ✓The 2024 national median monthly assisted living cost of $5,900, up 10% from $5,350 in 2023, with inflation identified as the leading driver; the survey methodology (4,610 completed assisted living surveys representing 17% of licensed communities; monthly private-pay rate for a one-bedroom unit; rates collected as a range from basic to substantial care with the high-low average used; approximately 58% of communities charging a one-time non-refundable fee; data collected July-December 2024 across all 50 states and DC); the region structure (431 regions based on 383 federal MSAs, the July 2023 OMB redelineation, regions often including counties from other nearby states, results reported only where data collection succeeded) and the specific Maryland region definitions listed in the report; and the statements that there is no uniform regulatory standard for assisted living, that licensing varies state to state, that more than 70 names or designations exist, and that fewer than 40% of communities use 'assisted living' in their formal name or licensure designation.
  2. 2.Genworth Financial / CareScout (2025). Genworth and CareScout Release Cost of Care Survey Results for 2024. Genworth Financial Investor Relations. link ✓The 2024 national median annual cost of assisted living of $70,800, a 10% year-over-year increase.
  3. 3.Centers for Medicare & Medicaid Services (2026). Long-term care coverage. Medicare.gov (U.S. Centers for Medicare & Medicaid Services). link ✓That Medicare and most health insurance, including Medigap, do not pay for long-term custodial care — help with activities of daily living — in assisted living, a nursing home, or the community when that is the only care needed.
  4. 4.Centers for Medicare & Medicaid Services (2025). Home & Community-Based Services 1915(c). Medicaid.gov (U.S. Centers for Medicare & Medicaid Services). linkThat Section 1915(c) waivers let states provide long-term services and supports in the home or community instead of an institution, targeted to populations who would otherwise require an institutional level of care, and that coverage and eligibility vary by state and authority.
  5. 5.Centers for Medicare & Medicaid Services (2025). Spousal Impoverishment. Medicaid.gov (U.S. Centers for Medicare & Medicaid Services). linkThat Medicaid spousal-impoverishment rules protect a portion of a couple's income and assets — the Minimum Monthly Maintenance Needs Allowance and the Community Spouse Resource Allowance — for the community spouse when the other spouse needs institutional or waiver long-term care lasting at least 30 days.
  6. 6.Centers for Medicare & Medicaid Services (2025). Estate Recovery. Medicaid.gov (U.S. Centers for Medicare & Medicaid Services). linkThat states must recover from the estates of deceased Medicaid enrollees aged 55 and older the cost of nursing-facility, home- and community-based, and related services, subject to mandatory exceptions for a surviving spouse or a minor or disabled child and an undue-hardship waiver process.

6 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy

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