Assisted Living Cost in North Carolina
North Carolina is the rare state where the assisted living median matches the national figure exactly, $6,200 a month, yet the metro gap is still wide: Raleigh costs $2,800 a month more than the state median. The payment story is also unusual: Medicaid does not pay room and board here, and a state supplement does instead, so the Medicaid section below names the program and its 2026 rates. If your parent lives near Raleigh, budget from the Raleigh figure, not the state figure.
Sources: CareScout Cost of Care Survey 2025, released March 2026, ranked state tables and Cost of Care calculator, accessed November 2026; North Carolina Department of Health and Human Services State/County Special Assistance information; North Carolina Department of Military and Veterans Affairs state veterans homes information.
North Carolina assisted living costs, against the national median
The table below is the CareScout 2025 survey for North Carolina, with the national median beside it. The survey collected more than 25,000 provider rates between July and November 2025 and reports medians, the middle price, not averages pulled up by luxury buildings. Assisted living figures are for a private one-bedroom apartment for 12 months of care.
| Care type | North Carolina median | National median |
|---|---|---|
| Assisted living, per month | $6,200 ($74,400 per year) | $6,200 ($74,400 per year) |
| Home care, non-medical caregiver, per hour | $30 ($68,640 per year at 44 hours a week) | $35 ($80,080 per year at 44 hours a week) |
| Adult day health care, per day | $84.50 ($21,970 per year at 5 days a week) | $95 ($24,700 per year at 5 days a week) |
| Nursing home, semi-private room, per month | $9,733 ($116,800 per year) | $9,581 ($114,975 per year) |
| Nursing home, private room, per month | $10,798 ($129,575 per year) | $10,798 ($129,575 per year) |
The assisted living cost North Carolina median matches the national median exactly, $6,200 a month and $74,400 over a full year. Home care at $30 an hour sits $5 below the $35 national rate. Adult day care at $84.50 a day sits $10.50 below the $95 national rate. A semi-private nursing home room at $9,733 sits $152 above the $9,581 national figure, and a private room at $10,798 matches the $10,798 national figure exactly. For the full national picture, read how much does assisted living cost and how much does a nursing home cost.
Assisted living cost North Carolina by place
Place medians come from the same CareScout survey, through its Cost of Care calculator, which reports the closest survey region for each place. All figures are 2025 monthly medians for a private one-bedroom apartment. The spread runs from $6,255 to $9,000, a gap of $2,745 a month between the lowest and highest North Carolina place in this table. Each place maps to its own metropolitan region, so read these as region figures, not as place-specific surveys.
| Place | Assisted living median per month, 2025 | Against the North Carolina median |
|---|---|---|
| Raleigh | $9,000 | $2,800 above |
| Greensboro | $6,638 | $438 above |
| Asheville | $6,619 | $419 above |
| Charlotte | $6,255 | $55 above |
All four places in this table sit above the $6,200 state median, which tells you smaller regions outside these places pull the state figure down, not up. Raleigh at $9,000 sits $2,800 above the state median, the largest place gap on this page, while Charlotte, the lowest place in this table, still sits $55 above it. Do not treat the state median as the price in any of these places: use the place figure, then replace it with three written quotes in that place, with apartment size and care level stated. For how to use competing quotes, read can you negotiate assisted living costs.
What the monthly bill includes, and what it leaves out
The median buys the building and the base service: a private apartment, meals, housekeeping, supervision, and activities, with staff on site around the clock. It does not buy every charge a resident actually pays. Care is priced in levels, and the level rises as help needs grow, so the second year costs more than the first even before any annual rate increase. Medication handling, a higher care level, and a second occupant are commonly billed on top of the base rate, and many buildings charge a one-time community fee at move-in.
North Carolina licenses adult care homes through the Department of Health and Human Services, Division of Health Service Regulation, Adult Care Licensure Section, under state law Chapter 131D. An adult care home is the North Carolina name for an assisted living residence with seven or more residents; a family care home is the smaller setting, for two to six residents. A Special Care Unit for Alzheimer's disease or a related disorder is a designation inside a licensed adult care home, not a separate license. There are more than 1,200 adult care homes in the state. Ask at the tour, in writing, which license a setting holds, which services the base rate covers and which are billed as extras, and what each extra costs. The tour checklist on assisted living checklist groups those questions for you.
Medicaid in North Carolina: State/County Special Assistance
North Carolina's help for assisted living works differently from most states, and the distinction matters. Medicaid does not pay room and board in an adult care home. Instead, the State/County Special Assistance program, a state supplement to federal SSI, pays room and board for older adults and adults with disabilities who cannot afford an adult care home, while Medicaid covers the personal care services and medical costs of a resident who qualifies. The 2026 Special Assistance basic rate is $1,397 a month, and the Special Care Unit rate for a resident with Alzheimer's disease or a related disorder is $1,792 a month, plus a $70 a month personal needs allowance. Apply through the county Department of Social Services where your parent lives; the decision takes up to 45 days for applicants age 65 and older and up to 60 days for applicants ages 18 to 64. The Community Alternatives Program for Disabled Adults, known as CAP/DA, is a separate Medicaid home and community based waiver that helps a disabled adult stay at home instead of entering an institution; it is not the room and board payer for adult care homes. For the national Medicaid rules, read does medicaid pay for assisted living, and for the full payment map, read how to pay for assisted living. Medicare does not pay for assisted living room charges or custodial care; see does medicare pay for assisted living for the exact boundary.
VA resources in North Carolina
For a veteran parent, two North Carolina routes sit beside the private market. The first is VA Aid and Attendance, a monthly cash benefit added to a VA pension for a veteran or surviving spouse who needs help with daily living; the amounts and rules are on VA Aid and Attendance requirements and veterans affairs assisted living. The second is the state's own veterans home system. North Carolina has four operating state veterans homes: Salisbury, Black Mountain, Kinston, and Kernersville, run by the Department of Military and Veterans Affairs. The Fayetteville home closed in 2024 after structural problems, and a replacement near Fort Bragg is planned but not yet built, so do not count Fayetteville as an open home. State veterans homes are skilled nursing facilities, not private assisted living communities, so treat them as a separate application track, not as a price comparison. For VA health care, use VA.gov to find the facility nearest your parent.
North Carolina against the national median, in one row
Assisted living cost North Carolina at $6,200 a month matches the $6,200 national median exactly, home care at $30 an hour sits $5 below the $35 national rate, adult day care at $84.50 a day sits $10.50 below the $95 national rate, and a nursing home semi-private room at $9,733 a month sits $152 above the $9,581 national figure. North Carolina is an average state for assisted living and nursing home rooms, and a cheaper state for home care and adult day care. At $9,733 a month, a semi-private nursing home room costs $3,533 a month more than the $6,200 assisted living median in the same state, so a parent whose needs are close to the nursing facility line should still price both settings in the same place.
Frequently asked questions
Does Medicaid pay room and board in a North Carolina adult care home?
No. Medicaid covers personal care services and medical costs for a resident who qualifies, but room and board is paid by the State/County Special Assistance program. The 2026 basic rate is $1,397 a month, and the Special Care Unit rate is $1,792 a month plus a $70 personal needs allowance. Apply through your county Department of Social Services, and budget the gap between the Special Assistance rate and the community's charge from income, VA benefits where eligible, or family funds.
What is an adult care home, and is it the same as assisted living?
Yes, in North Carolina an adult care home is the licensed name for an assisted living residence with seven or more residents. A family care home is the smaller setting, for two to six residents. Both are licensed by the Division of Health Service Regulation, and a Special Care Unit is a dementia designation inside a licensed adult care home, not a separate license. When a listing says adult care home, it is the North Carolina license behind the same product.
How long does a Special Assistance decision take?
Up to 45 days for applicants age 65 and older, and up to 60 days for applicants ages 18 to 64, counted from the application at the county Department of Social Services. Apply early, while your parent still has funds to cover the room and board charge, and call NC 211 at 1-888-892-1162 if you are unsure which county office to use.
Does the $6,200 median cover two people sharing one apartment?
No. The CareScout median is for a private one-bedroom apartment occupied by one person. A second occupant adds a second-person fee set by each community, on top of the median, not inside it. Couples should budget the median plus the community's written second-person fee, plus a care level for each spouse who needs help, since care is priced per person. See average cost of assisted living for a couple for how couples totals are built.
Your next step is to take the place median for the city where your parent will actually live, get three written quotes that state apartment size, care level, and every extra fee, and check State/County Special Assistance and VA eligibility before you sign. Start with assisted living checklist and assisted living costs.