In short
North Carolina's mountain and coastal retirement destinations — Asheville, Charlotte, the Outer Banks — draw families from across the country, and the state's assisted living averages about $6,496 a month. North Carolina's Medicaid HCBS program covers home and community-based services including assisted living for qualifying seniors through the Community Alternatives Program.
North Carolina’s senior care landscape
North Carolina’s senior care market is shaped by its popularity as a retirement destination, especially in the mountains around Asheville, the Piedmont around Charlotte and the Triangle (Raleigh-Durham), and the coastal areas. Continuing-care retirement communities in Asheville often have waitlists measured in years.
Home care is widely available across the state, and the concentration of hospital systems (especially around the research triangle) means access to medical specialists is strong in most metro areas. Rural areas, particularly in the eastern part of the state, have fewer options and longer travel distances for medical care.
North Carolina’s Division of Health Service Regulation (DHSR) licenses and inspects adult care homes and publishes inspection records online.
What care costs in North Carolina
These are North Carolina-wide medians from the 2025 CareScout Cost of Care Survey. Actual costs in your city can be higher or lower.
| Type of care | North Carolina median (2025) | National median (2025) |
|---|---|---|
| Assisted living | $6,496 a month | $6,200 a month |
| Nursing home (semi-private) | $9,733 a month | $9,581 a month |
| Home care (44 hrs/wk) | $5,720 a month | $6,673 a month |
Not sure where to start?
Tell us where your parent is and what kind of care they need. We’ll tell you the options in their area and help you narrow to the few worth your time.
How North Carolina helps families pay
North Carolina programs that help seniors pay for care
- Medicaid long-term care
- North Carolina’s Medicaid HCBS program (Community Alternatives Program) covers home and community-based services including assisted living for qualifying seniors.
- Who qualifies
- HCBS waiver income limit is about $1,330/month single. Asset limit is $2,000 single.
- Where to start
- Land of Sky Regional Council Area Agency on Aging, 828-251-6622; or your county Department of Social Services
- Veterans
- VA Aid and Attendance pension for wartime veterans who need help with daily activities.
- Medicare
- Does not pay for assisted living or long-term care. Covers short rehab stays.
Sources: NC Department of Health and Human Services; Medicare.gov; VA.gov. Rules change; confirm current eligibility.
Our North Carolina city pages
Each city page has specific cost ranges, local Area Agency on Aging contacts, neighborhood guidance, and answers to local questions.
| City | County | Typical AL cost |
|---|---|---|
| Asheville | Buncombe County | $5,500 to $7,000/mo |
Questions families ask
Does North Carolina have a Medicaid program for assisted living?
The NC Medicaid HCBS program (Community Alternatives Program) covers home and community-based services including assisted living for qualifying seniors.
How do I check a facility’s record in NC?
NC DHSR’s Adult Care Licensure Section posts inspection reports and star ratings online at info.ncdhhs.gov.
Does Medicare pay for assisted living in North Carolina?
No. Medicare does not pay for assisted living or any form of long-term custodial care.
Sources: CareScout Cost of Care Survey 2025, carescout.com/cost-of-care; State agency websites; Medicare.gov; U.S. Department of Veterans Affairs. Retrieved October 8, 2026.