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Private-pay runway,
state by state.

Enter your state and your non-exempt asset base. Get your approximate private-pay runway in months — the number that determines whether Medicaid planning is urgent or still elective.

Layered warm strata — horizontal bands of ochre, terracotta, and cream

What is a private-pay runway?

The number of months a household can cover long-term-care costs out-of-pocket before non-exempt assets deplete to Medicaid eligibility thresholds. Calculated as non-exempt assets ÷ monthly care cost. The shorter the runway, the more urgent the Medicaid-planning conversation.

Run your runway

The math: (non-exempt assets − Medicaid asset cap) ÷ (monthly care cost − monthly income) = private-pay runway in months. Bands below: under 12 months is crisis; 12–36 is plan-this-quarter; 36–60 is half-menu still open; 60+ is proactive territory.

Care level
Nursing-home costs are state-specific (Genworth 2024). Assisted-living and home-care are ratio estimates of the same state's nursing-home figure.

Estimate. State variations apply — particularly around CSRA (community-spouse asset shelter), home-equity exemptions, and managed-LTC programs. The federal individual asset cap of $2,000 is the floor; some states use slightly higher caps. Consult a Certified Medicaid Planner or elder-law attorney before relying on this number for any spend-down decision.

Where the math gets tricky

Community spouse present. Not all household assets are "at risk." The CSRA shelters up to $157,920 (2026 federal max) in most states, so the denominator changes.

Income contribution. Social Security, pensions, annuities continue to flow in. The real runway is asset-drawdown + monthly net cash need, not pure asset ÷ cost.

Care-level escalation. Home care is cheapest. Assisted living is medium. Skilled nursing is most expensive. A three-year trajectory through all three is the most common long-term-care arc and changes the math mid-runway.

Next

Runway tells you urgency. $500,000 at a $15,000/month Alaskan nursing-home bill = 33 months; the same $500,000 at a $7,000/month Louisiana bill = 71 months. Same net worth, radically different Medicaid-planning window.
Bank accounts, non-retirement brokerage, most retirement accounts (state-dependent), secondary homes, and rental property. Excluded: primary residence while you or your spouse live there, one vehicle, household goods, a prepaid funeral, and term life insurance.
Social Security and pension income reduce the monthly drawdown but don't count against the asset base. A $2,000/month SS benefit against a $9,000/month facility bill means your real monthly asset burn is $7,000, not $9,000 — runway stretches accordingly.
The divisor converts gifts into months of ineligibility (a penalty calculation). Runway converts your assets into months of paid care (a pre-Medicaid calculation). Both track state costs, but the inputs and purposes differ.
3+ years of runway: broad planning menu still available. 12-36 months: half-menu, still worth planning. Under 12 months or already in a facility: crisis planning — call a Certified Medicaid Planner or elder-law attorney within the week.