The Real Cost of Long-Term Care in Virginia: What Retirees Should Plan For

What Long-Term Care Actually Costs in Virginia

The CareScout (formerly Genworth) Cost of Care Survey is the most widely cited national benchmark for long-term care pricing. The 2025 survey, released in early 2026 and the latest available, reports these annual median costs:

For comparison, the national medians in the same survey are about $129,575 a year for a private nursing home room, $114,975 for a semi-private room, and $74,400 for assisted living. Virginia runs above the national median in every setting, roughly 8% higher for a private nursing home room and about 12% higher for assisted living. These are statewide medians, so actual costs vary by region and by facility.

Why the Numbers Matter When You Downsize

A downsizing move is a natural moment to think about the future, because the equity tied up in your home is often the largest single asset you have. If you sell a long-held family home, the proceeds can do far more than buy a smaller place; they can fund a plan for the care you may someday need.

The reality is that most people do not pay for long-term care out of pocket comfortably. Medicare does not cover long-term custodial care, and while Virginia's Medicaid program can help those who qualify financially, planning early gives you far more choice about where you receive care and how you pay for it.

• A smaller home means lower carrying costs. Moving to a low-maintenance home or 55+ community can free up monthly cash flow that would otherwise go to property taxes, utilities, and upkeep, money that can be redirected toward future care.
• Equity is a planning asset, not just a number. The proceeds from selling a large home can be invested or held to cover future care costs, giving you options you would not have if you stayed put.
• Location shapes your options. Moving near a hospital or into a community with on-site services can reduce the logistical burden on your family later. Our guide to hospitals and healthcare in the Fredericksburg region is a good starting point.

How to Plan and Pay

There is no one right answer, but a thoughtful plan usually combines several tools. Long-term care insurance, if you can still qualify and afford it, can cover a meaningful share of costs. Some retirees use a reverse mortgage or home equity to fund care rather than selling. Others simply set aside the equity from a downsizing sale in a dedicated reserve.

Because the rules around Medicaid, taxes, and insurance are complex and change, this is exactly the kind of decision to review with professionals. A CPA or elder law attorney who knows Virginia's rules can help you structure a plan that protects your savings and your family's future.

One practical first step: get a realistic picture of your own numbers. Talk with a financial planner about what you would need to set aside, and check with an insurance professional about whether long-term care coverage still makes sense at your age and health.

The Role of Home Equity

For many Virginia homeowners, the family home is the single most valuable asset they own, and the equity inside it is the quiet engine of a comfortable retirement. Selling at the right time, in the right market, can convert that equity into a flexible pool of cash that supports whatever comes next.

If you are weighing whether to stay or move, our guide to the true cost of staying vs. moving walks through the property taxes, maintenance, and utilities that quietly add up. And if you are leaning toward moving, our month-by-month downsizing timeline helps you plan the practical steps.