Winston-Salem Senior AdvisorHow much does assisted living cost in Winston-Salem?
No local figure is published; CareScout's 2025 North Carolina median is $74,400 a year, about $6,200 a month, and quotes around Winston-Salem spread above and below it.
| North Carolina median, 2025 | Per year | Per month (approx.) | Change from 2024 | U.S. median per year |
|---|---|---|---|---|
| Assisted living | $74,400 | $6,200 | -2% | $74,400 |
| Nursing home, semi-private room | $116,800 | $9,733 | +10% | $114,975 |
| Nursing home, private room | $129,575 | $10,798 | +9% | $129,575 |
| Home care, non-medical (44 hrs/week) | $68,640 | $5,720 | 0% | $80,080 |
| Adult day health care (5 days/week) | $21,970 | $1,831 | n/a | $24,700 |
CareScout 2025 Cost of Care Survey, North Carolina results (released March 2, 2026). Monthly figures are the annual medians divided by 12. Home care is priced at 44 hours a week for 52 weeks (exactly $30 an hour). CareScout's North Carolina release publishes statewide medians only: there is no Winston-Salem or Forsyth County figure and no memory care figure.
Does Medicare pay for assisted living?
No. Medicare does not pay for room, board or personal care in an adult care home or family care home; it pays only for medical services, including home health and hospice delivered there.
Private funds, long-term care insurance, VA pension and Special Assistance are the usual sources.
What is Special Assistance and who gets it?
State/County Special Assistance is a monthly cash supplement for low-income residents of licensed adult care homes that accept it, paying up to $1,397 a month (Basic Rate) or $1,792 in a special care unit in 2026.
| State/County Special Assistance in 2026 | Monthly amount |
|---|---|
| Basic Rate, adult care home or family care home | $1,397 |
| Enhanced Rate, special care unit | $1,792 |
| Personal needs allowance kept by the resident | $70 |
| Countable income must be under (Basic) | $1,467 |
| Countable income must be under (Enhanced) | $1,862 |
Source: NCDHHS Dear County Director letter EFS-SA-04-2025 (2026 Special Assistance rates), effective January 1, 2026. Each income limit is the rate plus the $70 allowance.
Is there a Medicaid waiver for assisted living in North Carolina?
No. North Carolina has no Medicaid waiver that pays assisted living rent; Special Assistance helps low-income residents and brings Medicaid eligibility, and Medicaid personal care services can then pay for some hands-on help.
CAP/DA, the state's Medicaid waiver for help at home, does not pay for adult care homes.
How much does home care cost per hour around Winston-Salem?
CareScout's 2025 North Carolina median is $30 an hour for a non-medical home care worker, about $5,720 a month at 44 hours a week.
| Paid hours of help each week | Monthly cost at $30/hour | Versus the $6,200 assisted living median |
|---|---|---|
| 12 | $1,560 | less |
| 24 | $3,120 | less |
| 36 | $4,680 | less |
| 44 | $5,720 | less |
| 60 | $7,800 | more |
| 84 | $10,920 | more |
| 168 | $21,840 | more |
Who can help us plan how to pay for care?
The county department of social services explains Medicaid and Special Assistance, the Piedmont Triad Regional Council Area Agency on Aging ((336) 904-0300) offers free options counseling, county veterans services officers help with VA pension, and an elder law attorney helps when assets or a spouse are involved.
None of the public agencies charges for help with applications.
