This Is the Worst State to Live in If You’re Over 65

As you prepare to retire or relocate, one crucial factor many Americans let slip is affordability. While the idea of a worry-free retirement is enviable, it isn’t realistic. Some states make retiring easier — and more affordable — while others are tougher on your budget and lifestyle.

This analysis of popular locations provides insight into which states are tougher to retire in, which are expensive to live in general (page 7) and the worst state to live in that will definitely surprise you (page 15).

15. South Carolina

Charleston, South Carolina, USA
Assisted living costs $34,000 on average in South Carolina. | Sean Pavone/iStock/Getty Images
  • $34,000 annual cost for assisted living
  • $77,000 annual cost for nursing home

The warm, summery state is a popular destination for retired couples, singles, and even families. However, when it comes to the cost of care for seniors, it rates around average.

The average cost for one person to seek assisted living is $34,000, while nursing home costs more than double that figure. Hiring a home health aide may be the best bet for senior citizens who need extra help — on average, an aide costs $45,000 annually.

Next: This state is fairly affordable and fun for retirees.

14. Tennessee

Nashville, Tennessee
Tennessee is relatively affordable. | SeanPavonePhoto/iStock/Getty Images
  • $43,000 annual cost for assisted living
  • $73,000 annual cost for nursing home

Tennessee is pretty affordable — and fun — for senior living. It’s about $10,000 cheaper than the national median to live in a nursing home, and an in-home health aide is less than $50,000.

Where retiring is concerned, a two-bedroom in Tennessee will run you an average of $995 a month. According to Numbeo, the cost of living in Nashville ranks 169th out of 534 major cities worldwide.

Next: The perks (and downfalls) of retiring in the Lone Star state.

13. Texas

Austin, Texas
Some parts of Texas are more affordable than others. | Roschetzky/iStock/Getty Images
  • Texas scores high for the cost of senior care, the cost of living, and elderly and family support services
  • The only issue is Texas’s size

The median cost for a nursing home in the Lone Star State is $54,000. While the median is cheaper than the national average, the costly cities of Texas make living in a flourishing area tough for most retirees.

“I live in Houston, and the cost and availability of senior services here is going to be vastly different than in many other parts of the state,” Jason Biddle, a senior care veteran and creator of The Helping Home, told Caring. “But if you live in Texas and you need to stretch your dollar, the good news is you could probably find a more affordable county without leaving the state.”

Next: This state balances its high cost of senior services with its low cost of living

12. Ohio

Sandusky, Ohio aerial photo
Senior care is expensive in Ohio, but the overall cost of living is low. | Ken Winters, U.S. Army Corps of Engineers/Wikimedia Commons
  • Cost of senior living in Ohio is on par with national medians
  • The average nursing home cost in Ohio is $81,000

While the Buckeye State starts off our list of costly senior care states — assisted living facilities run around $50,000 — the low cost of living in general balances it out. An in-home aide is the cheapest senior living option at $48,000 a year.

“Senior services might cost a bit more than some of these other Top 10 states, but the low cost of living winds up balancing that out a little bit,” Stephan Weiler, a professor of economics, confirmed.

Next: This state has popular (and expensive) cities for retired Americans.

11. Arizona

Monument Valley West Thumb, Arizona, USA
Arizona is a popular retirement destination. | lucky-photographer/iStock/Getty Images
  • Multiple Arizona cities are popular retirement destinations
  • It ranked third for the overall cost of living and 23rd for the cost of senior care services

Arizona is an increasingly popular state for retirees — Scottsdale, Arizona is the most popular city nationwide for seniors — and it’s still fairly affordable. The annual costs for assisted living facilities are a bit higher than the national median, while nursing homes cost about $10,000 less ($76,500).

The average rent for a studio in Arizona is $725, and compared to other major U.S. cities like Miami and Dallas, living in a hub like Phoenix is significantly cheaper.

Next: The seafood may be great, but it doesn’t come cheap.

10. Maine

Portland Head Lighthouse in Fort Williams park
Maine is expensive, but the quality of senior support services is high. | krblokhin/iStock/Getty Images
  • Being a senior in Maine isn’t cheap
  • Assisted living facilities and nursing homes will run you $24,000 more than the country’s median cost

While Maine is an expensive city to retire in — it ranks 39th for cost of living and 39th for the cost of senior services — it also ranks high for the quality of its elderly support services.

“For having such potentially secluded regions I think that’s a pretty promising stat for Maine,” Jim Miller, the publisher of told “But if you live in a part of the state where [they] actually have abundant access, I imagine it’s probably going to be expensive.”

Next: This great state for seniors comes at a great cost.

9. New Hampshire

Rye, New Hampshire, USA
Senior care costs more than average in New Hampshire. | travelview/Getty Images
  • The median costs for home aides, nursing homes, and assisted living facilities all exceed the national rates

The winter chill isn’t the only challenge New Hampshire presents for seniors: the Granite State ranks 44th for the overall cost of living and 45th for senior care services. The median cost per year for a home aide is over $60,000 and a nursing home will run you over $115,000 a year.

Still, New Hampshire proves a great place for access to supportive senior and family programs (it ranks 12th).

Next: This state’s unique landscape makes for an expensive retirement destination.

8. Delaware

Delaware lighthouse
A year in a nursing home in Delaware costs more than $127,000, on average. | Eva Hambach/AFP/Getty Images
  • The state is unique as it has both rural and coastal towns
  • The cost of living is moderately expensive but the price of everyday life fluctuates

Delaware has rural and isolated areas as well as coastal towns and cities that run fairly expensive compared to other U.S. cities. Costal, popular cities like Wilmington are around 8% more expensive than the national average for cost of living according to Payscale.

Delaware ranks 33rd for the overall cost of living and 41st for senior affordability. The median cost to live in a nursing home each year is $127,750, significantly higher than the national average of $86,500.

Next: It’ll come as no surprise this city is expensive regardless of your age

7. New York

New York City
Unsurprisingly, New York is expensive for retirees. | Sean Pavone/iStock/Getty Images
  • New York ranked 13th for elderly and family caregiver support services
  • It’s second-to-last for the overall cost of living

The median costs for home aides and assisted living facilities in New York are in line with the national medians. A nursing home, on the other hand, will run you about $47,000 more than the national average at over $130,000.

“I often say New York City and the surrounding metro area is one of the best places for seniors,” NYC-based eldercare advisor Joanna Leefer told “… it has so many accessible services and you can easily get almost anywhere you need to. If you’re in an upstate suburb it might not be as easy, but it will be cheaper.”


6. Alaska

The beautiful view of Wrangell-St Elias National Park
Alaska’s remoteness makes it expensive for seniors. | Z-lex/iStock/Getty Images
  • This state ranked last for the overall cost of senior care services
  • The median cost of a nursing home is nearly $300,000

Alaska senior care services are expensive for the exact opposite reason New York is — it’s remote and undeveloped nature. Hiring an in-home health aide costs nearly $63,000 and a nursing home is $206,000 more than the national average cost.

On a more positive note, Alaska ranks 10th for elderly caregiver support. believes this is a result of the relatively high population densities in the state’s major cities, Anchorage and Fairbanks.

Next: This state is pretty expensive to retire in … and we wouldn’t want to

5. North Dakota

An oil rig near Bismarck, North Dakota
North Dakota ranks near the bottom for the quality of elderly and family caregiver support. | Andrew Burton/Getty Images
  • Similar to Alaska, North Dakota’s remote nature affects affordability
  • The median cost for a nursing home is $127,630 annually

North Dakota placed 47 for the quality of elderly and family caregiver support. Its weather poses a problem for plenty of seniors as well. “Few people, especially seniors, can handle a climate like North Dakota’s … so you don’t have dense, urban clusters like you do in some other states,” said Jim Miller.

The best financial option for senior care is assisted living — the median cost is $36,000 a year, which is on par with other states and the national average.

Next: It may be your dream to retire here, but it’s also extremely expensive.

4. Hawaii

Maui, Hawaiian Islands
Life in Hawaii is expensive. | Digital Vision/Getty Images
  • Hawaii’s climate is to blame for the high cost of elderly care and living in general

Similar to North Dakota, Hawaii’s weather is to blame for the high cost of elder care services. Unlike North Dakota, it’s an extremely popular and desirable spot to retire. Hawaii falls in last place for the overall cost of living — housing, food, drinks, and insurance will break the bank there — and nursing homes are expensive as well.

The popular tourist destination charges an average $137,000 annually to live in a nursing home and around $60,000 a year for an in-home health aide.

Next: The most densely-populated U.S. state costs more than you’d expect

3. New Jersey

Newark, New Jersey
Living in New Jersey is costly. | SeanPavonePhoto/iStock/Getty Images
  • New Jersey is expensive due to its position as the most densely populated state in the U.S.
  • It’s one of the top 10 most expensive states for senior care services

The Garden State is prepared to handle senior services — it ranked 24th for caregiver support — but these services don’t come cheap. Hiring a home health aide is the best option as it falls in line with the national average, but the median cost of one year in a nursing home is $120,450, more than most families can afford.

The annual cost of residing in an assisted living facility is $24,000 above the national median as well. And while the coastline cities are enviable retirement destinations, they’ll burn a hole in your bank account for sure.

Next: All of this state’s elder care costs exceed national averages


2. Rhode Island

Providence, Rhode Island,
East Coast states like Rhode Island tend to be more expensive. | Source: iStock
  • Rhode Island reveals one truth about East Coast states and senior living
  • All of its elder care costs exceed the national averages

The analysis found that Rhode Island inevitably has more resources for seniors, yet it still only ranks 34th for family caregiver support. “Dense, popular, East Coast states are always going to be more expensive across the board,” Stephan Weiler revealed.

The New England state ranked 40th for the cost of senior care and 42nd for the overall cost of living. An assisted living facility will run you (or your parents) $61,860 per year while a nursing home puts you back $101,835 on average.

Next: The most expensive state for your aging parents, revealed

1. Wyoming

The sun hits the tips of the Grand Tetons October 5, 2012 in the Grand Teton National Park in Wyoming
Wyoming is the most expensive state for retirees. | Karen Bleier/AFP/Getty Images
  • It’s not an expensive state to call home
  • It’s still the most expensive state for aging adults

Wyoming isn’t necessarily an expensive state to call home, but its supportive policies and programs — or lack thereof — make it the most expensive state for retirees.

“This isn’t all that surprising given how rural and sparse Wyoming is,” Weiler said. “They simply have fewer facilities and support networks than other more densely populated parts of the country.”

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