North Carolina Seeing Growing Cost for LTC
North Carolina draws many newcomers from other states — drawn by its climate, relatively affordable housing, and diverse geography that includes mountains, coastlines and cities. According to the U.S. Census Bureau and state estimates, North Carolina’s population now exceeds 11 million, making it the ninth-largest U.S. state by residents.
The state offers many attractions beyond its size. It combines a lower cost of living than many states, access to major population centers with top medical services, and a mix of natural beauty — from mountain ranges to seaside coasts. It also offers culture, history, professional and college sports, and generally mild weather year-round.
At the same time, North Carolina is increasingly a retirement destination. Its older-adult population is growing rapidly. As of 2025, people age 65 and older make up about 17 percent of North Carolina's population.
This shifting age mix, with a growing share of older adults and a less rapidly expanding younger generation, will pose long-term-care challenges in the years ahead, impacting the cost of long-term care services.
Care Providers Preparing for Increasing Demand
Amada Senior Care is one of the leading in-home health agencies in the country. Like most long-term care providers, they are preparing for the greater demand for services.
Traci Bissett, who runs Amada Senior Care for Eastern North Carolina says the state is definitely getting older. She points out to the migration of many people, especially seniors, from other states. Bissett says that the number of North Carolinians over age 65 is expected to increase by 61% by the year 2038.
"As the demand for long-term health care grows, the cost of care will also grow. When working with the families of our senior clients, we see their shocked reaction to the cost of care. We hope to educate family members to use this experience to prepare for their long-term care expenses," Bissett explained.
According to the LTC NEWS Cost of Care Calculator, the state median cost of home health care services now averages $4,168 a month based on a 44 hour week. By the year 2044, the average median cost is expected to be $7,200 a month.
Brad and Gwen Smith, from Amada's Charlotte office, anticipate long-term health care costs and demand will increase significantly over the next several years.
"Here in Charlotte, many home care agencies have a waiting list for client start dates because there are more care needs than there are care providers. Although our prices have remained steady, we have seen our competitors raise their rates for care over the past year, they said.
The aging population will also put additional demand for adult day care centers, assisted living facilities, memory care facilities, and nursing homes. The costs will reflect the rising demand for services.
For example, according to the LTC News Cost of Care Calculator, the average base cost of an assisted living facility in Greensboro, NC, runs $4,465 a month. Additional charges will be assessed based on the number of services a person may require. However, by the year 2045, this average base cost is expected to run $7,606 a month. These costs would significantly impact the finances of families unprepared for long-term care.
Location Makes a Big Difference in Care Costs
However, location makes a big difference. The average cost in Rocky Mount, NC, is much lower. You see the same for other long-term care services. If you are thinking of relocating, one of the considerations should be the cost of long-term care and your resources to pay for these costs.
North Carolina is one of 45 states that offer Partnership Long-Term Care Insurance policies that offer dollar-for-dollar asset protection. North Carolina reciprocates with other states, so North Carolina will honor the additional asset protection if you already have a Partnership LTC policy from another state.
The best time to obtain Long-Term Care Insurance coverage is when you are in your 40s or 50s. In fact, most peopel aquire an LTC policy between teh ages of 47 and 67. No matter the age, your relatively good health today gives you the ability to get a policy as policies are medically underwritten.
LTC Insurance Helps but Premiums Vary Over 100% Between Companies
Keep in mind that premiums can vary over 100% between insurance companies. Be sure to seek the help of a licensed and experienced LTC Insurance specialist to help you navigate the many companies and options that are available. Find a trusted and qualified specialist by clicking here. According to AHIP’s 2025 Long-Term Care Insurance report, insurers have paid $5,152,268,180 in tax-free long-term care benefits since the first LTC policies were issued in the state. Those benefits help families access quality care without placing the burden of caregiving or financial stress on loved ones. They also preserve family budgets by paying for in-home care, assisted living, memory care, and nursing home services that would otherwise drain savings.
Aging is happening everywhere, not just in North Carolina. Many people, as they approach retirement, start looking to relocate. North Carolina is one of the more popular destinations. No matter where you live, planning for the future changes in your health, body, and mind is a critical part of a retirement plan.