Author: O.K. Hogan | REALTOR®/BROKER, CCIM, SFR
After more than 30 years of visiting Carteret County, and 25 years living in Beaufort, I have seen first-hand how families in North Carolina face the tough but important choice of senior housing. The question usually comes down to this: What is the difference between senior living and independent living, and which one is right for us?
I have watched neighbors, church members, and even close friends wrestle with these decisions. One of my Morehead City clients used to call her mother three times a day to remind her about medication. She wanted her mom to keep her independence but knew she needed a safer setup. That is the balance so many families are trying to strike.
This guide explains the difference between assisted living and independent living in plain language. We will compare care levels, costs, and state programs here in North Carolina. Along the way, I will add stories from my local experience and my financial background as a retired accountant and Certified Commercial Investment Member.
If you are considering senior-friendly housing in Coastal North Carolina, our dedicated resource may be the best next step. See our Senior Citizen Housing Alternatives on the North Carolina Coast page for real listings and community options. It covers low-maintenance homes, 55+ active adult communities, and senior-focused alternatives that align with the decisions discussed here.
Key Takeaways
- According to the 2024 CareScout Cost of Care Report, assisted living in North Carolina has a median cost of $76,245 per year (about $6,354 per month). The national median is $70,800, up about 10 percent year-over-year, and the National Investment Center (NIC) reports occupancy rising from 86.5 percent to 87.2 percent in 2024.
- Data from A Place for Mom’s 2025 Cost Guide shows that independent living typically costs about 40 percent less than assisted living, with most NC independent living communities averaging $3,550 per month.
- Assisted living communities in NC are licensed as Adult Care Homes by the NC Division of Health Service Regulation. Independent living is not licensed as a health care setting, though some register as Multi-Unit Assisted Housing with Services (MUAHS), which is a registration program only.
- Medicare does not cover assisted living rooms and boards. Some residents qualify for NC’s State and County Special Assistance or Special Assistance In-Home.
Assisted Living and Independent Living Comparison in NC
| Feature | Assisted Living in NC | Independent Living in NC |
| Care level | Help with ADLs, medication, meals, and supervision | No personal care included |
| Oversight | Licensed and inspected by NC DHSR Adult Care Licensure Section | Not health care licensed; some register as MUAHS |
| Typical monthly cost | About $6,354 per month | About 40 percent less; averaging $3,550 per month |
| Best fit | Seniors who need daily support | Active adults seeking convenience and lifestyle |
What Each Senior Living Option Means
Assisted Living
Assisted living in NC is officially called an Adult Care Home. These facilities provide housing, meals, and support with daily living, and they are licensed and inspected by the NC Division of Health Service Regulation. Families can view inspection histories and star ratings online before making a decision.
Independent Living
Independent living is all about maintenance-free living, activities, and social amenities. It is not a licensed health care setting. Some register under Multi-Unit Assisted Housing with Services, but these are not inspected or monitored by the state.
Memory Care and Special Care Units
For seniors with dementia, Special Care Units provide higher security and staff ratios within assisted living communities.
Senior Living Costs in North Carolina
Assisted Living Cost
- North Carolina: The CareScout 2024 report lists the NC annual median at $76,245 (~$6,354/month).
- United States: National assisted living costs reached $70,800 in 2024, with a 10 percent increase over 2023. NIC’s Senior Housing Occupancy Report shows occupancy rose from 85.1 to 85.6 percent in 2024.
Independent Living Cost
- A Place for Mom reports Independent Living costs are about 40 percent less than assisted living.
- In North Carolina, Independent Living communities range from $2,000 to $5,000 plus, with coastal cities such as Wilmington and Morehead City trending higher.
For examples of senior-friendly homes that fit different budgets, see Senior Citizen Housing Alternatives on the NC Coast.
How to Pay for Senior Living in North Carolina
Private Pay and Insurance
Most families rely on savings, pensions, or proceeds from home sales. Long-term care insurance can also help.
Medicare
According to Medicare.gov, Medicare does not cover assisted living rooms and boards. It covers medical services and short-term skilled nursing under specific conditions.
State and County Special Assistance
North Carolina offers State and County Special Assistance (SA) to help low-income residents pay for adult care homes. Recipients automatically qualify for Medicaid.
Special Assistance In-Home
For those who qualify for assisted living but want to remain at home, the Special Assistance In-Home program provides a monthly allowance and Medicaid eligibility.
Senior Living Regulation and Safety in NC
- Assisted living facilities are regulated by the NC DHSR Adult Care Licensure Section.
- Families can review inspections and penalties through the NC DHSR Star Rating System.
- Independent living facilities are not licensed health care providers, even if registered as MUAHS.
Senior Living Market Trends
- The CareScout 2024 Cost of Care Report found assisted living costs rose about 10 percent year-over-year.
- The National Investment Center (NIC) reported occupancy increased to 87.2 percent in 2024, up from 86.5 percent the year before.
Step-by-Step Guide: How NC Families Can Choose the Right Option
- Define care needs.
- Set a budget using NC Assisted Living and Independent Living benchmarks.
- Shortlist 3–5 communities.
- Tour with a checklist.
- Verify oversight through NC DHSR inspections.
- Explore funding (SA, SAIH, VA Aid and Attendance).
- Plan the move-in and reassess at 30 days.
Use our Senior Citizen Housing Alternatives on the NC Coast page for listings and tools that make this step easier.
Frequently Asked Questions
Is Independent Living Cheaper than Assisted Living in NC?
Yes. According to A Place for Mom’s cost guide, Independent Living is about 40 percent less expensive than Assisted Living.
Does Medicare Cover Assisted Living Costs?
No. Medicare.gov makes clear that room and board in Assisted Living are not covered.
What If We Cannot Afford Assisted Living in NC?
The NC Special Assistance program and Special Assistance In-Home provide support for qualifying residents who can’t afford Assisted Living.
Who Regulates Assisted Living in NC?
The NC DHSR Adult Care Licensure Section licenses and inspects Adult Care Homes.
Conclusion
Choosing between senior living and independent living is about more than money. It is about dignity, safety, and daily lifestyle. Some of my favorite moments have been seeing neighbors thrive after choosing the right community, finding more time for fishing, church, and grandchildren.
If you are considering options in Coastal North Carolina, start with our Senior Citizen Housing Alternatives on the NC Coast page. It showcases homes and communities designed for seniors. Then call Star Team Real Estate at (252) 727-5656. We will walk with you through each choice, with clarity and compassion.
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