In Chevy Chase, Maryland, senior care is a ladder with five rungs and roughly a $10,000-a-month spread between the bottom and the top: a few aide hours a week starts near $2,000 a month, and a semi-private skilled nursing bed in the Montgomery County market generally runs about $12,000 to $14,500 a month as of 2026. Most families do not fall off the ladder — they climb it, one rung at a time, and the plan that fails is the one that budgeted for the rung they started on.
Montgomery County prices above the Maryland median at every rung. The Maryland statewide median for a semi-private nursing home room sits in the range of roughly $11,000 to $12,500 a month, and for assisted living roughly $5,800 to $6,800; the Bethesda and Chevy Chase corridor typically quotes above both. These are ranges from published cost-of-care surveys trended forward to 2026, not quotes — pricing varies by building, room type, and care level, and a written fee schedule is the only number you should plan on.
This page climbs the ladder rung by rung with a real price at each, then does the arithmetic families actually need: assets divided by monthly cost equals months of runway. Medicaid gets one section, because for most households in this ZIP code it is the fifth question, not the first. Pine Lake Life Solutions provides education and a free policy review only; nothing here is legal, tax, or Medicaid-eligibility advice.
In This Article
- Rung One: Aide Hours in the House You Already Own
- Rung Two: Independent Living, and the Entrance-Fee Question
- Rung Three: Assisted Living in the Chevy Chase Corridor
- Rung Four: Memory Care
- Rung Five: Skilled Nursing in Montgomery County
- The Runway: Dividing What You Have by What It Costs
- The Medicaid Section: Maryland Medical Assistance and Where Montgomery County Fits
- Where an In-Force Life Insurance Policy Fits, and Where It Does Not
- Frequently Asked Questions
Rung One: Aide Hours in the House You Already Own
The first rung is the one nobody shops for, and it is where most Chevy Chase families spend their first year of care money. Home care aide time in the Washington metropolitan market generally runs roughly $33 to $40 an hour as of 2026, with agencies commonly requiring a four-hour minimum visit. That produces a price list families can plan against: four hours twice a week is about $1,200 a month; four hours daily is roughly $4,300 a month; eight hours daily lands near $8,700; and genuine round-the-clock coverage exceeds $24,000 a month, which is more than a private room in a skilled nursing facility in the same county.
That last comparison is the most useful number on this rung. The moment a household needs continuous supervision — typically driven by nighttime wandering, falls, or incontinence rather than by any single diagnosis — home care stops being the cheap option and becomes the expensive one. Families who miss that crossover keep paying a premium for the emotional comfort of the familiar address.
Chevy Chase has one structural advantage on this rung: it sits directly on the District line with dense access to Bethesda’s medical corridor, so specialists, adult day programs, and geriatric care managers are close. It also has a structural disadvantage — the housing stock includes many older single-family homes with bedrooms and bathrooms upstairs, and stair-related modifications, from a chair lift to a first-floor bath conversion, are a real capital cost that arrives on this rung and belongs in the budget.
Rung Two: Independent Living, and the Entrance-Fee Question
Independent living is housing with services, not care: meals, transportation, housekeeping, activities, and an emergency call system, with no hands-on assistance included. In the Chevy Chase and Bethesda corridor monthly fees commonly run in the range of roughly $3,800 to $7,500 depending on unit size, with a second-person fee on top.
The complication in this market is the continuing care retirement community model, where a substantial entrance fee buys future access to higher levels of care at a discounted rate. Entrance fees in the affluent inner Maryland suburbs commonly run from the low hundreds of thousands into seven figures, structured as fully refundable, partially refundable, or declining-balance contracts. The trade-off is straightforward to state and hard to evaluate: a refundable entrance fee ties up capital that could otherwise fund several years of private-pay care, but it caps the price of the rungs above and guarantees a place on them.
Two questions decide whether a CCRC contract is worth it for a specific family. First, what is the actual monthly cost at the assisted living and skilled nursing levels under this contract versus the market rate outside it? Second, is the entrance fee refund a contractual obligation with an escrow behind it, or a claim against the community’s future occupancy? Ask for the audited financial statements and the residency agreement, and have an attorney read the refund provision. Maryland regulates continuing care communities at the state level, and the Maryland Department of Aging is the right agency to ask about a community’s registration status.
Rung Three: Assisted Living in the Chevy Chase Corridor
Assisted living adds hands-on help with bathing, dressing, medication administration, and mobility. In Montgomery County, base rates in the Chevy Chase and Bethesda corridor commonly quote in the range of roughly $6,500 to $9,000 a month as of 2026, against a Maryland median nearer $5,800 to $6,800. The building’s base rate, however, is not the price.
Almost every assisted living community in this market layers a care-level surcharge on top of rent, tiered by an assessment of how much help the resident needs, and re-assessed periodically. A resident who enters at level one and progresses to level three can see $1,000 to $2,500 a month added without changing apartments. Add a one-time community fee at move-in, commonly one to two months of rent, plus charges for incontinence supplies, escorts to meals, or a second daily medication pass in some buildings.
Maryland licenses assisted living programs by level, and the Office of Health Care Quality within the Maryland Department of Health both licenses and inspects them. Ask for the licensure level, the most recent inspection findings, and the written schedule of care-level charges before signing. A community that will not put the care-level ladder in writing is telling you something about the second year.
Rung Four: Memory Care
Memory care is assisted living with a secured environment, higher staffing ratios, and dementia-specific programming. In this corridor it generally prices roughly $1,000 to $2,500 a month above the same community’s assisted living rate, which puts the practical range in Montgomery County near $8,000 to $11,000 a month as of 2026 — and higher in the newest purpose-built buildings.
Two cost mechanics matter on this rung. First, memory care is often billed all-inclusive rather than base-plus-levels, which makes it easier to budget but harder to compare against an assisted living quote; convert both to a fully loaded monthly number before comparing. Second, memory care is where families most often discover that a community can decline to keep a resident whose needs exceed its license — behavioral episodes, two-person transfers, or skilled nursing needs can trigger a discharge notice, and the next rung is not optional at that point.
Because Chevy Chase households frequently hold most of their wealth in a house rather than in liquid accounts, this is the rung where funding pressure typically becomes acute. It is also the rung where a life insurance policy that has been quietly costing money for thirty years is worth valuing rather than surrendering — see the honest version of that analysis further down.
| Rung | Chevy Chase / Montgomery County, 2026 | Maryland median | Runway on $400,000 |
|---|---|---|---|
| Home aide, 8 hrs/day | about $8,700/month ($33-$40/hour) | Lower statewide; hourly rates $28-$34 | about 46 months |
| Independent living | $3,800-$7,500/month plus possible entrance fee | $3,000-$5,500/month | about 62 months at $6,400 |
| Assisted living | $6,500-$9,000/month plus care-level fees | $5,800-$6,800/month | about 53 months at $7,500 |
| Memory care | $8,000-$11,000/month | $6,800-$8,500/month | about 42 months at $9,500 |
| Skilled nursing, semi-private | $12,000-$14,500/month | $11,000-$12,500/month | about 31 months at $13,000 |
| Skilled nursing, private | $14,000-$17,000/month | $12,500-$14,500/month | about 26 months at $15,500 |
Rung Five: Skilled Nursing in Montgomery County
Skilled nursing is the top of the ladder: 24-hour licensed nursing, physician oversight, and rehabilitation services. In the Montgomery County market as of 2026, semi-private rooms generally run in the range of roughly $12,000 to $14,500 a month and private rooms roughly $14,000 to $17,000, above the Maryland medians of about $11,000 to $12,500 and $12,500 to $14,500 respectively. Chevy Chase itself has limited facility inventory inside its own small boundaries, so families almost always place in nearby Montgomery County communities — Bethesda, Silver Spring, Rockville — which is worth knowing before touring, because “near Chevy Chase” is the real search radius.
What the daily rate covers: room, board, nursing care, meals, activities, laundry, and routine supplies. What arrives on top: private room differential, therapies beyond covered days, some pharmacy arrangements, bed-hold charges during a hospitalization, private-duty companions, salon services, and cable or telephone in some buildings.
Medicare does not solve this rung. Medicare Part A may cover a limited skilled nursing stay after a qualifying inpatient hospital admission, with full coverage for a limited number of days and substantial daily coinsurance thereafter — roughly $210 a day in recent years and indexed annually, so verify the 2026 figure with Medicare. It is a rehabilitation benefit measured in weeks, not a long-term care benefit. Before choosing a facility, compare staffing and quality ratings on Medicare’s Care Compare tool, which publishes inspection results, staffing levels, and quality measures for every certified facility in the county.
The Runway: Dividing What You Have by What It Costs
This is the arithmetic that determines every other decision. Take liquid assets — bank accounts, brokerage accounts, certificates of deposit, the cash value inside a permanent life insurance policy — and divide by the fully loaded monthly cost of the rung in question.
On $400,000 of liquid assets in Chevy Chase as of 2026: about 46 months at $8,700 for eight daily hours of home care; about 53 months at $7,500 of assisted living; about 42 months at $9,500 of memory care; and about 31 months at $13,000 for a semi-private skilled nursing bed. Net income changes the picture materially — a household with $6,000 a month of Social Security and pension income facing a $13,000 bill is only drawing $7,000 a month from savings, which stretches the same $400,000 from 31 months to about 57.
Two Chevy Chase-specific adjustments belong in that calculation. First, the house is usually the dominant asset here: median home values in the Chevy Chase area run well above $1 million, among the highest in Maryland, so home equity rather than liquid savings is the real balance sheet. That makes a home equity line, a bridge loan, or a sale timed to a move a serious funding lever in this market in a way it is not in most of the country. Second, the carrying cost of that house does not stop when a parent moves — property taxes, insurance, utilities, and lawn care on a $1.2 million property can run $2,500 a month or more, and that figure has to be subtracted from the runway until the house is sold or rented.
Rerun the runway every six months. Care levels escalate, and the number that mattered last year is not the number that matters now.
The Medicaid Section: Maryland Medical Assistance and Where Montgomery County Fits
When the runway runs out, the program is Maryland Medical Assistance, administered by the Maryland Department of Health, with long-term services delivered through Community First Choice and the Community Options waiver for people at home and through institutional Medical Assistance for nursing facility residents. Countable resources for a single applicant must come down to roughly $2,500 as of 2026 — Maryland’s figure is higher than the $2,000 used by many states, and it should be verified with the agency before you rely on it. Maryland reviews 60 months of transfers before the application for uncompensated gifts, imposing a penalty period rather than a denial, and operates an estate recovery program that seeks reimbursement from the estate after death.
Chevy Chase is not a single municipality — it is a cluster of small jurisdictions in Montgomery County, including the Town of Chevy Chase, Chevy Chase Village, Chevy Chase Sections 3 and 5, Chevy Chase View, and Martin’s Additions, alongside an unincorporated area that shares the name. None of them administers Medicaid. The application goes to Montgomery County, where eligibility for long-term care Medical Assistance is handled through Montgomery County government’s health and human services eligibility operation, headquartered in Rockville, the county seat, roughly ten miles up Rockville Pike.
Free help, all real: Maryland Access Point is the state’s Aging and Disability Resource Center network, and Montgomery County’s Aging and Disability Services division within county DHHS operates the local MAP and serves as the county’s Area Agency on Aging. Maryland’s State Health Insurance Assistance Program (SHIP), coordinated by the Maryland Department of Aging, answers Medicare and supplement questions at no charge. The Maryland Insurance Administration regulates insurers and licensing. Given Montgomery County home values, a Maryland elder law attorney is not a luxury on this rung — estate recovery against a $1 million-plus property is the single largest number in most local plans. Our overview of Maryland Medicaid asset and income limits covers the statewide figures, and the Chevy Chase spend-down page works through the eligibility mechanics in detail.
Where an In-Force Life Insurance Policy Fits, and Where It Does Not
A permanent life insurance policy is an asset on the runway calculation, and families routinely undervalue it. There are four ways it can fund care, in ascending order of typical yield: borrow against the cash value, which preserves a reduced death benefit but accrues interest; surrender it for cash surrender value, which is fast and usually the smallest number; elect an accelerated death benefit rider if one exists and the insured is terminally or chronically ill, which costs nothing because it is already in the contract; or sell it in the secondary market, where federal research on the market (GAO-10-775) found sellers typically received roughly 10% to 35% of face value and several times cash surrender value.
Now the honest cases where a policy does not help. Timing. A secondary-market transaction typically runs 60 to 120 days from review to funding, so it cannot pay a bill that is due in three weeks. Size. Below roughly $100,000 of death benefit, market interest thins out quickly. Health. Offers track life expectancy; an insured in strong health for their age will see thin offers or none, which is exactly the profile of many people entering assisted living rather than skilled nursing. Term insurance with no conversion right. A term policy that cannot be converted to permanent coverage generally has no market value at all. A surviving spouse who needs the benefit. If the death benefit is the plan for the widow or widower — a common structure in households where a federal pension survivor benefit is reduced — selling solves this year and creates a worse problem later.
The practical step is small: send the policy cover page showing carrier, face amount, and policy number for a free review, or call (305) 209-7183. If the answer is that the policy has no market value, you will hear that directly, and the cash value figure you get from the carrier still belongs in the runway math either way. Readers whose question is purely about a sale can start with our Chevy Chase life settlement page.
Frequently Asked Questions
How much does a nursing home cost in Chevy Chase, Maryland?
As of 2026, semi-private rooms in the Montgomery County market generally run roughly $12,000 to $14,500 a month and private rooms roughly $14,000 to $17,000, above Maryland medians of about $11,000 to $12,500 and $12,500 to $14,500. Chevy Chase itself has little facility inventory, so most families place in Bethesda, Silver Spring, or Rockville.
Is assisted living cheaper than home care here?
It depends on hours. In this market, home aide time runs roughly $33 to $40 an hour, so four hours a day is around $4,300 a month — less than local assisted living. But eight hours a day is about $8,700 and 24-hour coverage exceeds $24,000, well past assisted living and even past a private nursing home room. The crossover usually arrives with continuous supervision needs.
How long will $400,000 last in Chevy Chase?
About 31 months against a $13,000 semi-private nursing home bill, or roughly 53 months at $7,500 of assisted living, before counting income. A household with $6,000 a month of Social Security and pension income only draws $7,000 from savings against that $13,000 bill, which stretches the same $400,000 to about 57 months.
Which county office handles Medicaid for a Chevy Chase resident?
Montgomery County. Chevy Chase is a cluster of small jurisdictions rather than one city, and none administers Medicaid. Long-term care Medical Assistance eligibility is handled through Montgomery County government’s health and human services eligibility operation, headquartered in Rockville, the county seat, with the state program run by the Maryland Department of Health.
Does Medicare pay for long-term nursing home care?
No. Medicare Part A may cover a limited skilled nursing stay following a qualifying inpatient hospital admission, with full coverage for a limited number of days and substantial daily coinsurance after that — roughly $210 a day in recent years, indexed annually, so verify the 2026 amount. It is a rehabilitation benefit measured in weeks, not long-term care coverage.
Are continuing care retirement community entrance fees worth it in this area?
It depends on the contract. Entrance fees in the affluent inner Maryland suburbs commonly run from the low hundreds of thousands upward, and the value turns on the monthly rate at higher care levels and on whether the refund is escrowed or a claim against future occupancy. Ask for audited financials and have an attorney read the refund provision.
Can we use my father’s life insurance policy to pay for care?
Possibly, through a policy loan, surrender, an accelerated death benefit rider already in the contract, or a sale in the secondary market. Federal research found sellers typically received roughly 10% to 35% of face value. It will not help if the policy is small, the insured is healthy for their age, the term coverage cannot be converted, or a surviving spouse needs the benefit.
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Related Reading
- Medicaid Spend Down Chevy Chase Md
- Life Settlements Chevy Chase Md
- Maryland Medicaid Asset Income Limits
- Life Settlement Taxes Maryland
- Sell Life Insurance Policy Anne Arundel County Md
- Nursing Home Medicaid Spend Down
- How Much Is My Policy Worth
- Lapse Vs Surrender Vs Settlement
Pine Lake Life Solutions does not purchase life insurance policies and does not provide legal, tax, or investment advice. Information provided is for educational purposes only. Eligibility for any option, including life settlements, is not guaranteed and depends on individual circumstances, policy terms, underwriting, and market conditions. Consult independent legal, tax, or financial professionals before making decisions regarding a life insurance policy.