How to Build a Plan to Pay for Senior Care

Someone turning 65 today has almost a 70% chance of needing long-term care at some point, and Medicare won't pay for most of it.1 The families who handle that well aren't the ones with the most money. They're the ones who built a plan before the crisis hit. This guide lays out a plan to pay for senior care in five steps: figure out the care and what it costs, take stock of income and assets, find the payers you qualify for, put them in the right order, and get free help doing it.

You don't need to have all the answers before you start. You need to know the questions, and where each piece of the puzzle comes from.

A funding plan isn't a single decision. It's a sequence of them, and the order matters. Most families end up combining several payers rather than relying on one, so the goal is to know which ones apply to your situation and how to draw on them without tripping over the rules.2 Here's how to build that plan, one step at a time.

In This Guide

• Step #1: Estimate the Level and Cost of Senior Care
• Step #2: Inventory the Income and Assets
• Step #3: Identify the Payers You Qualify For
• Step #4: Sequence the Payers in Your Plan to Pay for Senior Care
• Step #5: Get Help Building Your Plan to Pay for Senior Care
• Where to Get Free Help
• Frequently Asked Questions
• Learn More

Step #1: Estimate the Level and Cost of Senior Care

Start with the care itself, because every dollar figure flows from it. The question isn't "how much money do we have." It's "what does this person actually need, and what does that cost where they live."

Care levels run along a spectrum. Some people need a few hours of help a week with errands and meals. Others need a home health aide several days a week, a move to assisted living, or full-time nursing care. The level can also change fast, so plan for where the need is likely heading, not just where it is today. On average, people need long-term care for about 3 years, but 1 in 5 will need it for more than 5.1

Then attach a price. The figures below are national medians from the CareScout 2025 Cost of Care Survey, released in March 2026 and the most recent national data. Your state or metro area can run well above or below them.3

In its 2025 survey, CareScout combined homemaker and home health aide services into a single "non-medical caregiver" category, priced at about $35 an hour, or roughly $80,080 a year at 44 hours of care a week.3 Multiply any of these by duration and the number gets serious quickly: at about $114,975 a year, three years in a semi-private nursing home room runs to roughly $345,000. That's the math a plan exists to handle. Our hub on how to pay for senior care breaks the costs down by setting in more detail.

Step #2: Inventory the Income and Assets

Once you know roughly what care will cost, take stock of what's available to pay for it. This step decides which payers are even on the table, because most of them turn on income and asset levels.

Pull together two lists. The first is income: Social Security, any pension, annuity payments, rental income, and required withdrawals from retirement accounts. The second is assets: bank and brokerage accounts, retirement accounts, the home and its equity, life insurance with cash value, vehicles, and anything else of real value.2 Note which assets are easy to convert to cash and which aren't, because a house doesn't help pay an assisted living bill until you sell it, rent it, or borrow against it.

This inventory does double duty. It tells you how long private money would last on its own, and it tells you whether the person is close to qualifying for need-based programs like Medicaid, where the asset limit for a single applicant is typically low. Get the real numbers down on paper now. Guessing here is where plans go wrong.

Step #3: Identify the Payers You Qualify For

With the care priced and the resources listed, the next step is matching them to payers. Almost nobody pays for long-term care from a single source, so think of this as building a roster rather than picking a winner.2 Here are the main players and who each one is for.

A few of these deserve a closer look as you sort out which apply.

Medicare is the one families most often misread. It pays for short-term skilled care, up to 100 days in a skilled nursing facility after a qualifying hospital stay, plus home health visits a doctor orders. It does not pay for ongoing custodial care, meaning the daily help with bathing, dressing, and eating that makes up the bulk of long-term care.1 Counting on Medicare to cover a nursing home stay is the single most expensive planning mistake.

Medicaid is the largest single payer for long-term care, and it's where many families land once savings run down. It's means-tested, so eligibility turns on income and assets, with limits and spousal protections that vary by state. Because the rules are detailed and the timing matters, this is the payer worth understanding early. Our guide to Medicaid planning strategies covers how families legally preserve assets and qualify.

VA benefits can add real monthly cash for wartime veterans and their surviving spouses who need help with daily activities, and that money can go toward any care setting. Long-term care insurance pays off only if a policy was bought years ago, so dig out any existing policy and read its benefit triggers. And private pay, drawn from savings, home equity, retirement accounts, and life insurance, fills whatever the others don't. We cover each of those private sources in its own guide, linked at the end.

Step #4: Sequence the Payers in Your Plan to Pay for Senior Care

Knowing which payers apply is half the job. The other half is the order you draw on them, because using them in the wrong sequence can waste money or accidentally disqualify someone from a program they'd otherwise get.

The logic is to use coverage that's already paid for or freely available before you spend down assets you might want to protect. In practice that often looks like this:

The order isn't rigid, and many people use several payers at once. A veteran can receive VA benefits and Medicaid together. Someone private-paying for assisted living today may shift to Medicaid later.2 The point of sequencing is to spend the right dollars first and to avoid moves, like gifting assets or pulling home equity at the wrong moment, that can trigger a Medicaid penalty. That's exactly where the next step comes in.

Step #5: Get Help Building Your Plan to Pay for Senior Care

You don't have to assemble this alone, and for most families the smart move is not to. Two kinds of help are worth knowing about: free public guidance to get oriented, and paid professional advice for the high-stakes legal and financial calls.

Start with the free option. The Eldercare Locator, a public service of the federal Administration for Community Living (ACL), connects families to local services and to their Area Agency on Aging (AAA), the state-designated agency that helps older adults find resources nearby. Call 1-800-677-1116 or visit eldercare.acl.gov.2 It costs nothing and it's the single best first phone call, covered in more detail in the next section.

For complex situations, bring in a professional. An elder-law attorney is the right call when asset protection or Medicaid eligibility is on the table, because the look-back rules and spousal protections are genuinely intricate and a wrong move can cost tens of thousands of dollars. A fee-only financial planner, one paid by you rather than by commissions on products they sell, can help you map income, assets, and the sequence of payers without a sales agenda.2 Paying for a few hours of good advice up front is usually far cheaper than the mistakes it prevents.

Where to Get Free Help

Before you pay anyone, use the public help that already exists. The federal government funds a network designed for exactly this moment, and the front door to it is one phone number. These are government resources, free, and not trying to sell you anything.2

The Eldercare Locator connects you to your local Area Agency on Aging (AAA), the state-designated agency for older adults, which can often help with benefits screening, in-home support, caregiver resources, and referrals to local programs you might not know exist. For families just starting out, that one phone call frequently surfaces options that change the whole plan.

Learn More

The steps above point outward to the rest of your plan. These guides go deeper on the pieces:

Find personalized help building a plan to pay for senior care at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.