Long-Term Care Cost and How Long You'll Need It

Someone turning 65 today has almost a 70% chance of needing long-term care at some point.1 It's a number worth planning around. This guide answers the two questions behind it: how likely you are to need care and for how long, then what that care actually costs and who pays the bill.

Start with the odds. Then look at the price tables and the payers below.

Will You Even Need It?

Probably. Someone turning 65 today has almost a 70% chance of needing some type of long-term care in their remaining years. That figure comes from the federal Administration for Community Living, which runs LongTermCare.gov.1

Long-term care means help with everyday activities: bathing, dressing, eating, getting around. It's not the same as the skilled medical care you get after surgery. Most of it is hands-on daily help, delivered at home, in assisted living, or in a nursing facility.

The odds split widely. About one-third of today's 65-year-olds may never need long-term care at all.1 At the other end, about 20% will need it for longer than 5 years.1 So this is not a small, predictable expense for most people. It's a likely risk with a long tail.

Needing care is not the same as paying for it, and that distinction decides your budget. A separate research brief published by HHS ASPE estimates that 70% of adults who survive to age 65 develop severe long-term care needs before they die, and 48% receive some paid care over their lifetime.1 The brief was prepared under contract by the Urban Institute from Health and Retirement Study data covering 1995 to 2014, and it carries a disclaimer that its views are the authors' and do not reflect the views of the Department of Health and Human Services.1 The brief adds that many older people with severe needs rely exclusively on family and unpaid caregivers.1 It defines severe needs as difficulty with two or more activities of daily living expected to last at least 90 days, or severe cognitive impairment, together with receiving unpaid care from family or friends or paid long-term services and supports.1 That is a separate statistic from the ACL figure above, not one finding confirmed twice: ACL's is a chance of needing some type of long-term care, and the brief's is the share who develop severe needs as the brief defines them.1 The brief also warns that the lifetime risk of receiving paid care is not evenly distributed across the population. Lengthy spells of severe need and paid care are much more common among older adults with few financial resources than among wealthier ones.1

How Long Does It Last?

Duration differs sharply by sex. Women need care longer than men: 3.7 years on average versus 2.2 years for men.1 ACL says the duration and level of care vary from person to person and often change over time, and that every one of these statistics is an average.1

Nursing home time is easy to underestimate, and underestimating it is expensive. The brief published by HHS ASPE finds that after age 65, 28% of adults receive at least 90 days of nursing home care, including 13% who receive long-term Medicaid-financed nursing home care.1 Among nursing home residents, half receive no more than two years of care after age 65, which means the other half receive more, while across all older adults, 15% receive more than two years.1 Budgeting a single year can fall short: two years is the midpoint among nursing home residents, and at the national median a second year costs as much as the first, roughly another $114,975 for a semi-private room.1,2 The duration is what makes the math hard: a year is survivable for many budgets, five years is not.

So plan around two numbers, not one. The chance you'll need care at all is high, almost 70%.1 The chance you'll need it for longer than 5 years is real but smaller, about 1 in 5.1 A plan that covers only a short stay leaves the expensive tail uncovered, and at the costs below, the long stay is the part that drains savings.

What Long-Term Care Costs

These are national medians from the CareScout 2025 Cost of Care Survey, released March 2, 2026, and the most recent national data available.2 CareScout collects rates at the metropolitan-area level and warns that actual long-term care expenses vary with individual care needs, provider availability, and local market conditions, so read these as medians, not prices.2 Your state and metro area can run well above or below them.

Adult day health care is the cheapest option, at a national median near $24,700 a year.2 A nursing home private room is the most expensive, at a national median near $129,575.2 In the 2025 survey, homemaker and home health aide services were merged into a single non-medical caregiver line at about $35 an hour.2

Now combine cost with duration. At about $315 a day, a single year in a semi-private nursing home room runs about $114,975.2 Five years at that rate is about $574,875, five times the $114,975 annual median, before any program kicks in. Care that long is not rare: about 20% of today's 65-year-olds will need long-term care for longer than 5 years, though that figure counts long-term care of any type, not nursing home care alone.1,2 Costs are still rising, though growth slowed in 2025 after several years of larger increases: the semi-private nursing home median rose 2% and assisted living rose 5%.2 Over a planning horizon the compounding matters more than today's price. The federal FLTCIP program, run by the Office of Personnel Management, puts the national average semi-private nursing home year at $112,420 under its own 2024 survey and projects that the same year would cost almost $186,000 in 20 years.2 That combination is why it helps to plan on more than one payer rather than paying it all yourself.

The setting matters as much as the duration. Home care from a non-medical caregiver runs about $35 an hour, or about $80,080 a year at 44 hours a week, less than a semi-private nursing home room, but only if part-time hours are enough.2 Round-the-clock home care can cost more than a facility, because you're paying for the staff hours directly. Assisted living, at about $6,200 a month, sits in the middle and bundles housing with daily help.2 The cheapest workable option is the one that matches the actual level of care needed, not the lowest number on the table.

Match these national figures against your own area before you budget. A high-cost state or metro can run far above the median, and a low-cost state can run well below it.2 The table is a starting point, not a quote.

Who Pays the Cost of Long-Term Care

Medicare does not pay for most long-term care.1 It pays only if you require skilled services or rehabilitative care: in a nursing home for a maximum of 100 days, where the average Medicare-covered stay is much shorter, about 22 days, or at home if you are also receiving skilled home health or other skilled in-home services, where long-term care services are generally provided only for a short period of time.1 It does not pay for the non-skilled assistance with activities of daily living that makes up the majority of long-term care services.1

Your other health insurance probably will not fill that gap. Most employer-sponsored or private health insurance covers only the same kinds of limited services as Medicare.1

That leaves three main sources, and you can use more than one.

Out-of-pocket. Savings, Social Security income, pensions, and home equity. This is where you pay for whatever no public or private insurance program covers.1 The risk is duration: at the costs above, savings drain fast over a multi-year stay.

Medicaid. For people who qualify, Medicaid pays for the largest share of long-term care services in the country.1 It pays only if your income is below a certain level and you meet your state's minimum eligibility requirements, which are based on how much help you need with daily activities.1 What it covers depends on the setting. Nursing facility care is on CMS's list of benefits every state must provide under federal law, and the statute sets that benefit for people 21 or older.3 Care at home or in the community is different: a state may cover it through a home and community-based services waiver, for people who would otherwise require the level of care provided in a hospital or nursing facility, and the state may cap how many people the waiver serves.4 In assisted living, a waiver may pay for the personal care and supportive services a resident receives, but federal Medicaid law does not cover room and board there, so the resident remains responsible for housing and meals.5 Confirm what your state covers, and who qualifies, with your state Medicaid agency before you count on it.

Long-term care insurance and other tools. If your loved one bought a policy years ago, it may pay toward home care, assisted living, or a nursing home, up to the policy's own limits. VA benefits, life insurance, and a reverse mortgage are other possible sources, each with its own eligibility rules.

These payers can be combined. For example, private savings might cover the first stretch, a long-term care policy or VA benefit might offset part of the monthly bill, and Medicaid might come later for someone who meets the income and care-need requirements above. The order matters for planning, because federal law penalizes giving assets away. A transfer that you or your spouse make for less than fair market value on or after Medicaid's look-back date can trigger a period of ineligibility. For someone in a nursing facility, its length in months is the total uncompensated value transferred divided by the average monthly private-pay cost of nursing facility services in the state.6 Talk to an elder law attorney or your state Medicaid agency before you move money. The detail on each payer, who qualifies, and how to combine them legally is its own guide.

The federal consumer resource at LongTermCare.gov, run by the Administration for Community Living, gives the bottom line: Medicare does not pay for most long-term care, Medicaid pays for the largest share, and you pay for whatever no public or private insurance program covers.1

For how each payer works in detail, who qualifies, and how to combine them, see our full guide on how to pay for senior care.

Learn More

Find personalized help estimating your long-term care costs and coverage 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.