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 That's the number most families don't plan for. 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 coin-flip risk with a long tail.

Needing care is not the same as paying for it, and that distinction decides your budget. HHS ASPE reaches the same 70% headline through its Health and Retirement Study analysis, but finds that only 48% of people receive any paid care over their lifetime, because many older people rely exclusively on family and unpaid caregivers.1 ASPE is also precise about what it counts: difficulty with two or more activities of daily living expected to last at least 90 days, or severe cognitive impairment, together with actually receiving unpaid or paid care.1 And the risk is not evenly distributed. 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 stresses that the level of care changes over time and that every one of these statistics is an average.1 Women tend to live longer and more often outlive a spouse who could have cared for them, so they more often pay for care.

Nursing home time is the piece families most often get wrong, and they get it wrong in the expensive direction. 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 is the common mistake: two years is the midpoint for people who enter a nursing home, and at the national median that second year costs as much as the first, roughly another $114,975 for a semi-private room.2 The longer, multi-year care is more often delivered at home or in assisted living. 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, near 70%.1 The chance you'll need it for years rather than months is real but smaller, about 1 in 5.1 A plan that covers only a short stay leaves the expensive tail uncovered, and the expensive tail is exactly what bankrupts families.

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, and that is the bill facing the 20% who need care for longer than 5 years, before any program kicks in.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 most middle-class families end up combining payers rather than paying it all themselves.

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, and that surprises most families.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.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 almost certainly will not fill that gap. Most employer-sponsored and private health insurance covers only the same kinds of limited services as Medicare, and where a plan covers long-term care at all it is typically only skilled, short-term, medically necessary care.1

That leaves three main sources, and most families use more than one.

Out-of-pocket. Savings, Social Security income, pensions, and home equity. Most families start here. The risk is duration: at the costs above, savings drain fast over a multi-year stay.

Medicaid. For people who qualify financially, Medicaid is the single largest payer for long-term care in the country.1 It covers nursing home care and many in-home and assisted living services, but it's means-tested, so it covers people with limited income and assets. Many families reach it only after private savings run low.

Long-term care insurance and other tools. If your loved one bought a policy years ago, it pays toward home care, assisted living, or a nursing home up to a benefit limit. VA benefits, life insurance, and reverse mortgages fill gaps for some families.

These payers stack. A common path looks like this: private savings cover the first stretch, an old long-term care policy or VA benefit offsets part of the monthly bill, and Medicaid takes over once countable assets fall below the limit. The order matters for planning, because Medicaid reviews several years of past financial records, and moving money the wrong way can create a penalty period. 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, and the planning data from HHS ASPE both confirm the same bottom line: Medicaid and out-of-pocket spending carry most of the long-term care bill, not Medicare.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.