Long-term care insurance can help protect your savings from the potentially high cost of extended personal care, assisted living, and nursing home services. However, the price of coverage varies considerably depending on your age, health, location, policy benefits, and optional features.
For many Americans, the biggest challenge is balancing affordable premiums today against the possibility of expensive care later in life. Buying more coverage may provide greater financial protection, but an unnecessarily expensive policy can become difficult to maintain during retirement.
This guide explains how much long-term care services cost in the United States, what determines long-term care insurance premiums, how policy benefits work, and how to evaluate whether coverage makes financial sense.
1. What Is Long-Term Care Insurance?
Long-term care insurance (LTCI) is designed to help pay for services needed when someone can no longer perform certain everyday activities independently or requires supervision because of a serious cognitive impairment.
Unlike traditional health insurance, which primarily covers medical treatment, long-term care insurance focuses on ongoing assistance with daily living.
Examples of covered services may include:
- Assistance with bathing, dressing, and eating
- Help using the bathroom and moving between a bed and chair
- Supervision for people with Alzheimer’s disease or other forms of dementia
- In-home personal care services
- Assisted living facility expenses
- Nursing home care
- Adult day care services
- Respite care for family caregivers
The exact services covered depend on the policy.
Some policies provide comprehensive coverage for care at home and in facilities, while others restrict benefits to specific types of care.
Long-term care insurance is particularly relevant to people who want to preserve retirement savings, reduce the financial burden on family members, and have more flexibility when choosing where to receive care.
2. How Much Does Long-Term Care Cost in the United States?
Before comparing insurance premiums, it is important to understand the potential cost of care itself.
According to the 2025 CareScout Cost of Care Survey, the national median costs for several major long-term care services were:
| Type of care | National median cost |
|---|---|
| Non-medical in-home caregiver | $35 per hour |
| In-home care, 44 hours per week | $6,673 per month |
| Assisted living facility | $6,200 per month |
| Nursing home, semi-private room | $9,581 per month |
| Nursing home, private room | $10,798 per month |
| Adult day health care | $95 per day |
These figures are national medians, not guaranteed prices. Actual expenses can be significantly higher or lower depending on the state, city, provider, and level of assistance required.
In-home care
Many older adults prefer to remain in their own homes rather than move into a residential care facility.
In-home caregivers can assist with everyday activities such as:
- Preparing meals
- Bathing and dressing
- Light housekeeping
- Transportation
- Medication reminders
- General supervision
At the 2025 national median rate of $35 per hour, receiving 44 hours of care per week would cost approximately $6,673 per month.
That adds up to approximately $80,080 annually.
The actual expense depends on how many hours of assistance are needed. Someone requiring only a few hours of help each week may spend considerably less, while someone who needs around-the-clock assistance could face substantially higher expenses.
Assisted living facilities
Assisted living communities provide residential accommodations and varying levels of personal assistance.
Residents may receive help with bathing, dressing, meals, medication management, and other daily activities.
The 2025 national median cost was approximately $6,200 per month, or $74,400 per year.
Additional services, specialized memory care, private accommodations, and local market conditions can increase the total cost.
Nursing homes
Nursing homes generally provide a higher level of supervision and assistance than assisted living communities.
They may be appropriate for people who need extensive daily support or ongoing nursing services.
The 2025 national median costs were:
- Semi-private room: $9,581 per month
- Private room: $10,798 per month
A private nursing home room at the national median could cost approximately $129,575 annually.
Someone who needs several years of nursing home care could therefore face a substantial financial burden.
Why location matters
Long-term care costs vary significantly across the United States.
For example, a person living in a relatively affordable state may find that in-home care or assisted living is considerably less expensive than in a high-cost metropolitan area.
Before purchasing coverage, compare actual care costs in the location where you expect to retire.
Useful resources include the CareScout Cost of Care Survey and local state aging agencies.
3. How Much Does Long-Term Care Insurance Cost?
There is no single national premium that applies to every applicant.
Two people of the same age may receive very different quotes because their health histories, benefit amounts, inflation protection, and policy structures are different.
The National Association of Insurance Commissioners (NAIC) identifies several major factors affecting premiums:
- Age when coverage is purchased
- Current health and medical history
- Daily or monthly benefit amount
- Maximum benefit period
- Inflation protection
- Elimination period
- Additional policy options
A policy designed to provide a larger daily benefit for a longer period will generally cost more than a policy with limited benefits.
Why age affects premiums
Age is one of the most important factors in long-term care insurance pricing.
Buying coverage at a younger age can generally result in a lower initial premium because the applicant is statistically less likely to need care immediately.
However, purchasing too early also means paying premiums for a longer period before benefits may be needed.
Waiting until retirement can create another problem: premiums may be significantly higher, and some applicants may no longer qualify because of their health.
For example, consider two hypothetical applicants:
| Factor | Applicant A | Applicant B |
|---|---|---|
| Age at application | 50 | 65 |
| Health | Good | Good |
| Benefit amount | Same | Same |
| Inflation protection | Same | Same |
| Expected initial premium | Generally lower | Generally higher |
This comparison illustrates why application age matters. It is not an actual insurer quote, and the final premium depends on underwriting and policy design.
Health conditions can affect eligibility
Long-term care insurance generally involves medical underwriting.
Insurers may review:
- Existing chronic conditions
- History of strokes
- Cognitive impairment
- Mobility limitations
- Previous hospitalizations
- Current medications
- Assistance already required with daily activities
Certain medical conditions may result in higher premiums, restrictions, or an application being declined.
This is another reason to investigate coverage before significant health problems develop.
4. What Determines Your Long-Term Care Insurance Premium?
Understanding policy design is essential because two policies with similar monthly premiums may provide very different financial protection.
Daily benefit amount
The daily benefit is the maximum amount the insurer will pay for eligible care under the policy.
For example, suppose a policy provides a daily benefit of $150.
If the insured receives eligible care costing $200 per day, the policy may pay up to $150, leaving the remaining $50 to be paid personally.
The actual payment method depends on whether the policy uses reimbursement benefits or an indemnity-style benefit structure.
A higher daily benefit generally increases the premium.
When selecting a benefit amount, compare it with the cost of care in your retirement location.
Benefit period
The benefit period determines how long the policy can provide benefits, subject to its terms and maximum benefit limits.
Common benefit periods include:
- Two years
- Three years
- Four years
- Five years
- Longer or lifetime coverage, where available
A longer benefit period generally increases the premium.
For example, a policy with a four-year benefit period offers a longer potential protection period than a policy with a two-year benefit period, assuming the same benefit amount and other conditions.
However, a longer benefit period does not automatically make a policy better for everyone.
People with substantial retirement savings may prefer a shorter insurance benefit period combined with personal assets. Others may prioritize more extensive coverage because they want to reduce the possibility of exhausting their savings.
Maximum benefit pool
Some policies calculate their maximum benefits using a total benefit pool.
For example:
- Daily benefit: $200
- Maximum benefit period: 3 years
- Illustrative maximum benefit pool: $219,000
The calculation is:
$200 × 365 days × 3 years = $219,000.
This is a simplified illustration. Actual policy calculations may depend on covered services, benefit eligibility, inflation adjustments, and the insurer’s payment rules.
The important point is that the daily benefit and benefit pool work together to determine the financial protection available.
Elimination period
The elimination period is the waiting period before insurance benefits become payable after the policyholder meets the policy’s eligibility requirements.
Common options may include:
- 30 days
- 60 days
- 90 days
- 180 days
A longer elimination period may reduce the premium, but it means the policyholder must pay for eligible care during a longer initial period.
For example, if a policy has a 90-day elimination period, the insured may need to cover the initial qualifying period using personal savings.
Check whether the elimination period is measured in calendar days or days of actual covered services. Some policies count only days on which eligible care is received.
This distinction can make a significant difference.
Inflation protection
Inflation protection is one of the most important features to evaluate.
A policy purchased today may provide benefits decades later. However, the cost of long-term care can increase over time.
Without inflation protection, a fixed daily benefit may cover a much smaller percentage of actual care expenses in the future.
For example, imagine purchasing a policy with a $150 daily benefit at age 55.
If the policy provides no inflation adjustment, the daily benefit may remain $150 even when the insured reaches age 80.
By contrast, an inflation protection option may increase the available benefit over time.
Common structures include:
- Simple inflation protection
- Compound inflation protection
- Fixed percentage annual increases
- Other insurer-specific benefit adjustment options
Compound inflation protection can produce substantial benefit increases over long periods, but it can also increase premiums.
Compare the projected future benefit amount rather than looking only at the initial daily benefit.
5. What Is the Difference Between Traditional and Hybrid Long-Term Care Insurance?
Consumers generally encounter two broad approaches to long-term care protection: traditional long-term care insurance and hybrid life insurance or annuity products with long-term care benefits.
They are not interchangeable, and their costs should be compared carefully.
Traditional long-term care insurance
Traditional LTCI is designed specifically to provide benefits for qualifying long-term care needs.
Its main advantages may include:
- Dedicated long-term care benefits
- Flexible care settings, depending on the policy
- Options for inflation protection
- Potentially lower initial premiums than some hybrid arrangements
However, there are important disadvantages.
If the policyholder never needs qualifying care, traditional coverage generally does not return all premiums paid.
Premiums may also increase over time if the insurer obtains regulatory approval for a class-wide rate increase where permitted.
This means buyers should evaluate whether they can afford the premiums over the long term.
Hybrid life insurance with long-term care benefits
Hybrid products combine life insurance with long-term care benefits.
Depending on the contract, the policy may allow the insured to use part of the death benefit to pay for qualifying long-term care expenses.
Potential advantages include:
- A death benefit may remain available if long-term care benefits are not fully used.
- Some products offer a return-of-premium feature.
- Certain contracts offer a single-premium payment option.
- The product may appeal to people who dislike the possibility of paying premiums without receiving benefits.
However, hybrid policies can require a substantial initial payment or larger ongoing premiums.
The long-term care benefit may also reduce the remaining death benefit.
Policyholders should carefully examine:
- Total premium payments
- Guaranteed and non-guaranteed values
- Maximum long-term care benefit
- Benefit payment period
- Death benefit after long-term care claims
- Surrender charges
- Inflation protection options
A hybrid product should not be considered automatically superior simply because it includes a death benefit.
The best choice depends on the buyer’s insurance needs, available assets, and willingness to commit money to the contract.
6. Does Medicare Pay for Long-Term Care?
One of the most common misconceptions about retirement planning is that Medicare will cover long-term nursing home expenses.
In general, Medicare does not pay for ongoing custodial long-term care.
Custodial care means assistance with everyday personal activities such as:
- Bathing
- Dressing
- Eating
- Using the bathroom
- Moving around safely
Medicare may cover certain skilled nursing facility services and limited home health services when specific medical and coverage requirements are met.
However, this is different from paying for extended personal care simply because someone needs help with daily activities.
Medicare Supplement Insurance, commonly called Medigap, generally does not fill this long-term care coverage gap either.
What about Medicaid?
Medicaid can help pay for qualifying long-term care services for people who meet the applicable state and federal eligibility requirements.
However, eligibility rules include financial and other requirements.
Depending on the state and circumstances, applicants may need to meet income and asset limits.
Some people pay for care using personal savings until they meet Medicaid eligibility requirements.
This process is often described as spending down assets.
Certain states also participate in Long-Term Care Partnership programs, which can allow qualifying policyholders to protect some assets when applying for Medicaid, subject to state rules.
The key distinction is:
- Medicare is not a general long-term care funding program.
- Medicaid may provide assistance to eligible individuals.
- Private long-term care insurance can help pay covered expenses before personal assets are depleted.
7. Can Long-Term Care Insurance Premiums Be Tax Deductible?
Qualified long-term care insurance premiums may receive favorable federal tax treatment.
Under IRS rules, qualifying premiums can generally be included as medical expenses on Schedule A, subject to annual age-based limits.
However, this does not mean every dollar of premiums automatically creates a tax deduction.
The taxpayer generally must itemize deductions, and total eligible medical expenses must exceed the applicable percentage of adjusted gross income.
For self-employed individuals, different rules may apply depending on eligibility and the type of policy.
There are also requirements for a policy to qualify as a tax-qualified long-term care insurance contract.
Before assuming that premiums will reduce your tax bill, review the current IRS guidance or consult a qualified tax professional.
Useful IRS resources include:
- IRS Publication 502
- IRS Publication 554
- Schedule A instructions
Tax limits can change from year to year, so use the limits applicable to the tax year in question.
8. When Is the Best Time to Buy Long-Term Care Insurance?
There is no universal best age for purchasing long-term care insurance.
However, waiting until care is already needed is generally too late.
Most policies require applicants to qualify medically before coverage is issued.
Buying in your 40s or early 50s
Potential advantages:
- Better opportunity to qualify medically
- Generally lower initial premiums
- More time for inflation protection to increase future benefits
Potential disadvantages:
- A longer period of premium payments
- A greater possibility of paying premiums for many years before using benefits
- Future premium increases may affect affordability
Buying in your late 50s or early 60s
For many people, this period is worth serious consideration.
They may have a clearer picture of their retirement income, assets, housing plans, and expected retirement location.
They can also compare coverage with their anticipated retirement budget.
However, premiums are generally higher than for younger applicants, and medical underwriting remains important.
Buying after age 65
Coverage may still be available to some applicants over 65, but the cost can be higher.
Medical conditions may also make qualifying more difficult.
People considering coverage later in life should compare traditional policies, hybrid products, and self-funding strategies.
The most important question is not simply how old you are. It is whether the premiums are affordable and whether the policy provides meaningful protection relative to your financial situation.
9. How Much Long-Term Care Insurance Coverage Do You Actually Need?
The appropriate amount of coverage depends on the difference between expected care costs and the resources available to pay for them.
A useful starting point is to estimate your potential monthly care expense.
Consider this hypothetical example:
| Item | Amount |
|---|---|
| Estimated monthly care cost | $8,000 |
| Available monthly retirement income | $3,000 |
| Monthly funding gap | $5,000 |
| Annual funding gap | $60,000 |
If the person needs this level of care for three years, the total funding gap would be approximately $180,000.
This does not mean the person automatically needs a policy with a $180,000 benefit pool.
Other factors must be considered:
- Existing retirement savings
- Investment income
- Home equity
- Spouse’s financial needs
- Expected Social Security benefits
- Potential family assistance
- Medicaid eligibility
- Future inflation
- The possibility of needing care for longer than expected
A person with substantial liquid assets may choose to self-fund part of the risk.
Someone who wants to preserve assets for a spouse or family members may prefer more insurance protection.
Avoid buying too little coverage
A policy with a very low daily benefit may provide limited protection if care costs are high.
For example, if a nursing home costs $10,000 per month and the policy provides only $2,000 per month, the insured must cover most of the expense personally.
Avoid buying more coverage than you can afford
A policy with extensive benefits may appear attractive, but premiums must remain affordable throughout retirement.
If the policyholder eventually cancels coverage because premiums become too expensive, the intended financial protection may disappear.
A sustainable policy is generally more valuable than an expensive policy that cannot be maintained.
10. What Should You Compare Before Buying a Policy?
Comparing premiums alone is not enough.
Two insurers may offer similar monthly premiums but significantly different benefit structures.
Use the following checklist when reviewing quotes.
| Feature | What to check |
|---|---|
| Daily benefit | Maximum amount payable per day |
| Monthly benefit | Whether the policy has a monthly payment limit |
| Benefit period | How long benefits can continue |
| Maximum benefit pool | Total available benefit amount |
| Elimination period | How long you must wait before benefits begin |
| Inflation protection | Whether benefits increase over time |
| Covered care settings | Home care, assisted living, nursing home |
| Benefit eligibility | Required medical and functional conditions |
| Care plan requirements | Whether a licensed professional must certify the need |
| Premium structure | Whether premiums are guaranteed or subject to increases |
| Rate increase history | Whether the insurer has requested class-wide increases |
| Nonforfeiture options | Whether some benefits remain after certain premium-payment situations |
| Financial strength | Insurer financial condition and ratings |
Understand premium increases
Many traditional long-term care insurance policies are guaranteed renewable.
This generally means the insurer cannot cancel an individual policy simply because the insured’s health changes, provided the policyholder continues paying premiums and follows the contract.
However, guaranteed renewable does not necessarily mean the premium is guaranteed to remain unchanged forever.
Depending on state law and policy terms, an insurer may be able to request a premium increase for an entire class of similar policies.
The insurer generally cannot single out one policyholder for an increase because that person filed a claim or developed a medical condition.
Ask the insurer or agent for information about historical rate increases and the policy’s rate-increase provisions.
Check the financial strength of the insurer
Long-term care insurance is designed to protect against risks that may not occur for many years.
That makes the insurer’s long-term financial condition particularly important.
Consider reviewing financial strength ratings from established rating agencies and the insurer’s complaint information through your state insurance department.
A low premium should not be the only reason to choose a company.
11. What Happens If You Never Use Your Long-Term Care Insurance?
This is an important consideration when deciding whether to purchase traditional coverage.
Traditional long-term care insurance generally works like other risk-transfer products: the policyholder pays premiums in exchange for protection against a covered event.
If the insured never meets the policy’s benefit requirements, the policy may pay nothing.
This can make some consumers hesitant to purchase coverage.
Hybrid life insurance products may address this concern by providing a death benefit if long-term care benefits are not fully used.
However, hybrid policies may require significantly more capital and have different costs and limitations.
The decision should be based on the overall financial value of the contract, not simply the possibility of receiving something back.
Ask yourself:
- Would I rather pay a lower premium for dedicated long-term care protection?
- Do I want a potential death benefit if I never need care?
- Can I afford a larger initial payment?
- Would I be better off keeping the money invested or available for emergencies?
There is no single correct answer for every household.
12. Alternatives to Long-Term Care Insurance
Long-term care insurance is not the only way to prepare for future care expenses.
Depending on your financial circumstances, other approaches may be appropriate.
Self-funding
Self-funding means using personal savings, investments, retirement income, or other assets to pay for care.
This may be practical for people with substantial financial resources.
However, a long period of care can consume assets much faster than expected.
A person planning to self-fund should estimate several possible care scenarios rather than relying on a single expected cost.
Hybrid life insurance
A life insurance policy with long-term care benefits may provide a combination of protection.
It can be useful for people who want life insurance coverage and also want access to funds for qualifying care.
The cost and benefit structure must be compared with traditional LTCI.
Medicaid planning
Medicaid may help eligible individuals pay for certain long-term care services.
However, qualification rules vary by state, and asset-transfer rules can be complicated.
Anyone considering Medicaid planning should consult a qualified elder law attorney or specialist familiar with the relevant state’s rules.
Family caregiving
Some people receive care from spouses, adult children, or other relatives.
Family support can reduce direct care expenses, but it can also create emotional, physical, and financial pressure.
Caregiving may require relatives to reduce working hours, leave employment, or pay for additional services.
A realistic long-term care plan should consider the needs and limitations of family members rather than assuming they will always be available.
13. Frequently Asked Questions About Long-Term Care Insurance
How much does long-term care insurance cost per month?
There is no universal monthly premium.
The price depends on the applicant’s age, health, location, daily benefit, benefit period, inflation protection, and other contract options.
The best way to determine the actual cost is to request multiple quotes using the same coverage assumptions.
Is long-term care insurance worth it?
It may be worthwhile for people who have assets they want to protect but do not want to pay all potential care expenses themselves.
It may be less attractive for people who have very limited financial resources or enough assets to comfortably self-fund care.
The decision should consider both the premium and the potential financial exposure.
Does Medicare cover nursing home care?
Medicare may cover certain qualifying skilled nursing facility services for a limited period under specific conditions.
However, it generally does not cover ongoing custodial care when the primary need is assistance with daily activities.
Can I buy long-term care insurance after age 70?
Some insurers may offer coverage to applicants over 70, but availability, premiums, and underwriting requirements vary.
Applicants with significant health conditions may have difficulty qualifying.
Can long-term care insurance cover care at home?
Many comprehensive policies can cover qualifying home care services.
However, the contract may specify eligible caregivers, service providers, care plans, and benefit conditions.
Confirm that the policy covers the type of home assistance you expect to need.
Can my long-term care insurance premium increase?
Some traditional policies allow insurers to request class-wide premium increases, subject to applicable state requirements.
A guaranteed renewable policy does not necessarily guarantee that the premium will remain unchanged.
Review the policy’s rate-increase provisions before purchasing.
Does long-term care insurance cover Alzheimer’s disease?
Many policies can cover qualifying care related to Alzheimer’s disease and other cognitive impairments.
However, the insured must satisfy the policy’s benefit eligibility requirements.
Coverage may involve substantial supervision requirements, medical certification, and an approved plan of care.
Is long-term care insurance tax deductible?
Qualified long-term care insurance premiums may be treated as medical expenses for federal income tax purposes, subject to age-based limits and other tax rules.
The ability to claim a deduction depends on the taxpayer’s circumstances and applicable IRS requirements.
What is the difference between long-term care insurance and health insurance?
Health insurance primarily covers eligible medical expenses, such as doctor visits, hospital treatment, and prescription drugs.
Long-term care insurance is designed to help pay for extended assistance with daily living activities and qualifying care services.
The two types of coverage serve different purposes.
14. Final Thoughts: Plan for Long-Term Care Before You Need It
Long-term care can become one of the largest financial risks during retirement.
The 2025 CareScout survey reported national median costs of approximately $6,200 per month for assisted living and $10,798 per month for a private nursing home room.
These expenses can place considerable pressure on retirement savings, especially when care is needed for several years.
Long-term care insurance can help transfer part of that financial risk to an insurer, but the policy must be designed carefully.
The most important considerations are:
- Compare care costs in the state where you expect to retire.
- Evaluate your existing savings and retirement income.
- Choose a daily benefit that provides meaningful protection.
- Consider inflation protection for future care costs.
- Review the elimination period and maximum benefit pool.
- Confirm whether premiums can increase.
- Make sure the premium remains affordable throughout retirement.
Ultimately, the goal is not necessarily to insure every possible dollar of future care expenses.
It is to create a sustainable plan that protects your financial independence while preserving enough flexibility to handle unexpected changes in health and living arrangements.
Planning early can provide more options, but purchasing insurance should always be based on a realistic assessment of your financial resources and long-term needs.
Sources
- CareScout, 2025 Cost of Care Survey: https://www.carescout.com/cost-of-care
- Genworth Financial, 2025 Cost of Care Survey Results: https://investor.genworth.com/news-events/press-releases/detail/1054/carescout-releases-2025-cost-of-care-survey-results
- National Association of Insurance Commissioners (NAIC), Long-Term Care Insurance: https://content.naic.org/insurance-topics/long-term-care-insurance
- NAIC, A Shopper’s Guide to Long-Term Care Insurance: https://content.naic.org/sites/default/files/publication-ltc-lp-shoppers-guide-long-term.pdf
- Medicare.gov, Long-Term Care Coverage: https://www.medicare.gov/coverage/long-term-care
- Administration for Community Living, Where to Look for Long-Term Care Insurance: https://acl.gov/ltc/costs-and-who-pays/what-is-long-term-care-insurance/where-to-look-for-long-term-care-insurance
- Internal Revenue Service, Publication 554: https://www.irs.gov/publications/p554
- Internal Revenue Service, Publication 502: https://www.irs.gov/publications/p502
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