Part of our guide: Long-Term Care Insurance: Costs, Options and Planning →
Long-term care is the unsolved problem in many middle- and upper-middle-income retirement plans. These are the numbers that matter most in client conversations, from reliable, current sources.
Key takeaways
- Someone turning 65 today has almost a 70% chance of needing some type of long-term care, and 20% will need it for more than five years.
- In 2025, national median costs were $35 an hour for in-home care, $6,200 a month for assisted living, and $10,798 a month for a private nursing home room.
- Medicaid paid 61% of the $459 billion spent on long-term care in 2023, and 63 million Americans now provide unpaid family care.
Almost 70% of people turning 65 will need long-term care, and 1 in 5 will need it for more than five years.
How likely is it, and how long does it last?
- Someone turning 65 today has almost a 70% chance of needing some type of long-term care services and supports.
- Women need care longer on average (3.7 years) than men (2.2 years).
- About one-third of today’s 65-year-olds may never need long-term care, but 20% will need it for more than five years.
Source: U.S. Administration for Community Living. Averages hide the real risk: the long, expensive claims. See why the average claim misleads clients.
What care costs (2025 national medians)
- In-home care: $35 an hour (about $80,080 a year at 44 hours a week)
- Assisted living: $6,200 a month ($74,400 a year)
- Nursing home, private room: $10,798 a month (about $129,600 a year)
- Private duty nursing: $90 an hour
- Cost growth slowed in 2025, with most settings rising 1–5% year over year
Source: CareScout 2025 Cost of Care Survey. At 3% inflation, a three-year private nursing stay costing about $389,000 today would cost more than $800,000 in 25 years. More in our cost of care summary.
Who pays for long-term care
- Medicaid paid 61% of the $459 billion spent on long-term care in the U.S. in 2023.
- Long-term care accounts for roughly 36–37% of all Medicaid spending.
- Medicare doesn’t pay for most extended custodial care; it covers limited skilled care after a qualifying hospital stay.
Source: KFF. Medicaid generally requires spending down assets first; see what Medicare and Medicaid actually cover.
The toll on family caregivers
- 63 million Americans, nearly 1 in 4 adults, provided ongoing care to an adult or a child with a complex medical condition or disability in the past year.
- That’s an increase of 20 million caregivers from 2015 to 2025.
Source: AARP and National Alliance for Caregiving, Caregiving in the US 2025. See why family shouldn’t be the long-term care plan.
Planning options for the middle
High-net-worth clients may be able to self-fund, and many lower-income households rely on Medicaid. Clients in between face the hardest choices: traditional LTC insurance (with the possibility of rate increases), hybrid life or annuity products with guaranteed premiums, or self-funding. Compare approaches in traditional, hybrid, and rider options.
Frequently asked questions
What percentage of people need long-term care?
According to the U.S. Administration for Community Living, someone turning 65 today has almost a 70% chance of needing some type of long-term care.
How much does long-term care cost in 2025?
CareScout’s 2025 national medians: $35 an hour for in-home care, $6,200 a month for assisted living, and $10,798 a month for a private nursing home room.
Who pays for most long-term care in the U.S.?
Medicaid, which paid 61% of long-term care spending in 2023, according to KFF.
Reviewed by Tim Fuller on 2026-09-28
Tim Fuller
President, SRS Inc.
Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.
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