Long-Term Care: How Much You May Need, Who Pays, and LTC Insurance Basics

Long-Term Care: The Bill Medicare Mostly Doesn't Pay

Key takeaways

• Someone turning 65 has almost a 70% chance of needing long-term care.[1]
• Women need care longer (3.7 years) than men (2.2 years), on average.[1]
• Medicare covers skilled care for a limited time, not ongoing help with bathing or dressing.[2][3]
• Medicaid pays for long-term nursing home care for people who qualify.[4]
• LTC insurance pays a daily amount up to a limit. Premiums can go up.[5]

How much care people use

Source: ACL/LongTermCare.gov.[1] One-third may never need care. 20% will need it for more than 5 years.[1]

What Medicare pays (and doesn't)

• Skilled nursing facility, per benefit period (2026): days 1–20 $0; days 21–100 $217 a day; day 101 on, you pay everything.[2]
• Home health care: $0 for covered services.[2]
• Long-term "custodial" care — help with bathing, dressing, eating — is what LTC insurance is designed for.[5]

Who pays: your options

1. Your savings and income.[3]
2. Long-term care insurance.[3][5]
3. Life insurance with a long-term care feature.[3]
4. Reverse mortgage or annuities. See reverse mortgage pros and cons.[3]
5. Medicaid, if you qualify. See Medicaid eligibility.[4]
6. Unpaid family care — the most common kind.[1]

How LTC insurance works

The policy pays a daily amount, up to a limit you choose, for help with daily activities.[5]

Your price depends on:[5]

• Your age when you buy.
• The daily maximum.
• How many years it pays.
• Extras, like inflation protection.

Most policies need medical underwriting. If you are already ill, you may not qualify.[5]

Before you buy: original question list

• What is the daily maximum and lifetime maximum?
• How many years does it pay? (Many pay 2–5 years.[5])
• Does it cover home care, assisted living, and nursing homes?
• Is there inflation protection?
• What is this company's rate-increase history?[5]
• What happens if I stop paying?
• Ask your State Insurance Department for the NAIC Shopper's Guide.

We don't sell or recommend any policy or company.

Wondering whether Medicaid could help pay for long-term care? Try our

for a first look.

Sources

1. Administration for Community Living. How much care will you need? LongTermCare.gov / acl.gov. https://acl.gov/ltc/basic-needs/how-much-care-will-you-need. Last modified Feb 18, 2020. Accessed October 29, 2026.
2. Centers for Medicare & Medicaid Services. Costs (Part A 2026). Medicare.gov. https://www.medicare.gov/basics/costs/medicare-costs. Accessed October 29, 2026.
3. Administration for Community Living. Costs & who pays. https://acl.gov/ltc/costs-and-who-pays. Accessed October 29, 2026.
4. See our Medicaid eligibility page and its sources (Medicaid.gov, CMS).
5. Administration for Community Living. What is long-term care insurance? https://acl.gov/ltc/costs-and-who-pays/what-is-long-term-care-insurance. Accessed October 29, 2026.

Disclaimer

This article is for general education only and is not medical, legal, or financial advice. We do not sell, endorse, or recommend any insurance plan or company. Talk to your doctor, a licensed attorney, or a SHIP counselor (Medicare) about your situation. In an emergency, call 911.

Attribution

Portions of this page are adapted from "HowToLiveBetter" (高性价比人生指南) by eternity4719, https://github.com/eternity4719/HowToLiveBetter, licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Changes: adapted and rewritten for the U.S. context (not a direct translation), and re-sourced to U.S. official guidance. The source chapter on China's health insurance (ch. 24) was not used; all Medicare content is written from scratch.