Long-Term Care Insurance Calculator

How Much Does Long-Term Care Cost in 2025?

The 2025 Genworth Cost of Care Survey tracks median LTC costs across all 50 states. Nationally, costs have risen an average of 3–5% per year over the past decade, and the gap between care types is wide — ranging from adult day services at roughly $20,000/year to a private nursing home room approaching $117,000/year.

Regional variation is significant. States in the Northeast and on the West Coast typically run 30–50% above the national median. New York City area nursing homes exceed $180,000/year for a private room. In contrast, the Southeast and parts of the Midwest tend to run 10–25% below national averages. The calculator above adjusts base costs by region using weighted Genworth data.

What Is Long-Term Care Insurance and Who Needs It?

Long-term care insurance (LTCI) pays a daily or monthly cash benefit when you can no longer perform two or more of the six activities of daily living (ADLs): bathing, dressing, eating, transferring, toileting, and continence — or when you have a cognitive impairment like dementia. The benefit covers care at home, in an assisted living facility, a memory care unit, or a nursing home.

The statistics are stark:

• About 70% of Americans who reach age 65 will need some form of long-term care in their lifetime (U.S. Department of Health & Human Services).
• The average care episode is 2.5 years, but 14% of people need care for 5 or more years.
• Women need care for an average of 3.7 years vs. 2.2 years for men, largely because women live longer and are more likely to outlive spouses who could otherwise provide informal care.
• At national median costs, a 2.5-year assisted living stay costs roughly $160,500 in today's dollars — and nearly $250,000 if care begins in 20 years assuming 3% annual inflation.

LTCI is most valuable for people with assets in the $250,000–$2,000,000 range. Below that threshold, Medicaid spend-down may be the default path. Above it, some families self-insure. But for most middle-class American families, LTCI protects the retirement assets they have spent decades building.

Long-Term Care Insurance Cost by Age (2025 Premium Table)

Premiums for traditional long-term care insurance are primarily driven by your age at purchase and your health status. The table below shows 2025 estimated annual premiums from major insurers (Genworth, Mutual of Omaha, Northwestern Mutual) for a policy providing $165/day benefit ($5,000/month), a 3-year benefit period, 90-day elimination period, and a 3% compound inflation rider.

Women pay substantially more than men because they statistically live longer, file more claims, and keep claims open longer. A couple buying at age 55 can often obtain a spousal discount, bringing the combined premium to roughly $3,500/year for both — approximately the cost of a modest vacation.

Note: premiums can increase over time. Traditional LTCI policies are not guaranteed level-premium for life; rate increases have occurred historically. Hybrid policies (see below) lock in your premium at purchase.

Does Medicare Cover Long-Term Care?

This is one of the most common misconceptions in retirement planning: Medicare does not pay for long-term custodial care. Here is what Medicare actually covers:

• Skilled nursing facility (SNF) care — only after a qualifying hospital admission of at least 3 consecutive days. Medicare covers days 1–20 at 100%. For days 21–100, you pay a daily copay ($209.50/day in 2025). After day 100, Medicare pays nothing.
• Home health care — Medicare covers intermittent skilled nursing or physical/occupational therapy at home when ordered by a physician, but does not cover full-time home health aide services.
• Assisted living — Medicare does not cover assisted living facility costs at all, regardless of your medical need.

The critical distinction is between skilled care (medical treatment by licensed professionals) and custodial care (help with daily activities). Medicare covers the former in limited circumstances. Long-term care — which is predominantly custodial — is not a Medicare benefit.

Medicare Advantage plans may offer limited supplemental benefits like adult day care or some home aide hours, but these are not equivalent to comprehensive LTC coverage. Do not rely on Medicare Advantage as an LTC strategy without reviewing the specific plan details carefully.

Medicaid and Long-Term Care: The Spend-Down Reality

Medicaid pays for approximately 42% of all nursing home care in the United States — making it the largest single payer of long-term care. But qualifying requires a difficult reality: you must first spend down virtually all of your assets.

In most states, an individual must have no more than $2,000 in countable assets to qualify for Medicaid long-term care. Countable assets include bank accounts, investment accounts, and second homes. Exempt assets typically include your primary residence (subject to conditions), one vehicle, and personal belongings. A spouse who continues living at home (the "community spouse") can retain a portion of assets — up to $154,140 in 2025 in most states.

However, Medicaid estate recovery laws allow the state to place a lien on your home after death to recoup benefits paid. In many states this means your home cannot be inherited by your adult children if you received Medicaid long-term care benefits.

Medicaid planning — legally repositioning assets to qualify for benefits while protecting your estate — is a specialty area of elder law. The 5-year look-back rule means transfers made within 5 years of applying for Medicaid are subject to penalties. Planning must begin years in advance.

Long-Term Care Insurance vs. Hybrid Policies (Life + LTC Combo)

Traditional LTC insurance has declined in popularity as major insurers have exited the market due to underestimated claims. Today, hybrid policies (also called linked-benefit or combination policies) are the fastest-growing segment of the LTC market. Here is how they compare:

Many financial advisors now recommend hybrid policies to clients who have a significant CD, savings account, or annuity that can be repositioned. A $100,000 lump sum can typically generate $250,000–$400,000 in LTC benefits while preserving a death benefit if care is never needed.

When to Buy Long-Term Care Insurance

The optimal window to purchase long-term care insurance — traditional or hybrid — is between ages 50 and 65. Here is why this window matters:

• Before 50: Premiums are lowest, but you are paying for decades before likely needing benefits. The cumulative premium cost may exceed a later purchase.
• Ages 50–65: The best balance of affordable premiums and meaningful benefit period. Most people are still healthy enough to qualify. A 55-year-old couple buying together can often save 20–30% through spousal or partner discounts.
• Ages 65–75: Premiums are significantly higher — a 65-year-old woman pays 2–3x the premium of a 55-year-old for identical coverage. You can still qualify if healthy, but the math becomes harder.
• After 75: Most insurers will not issue new policies. Existing health conditions frequently disqualify applicants. Coverage is very difficult or impossible to obtain.

A common regret among retirees is waiting too long. A chronic condition — diabetes, heart disease, a history of cancer — can make you ineligible for coverage. Health determines eligibility; age determines premium. The longer you wait, the more both disadvantages compound.

5 Alternatives to Long-Term Care Insurance

Traditional LTCI is not right for everyone. These alternatives deserve consideration as part of a comprehensive long-term care plan:

Frequently Asked Questions