As Americans live longer, more families are facing the realities of long-term care — and the costs that come with it. Nearly 70% of people over 65 will need some form of long-term care in their lifetime, according to the U.S. Department of Health and Human Services.
What counts as long-term care?
Long-term care includes help with everyday activities such as bathing, dressing, meal preparation, transportation, and medication management. This care may be provided at home, in assisted living, or in a nursing facility — and it can be costly.
How much does it cost?
The Genworth Cost of Care Study for 2024 estimates current national averages as:
Home health aide (44 hrs/week): $6,483 per month
Assisted living facility: $5,900 per month
Nursing home (private room): $10,646 per month
These are national figures, but in the Northeast — especially New England — costs are often much higher, with some nursing homes reaching $180,000 to $190,000 per year. Prices vary by location, facility, and level of care, underscoring why early planning is so important.
How to pay for care
Medicare covers short-term, skilled care after a hospital stay but does not cover ongoing custodial care.
Medicaid covers long-term care for those with limited income and assets. In 2025, the asset limit is about $2,000 for individuals and $3,000 for couples, though it varies by state. Applicants must meet strict financial criteria, and most states apply a five-year “look-back” period on asset transfers.
Long-Term Care Insurance (LTCI) can help cover costs if purchased in advance. Some policies pay for home care, adult day care, assisted living, and nursing facilities. Hybrid life-insurance-plus-LTC policies are also becoming more popular, offering flexibility if long-term care isn’t needed.
Reverse mortgages may allow homeowners age 62 and older to tap into home equity for care expenses, though they should be used cautiously and only after exploring other options.
Create a care budget
Even if you’re not yet facing a care decision, it’s important to think ahead. Building a caregiving budget helps clarify what’s affordable and where gaps exist. Start by:
1. Reviewing all sources of income and savings. Include pensions, investments, and retirement accounts.
2. Listing potential care expenses, such as:
- Home modifications (grab bars, ramps, stair lifts)
- Transportation and mobility support
- In-home care or adult day programs
- Medical equipment and supplies
3. Exploring benefits and assistance programs. Local senior centers, veteran programs, and state resources may offer support.
Final thought
Long-term care is more than a financial decision — it’s a family decision. Planning ahead helps protect not only savings but also peace of mind. Because care needs often overlap legal, medical, and financial areas, it’s wise to assemble a team of professionals — such as a financial planner, elder law attorney, and care manager — to help you make informed choices. With the right planning and support, families can focus on what truly matters: quality care, comfort, and dignity for their loved ones.
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