# February, 20, 2020

Do You Need Long-Term Care Insurance?

Life expectancy in America and across the world has been increasing for decades. As a result, there are 52 million Americans over the age of 65, a number predicted to hit 95 million in the next 40 years. While people living longer is a good thing, it has brought about new challenges to our society. One of these is a greater need for long-term care, which is rarely covered by either private health insurance plans or Medicare. Enter long-term care insurance. But, do you really need it?

The Definition of Long-Term Care

Long-term care is assistance to perform the daily activities of normal life; it does not necessarily include medical care. However, injury or illness may be the reason one requires long-term care.

According to the Department of Health and Human Services (HHS) the daily activities of normal life fall into one of two categories. Anyone who needs assistance with two or more of these activities qualifies as needing long-term care.

Daily Activities of Normal Life

Activities of Daily LivingInstrumental Activities of Daily Living
BathingResponding to emergency alerts, such as fire alarms and smoke detectors
Dressing and undressingManaging finances
EatingPerforming household chores
Getting into or out of a bed or a chairTaking care of pets
Using the toiletPreparing meals
Incontinence careShopping
Taking medication
Using the telephone and other communication devices
If you require help with two or more of these, you qualify as needing long-term care.

You qualify for long-term care whether you need assistance with these activities indefinitely or only for a short time.

What Is the Cost of Long-Term Care?

Long-term care costs vary according to the type of care you need and who supplies it. HHS breaks down average long-term care costs as follows:

  • Private room in a nursing home: $7,698 per month
  • Semi-private room in a nursing home: $6,844 per month
  • Assisted living: $3,628 per month
  • Home health aide: $20.50 per hour
  • Housekeeper services: $20 per hour
  • Adult daycare: $68 per day

In addition to the types of care provided, prices vary depending on where you live and the particular facility.

Does Medicare Pay for Long-Term Care?

Medicare does not pay for long-term care. Few health insurance plans do. Unless you have long-term care insurance, you are responsible for any long-term care costs.

What Is Long-Term Care Insurance?

Long-term care insurance covers the costs of long-term care. How much it covers depends on the individual policy.

As with most types of insurance, you have a variety of options for your long-term care policy, including:

  • How much it pays per day
  • The type of care covered, such as in-home or nursing home
  • Maximum lifetime limit amounts and/or days
  • Cost of living adjustments

The coverage you choose impacts the cost of your plan.

How Much Does Long-Term Care Insurance Cost?

The average cost of long-term care insurance is around $2,700 per year. There are broad variations on that price, though, depending on:

  • Your age when you bought the policy
  • Health and medical history
  • Amount of coverage you choose
  • Marital status
  • Gender, with women paying more than men do because they live longer, therefore increasing the odds they’ll need long-term care

Your rates will be lower if you’re younger and healthier when you buy the policy. So, if you’re going to buy long-term care insurance, buy earlier rather than later. You’ll also pay less if you’re married and you and your spouse both buy policies (similar to the discount you get for insuring two vehicles).

Long-term care insurance

How Else Can You Pay for Long-Term Care?

Not everyone needs long-term care insurance. In fact, most people never have any long-term care costs, because their spouse or other family member provides said care. But, according to AARP, if you are now over the age of 65, you have about a one-in-four chance of requiring $50,000 or more in long-term care.

Some whole life policies include provisions for long-term care. However, you’ll usually pay more for this than you would for long-term care insurance.

If you are or your spouse is/was a veteran, you may qualify for Veterans Aid and Attendance. To be eligible, you must receive a VA pension. In addition, at least one of the following must be true:

  • Illness requires you to spend the majority of your day in bed
  • You require assistance with two or more activities of daily living
  • You are a nursing home patient due to disability (either physical or mental)
  • Your eyesight is limited

Another option for vets who receive a VA pension is Housebound benefits. As the name implies, you must be housebound due to permanent disability.

Vets only qualify for one of these benefits at a time.

Types of Long-Term Care

The most common type of long-term care is that received in your home. Commonly referred to as in-home care, spouses and family members usually provide this type of care. Paid caregivers may also play a role, even if it’s only a few hours a week to give the primary caregiver a break.

Adult daycare is fast-growing in popularity as a solution that allows the individual to maintain their independence. Programs offer a variety of services, including:

  • Counseling
  • Education
  • Exercise
  • Meals
  • Medical care
  • Physical therapy

Programs are generally available Monday through Friday from 8 AM to 5 PM.

Assisted living facilities are also popping up in communities across the country. Most resemble apartment-style living, although the facility may also be what is essentially a large residence with individual living quarters. Services typically include live-in staff to assist with medication and meal prep. There are also socialization options, such as communal dining and games.

Custodial nursing homes offer a wide range of services, including medical care, assistance with the activities of daily living, and personal care.


Most people never require long-term care insurance. However, around 37 percent need some level of paid care, with 25 percent needing $50,000 or more. If you choose to not buy a long-term care policy, you want to at least plan for that expense, perhaps with extra savings.

Do you need help understanding your Medicare plan options? Our Find a Plan tool makes it easy to compare Medicare Advantage and prescription drug plans.


Kolt Legette

Since 2015, Kolt Legette has helped clients navigate the often-confusing world of insurance. His number one goal is protecting the medical and financial wellbeing of every person he speaks with, whether they choose to buy insurance or not. Kolt loves representing the best brands in medical insurance as it allows him to provide side-by-side comparisons for his clients. This allows the client to decide which company works best for them. By putting the needs of the client above everything else, Kolt helps real people find affordable health insurance solutions for their most pressing healthcare needs. With his belief that peace of mind is priceless, Kolt's goal in every interaction is to make sure every person he speaks to leaves with the peace of mind they rightfully deserve.

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For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

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Last Updated 12/21/2018