Quick answer
Long-term care insurance pays for help with everyday activities, like bathing, dressing and eating, when you can’t manage them on your own because of age, illness or dementia. It can cover care at home, in assisted living or in a nursing home. It matters because Medicare and regular health insurance don’t pay for this kind of ongoing care, and it’s expensive: a private nursing home room cost a median $129,575 a year in 2025.
Key takeaways
- Someone turning 65 has almost a 70% chance of needing some long-term care, according to the federal government.
- Medicare covers only short skilled nursing stays after a hospital stay, not ongoing custodial care.
- Medicaid pays for long-term care only after your income and savings are very low.
- Premiums are lower if you buy in your 50s and in good health; you usually can’t buy after a serious diagnosis.
- Washington state began paying public long-term care benefits in July 2026.
On this page
What long-term care costs
| Type of care | National median cost, 2025 |
|---|---|
| In-home caregiver (44 hours a week) | $35 an hour, about $80,080 a year |
| Adult day health care | $95 a day, about $24,700 a year |
| Assisted living | $6,200 a month, about $74,400 a year |
| Nursing home, semi-private room | $315 a day, about $114,975 a year |
| Nursing home, private room | $355 a day, about $129,575 a year |
What Medicare and health insurance cover
Regular health insurance, including marketplace plans and job-based plans, pays for medical care, not help with daily living. Medicare covers up to 100 days in a skilled nursing facility after a qualifying hospital stay of at least three days, with a copay of $217 a day for days 21 to 100 in 2026. It doesn’t pay for long-term custodial care. See will health insurance pay for a nursing home.
Medicaid is the biggest payer of long-term care in the U.S., but you have to meet strict income and asset limits, and gifts or transfers made in the five years before you apply can delay coverage.
How long-term care insurance works
- Benefit trigger. Policies usually pay when you need help with at least two of six daily activities, or have a severe cognitive impairment like dementia.
- Daily or monthly benefit. The most the policy pays, for example $200 a day.
- Benefit period or pool. How long or how much the policy pays in total, such as three years or a set dollar amount.
- Elimination period. Like a deductible measured in days. You pay for care yourself for the first 30, 60 or 90 days.
- Inflation protection. Raises your benefit over time so it keeps up with care costs. It costs more but matters if you buy young.
Some people buy hybrid policies that combine life insurance with long-term care benefits, so the money isn’t lost if you never need care.
Who should consider it
Long-term care insurance is usually worth a look if you’re in your 50s or early 60s, have savings you want to protect, and can afford the premiums without strain. If your income and savings are low, Medicaid may be your safety net. If you’re wealthy, you may be able to pay for care yourself. Buy while you’re healthy, since insurers can turn you down because of your health.
If you’re planning an early retirement, think about long-term care alongside your health coverage before Medicare; see can I get health insurance if I retire early.
Other ways to get coverage
- Through work. Some employers offer group long-term care insurance as a voluntary benefit, alongside job-based health coverage.
- State partnership programs. In many states, partnership-qualified policies let you keep more of your savings if you later need Medicaid.
- Washington’s WA Cares Fund. The first public long-term care insurance program started paying benefits on July 1, 2026, with a lifetime benefit of $36,500 that grows with inflation.
Long-term care insurance is separate from dental and vision coverage, which also aren’t part of most medical plans; see does Obamacare cover dental.
Also shopping for health insurance before Medicare? Compare plans by ZIP code.
Frequently asked questions
Does Medicare pay for long-term care?
No, not for ongoing custodial care. It covers short skilled nursing and home health care after an illness or injury.
When should I buy long-term care insurance?
Many people buy in their 50s or early 60s. Premiums rise with age, and health problems can make you ineligible.
Are long-term care insurance premiums tax-deductible?
Premiums for tax-qualified policies can count as medical expenses, up to limits based on your age, if you itemize deductions.
Sources
This article is general information, not insurance, tax or financial advice. Policies vary a lot, so compare carefully and talk with a licensed agent or financial advisor. Last reviewed September 2026.