Long-term care: the retirement cost nobody plans for

70% of Americans over 65 will need some form of long-term care. See what it costs in your state — and what today's options are for covering it.

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The costs Medicare doesn't cover — and why they matter

Long-term care means help with daily activities — bathing, dressing, eating, getting around — when illness, injury, or cognitive decline makes those things hard or impossible. It's custodial care, not medical care, which is why Medicare barely covers it. In 2026, a private nursing home room runs about $9,500/month nationally. Assisted living averages $5,900/month. In-home aide care runs around $5,200/month for 44 hours per week. These aren't worst-case scenarios. The U.S. Department of Health estimates 70% of Americans over 65 will need some form of this care.

Medicaid does cover long-term care — but only after most of your assets are spent down to state-defined limits (often under $2,000). The financial exposure for everyone above that threshold falls on personal savings or family. Use the calculator below to see what the costs look like in your state, at your projected care type, so you have a real number to plan around.

Long-Term Care Cost Estimator — 2026

Uses 2026 senior care cost benchmarks adjusted by state. Figures include 3% annual inflation projection. · Updated October 2026

Content written and reviewed by Brenda Kay · Editorial Policy

Total Estimated Care Cost
Estimated Total Long-Term Care Cost (in future dollars)
Monthly Cost (today)
Monthly Cost (at care start)
Years Until Care Need (est.)
Inflation-Adjusted Total

Child support in 2026 is calculated using one of three state models: income shares (40 states), percentage of income (7 states), or the Melson Formula (Delaware, Hawaii, Montana). Most states factor in both parents' incomes, custody time, and add-on expenses like childcare and health insurance. Average child support received ranges from roughly $4,450/year in lower-award states to $16,656/year in Hawaii, based on federal data.

Why this is the one retirement expense that catches people off guard

People plan carefully for retirement income — Social Security timing, 401(k) contributions, Roth conversions. Long-term care is the expense that doesn't fit any of those plans. Senior living costs have risen 5–8% annually, driven by healthcare labor shortages and post-pandemic care worker wages. A 55-year-old planning to retire at 65 should know that today's $9,500/month nursing home cost will be approximately $14,000/month by age 80 at 3% annual inflation. A couple where both spouses need care could face $600,000–$900,000 in cumulative costs. Without a specific plan for that, the burden falls to savings, Medicaid spend-down, or unpaid family members who absorb an average of $324,000 in lost earnings to provide care.

What Medicare actually covers — and where it stops

Medicare covers skilled nursing care for up to 100 days after a qualifying 3-day hospital stay, with a co-pay of $204/day after day 20 in 2026. After day 100, it stops completely. Custodial care — the everyday help with bathing, dressing, and mobility that most people with dementia or chronic conditions actually need — is not covered by Medicare at any level. Medicaid covers long-term care, but only after most assets are depleted (typically under $2,000 in countable assets for a single individual). The five-year Medicaid look-back period means transferring assets within five years of applying can delay your eligibility. The window for advance planning is wide — the time to address this isn't when you need care, it's a decade before.

Traditional LTC insurance vs. hybrid policies: what's changed

Standalone LTC insurance has become hard to find — most major insurers exited the market after decades of underpriced premiums and significant rate increases on existing policyholders. Hybrid life/LTC policies now dominate new sales. They combine life insurance with a long-term care rider: if you need care, the LTC benefit pays. If you die without needing care, your heirs receive the death benefit. Nothing is "lost." A typical hybrid policy at age 55 in 2026 might require a lump-sum premium of $70,000–$150,000 or a 10-year premium of $7,000–$15,000/year, providing $300,000–$600,000 in lifetime LTC benefits. The right structure depends heavily on your specific asset level, health, and goals — which is why this is one of the few insurance decisions worth paying a fee-only financial planner to think through with you.

Frequently Asked Questions

Most states use the income shares model, which combines both parents' incomes to determine a total child support obligation, then divides it proportionally by each parent's share. For example, in Washington State, two parents with a combined monthly net income of $8,500 and two children would owe a combined $1,988/month in basic support. Seven states use a percentage of the non-custodial parent's income — Alaska applies 20% for one child and 27% for two.
Average child support received ranges from roughly $4,450/year in states like Maine to $16,656/year in Hawaii, according to federal data. The actual amount depends on both parents' incomes, number of children, state model, and custody arrangement — not a single flat percentage. High-income cases can result in orders well above these averages; low-income cases may qualify for minimum orders of $25–$50/month.
Most states allow child support modification when there is a substantial change in circumstances, such as a significant income change for either parent, a change in custody time, or changes in the child's needs. Many states set a threshold — typically a 15% or more change in income — before modification is automatic. Either parent can request a review through the court or state child support enforcement agency.
Basic child support generally covers ordinary day-to-day living expenses. Most states add separate obligations on top: health insurance premiums, out-of-pocket medical costs, work-related childcare, and sometimes extraordinary expenses like special education or therapy. These add-ons are typically shared between parents in proportion to each parent's share of combined income, not split evenly.
In most income-shares states, the amount of time each parent spends with the child directly affects the support calculation — more parenting time for the paying parent generally reduces the obligation. In percentage-of-income states, custody time may be a separate adjustment factor. In all states, custody arrangements should be clearly documented in the court order, as informal changes to parenting time typically do not automatically change the support amount.

2026 Long-Term Care Monthly Costs by Type and State

Monthly cost benchmarks based on Genworth 2026 Cost of Care Survey. Costs vary significantly by city; these represent state median figures.

State In-Home Aide
44 hrs/wk
Assisted Living
private room
Memory Care
facility
Nursing Home
private room
Alaska$14,600$9,800$12,400$28,400
Massachusetts$8,800$7,400$9,200$14,300
Connecticut$8,100$6,900$8,700$13,200
New York$7,700$6,400$8,200$12,800
California$7,100$6,000$7,600$11,200
National Average$5,200$5,900$7,800$9,500
Florida$4,800$4,300$5,600$8,400
Ohio$4,600$4,100$5,200$8,100
Texas$4,400$3,900$5,000$7,700
Missouri$4,000$3,600$4,600$7,000
Mississippi$3,700$3,200$4,200$6,500

Source: Genworth Cost of Care Survey 2026. Memory care costs are typically $1,000–$2,500/month higher than standard assisted living. All figures are monthly. Nursing home rates shown for private room; semi-private runs 15–20% less.

Long-Term Care Funding Options: A Side-by-Side Comparison

There is no single right answer — the best strategy depends on your assets, health, family situation, and risk tolerance. Here's how the main options compare.

Funding Option Best For Key Advantages Key Risks / Limits
Self-Insurance (savings)Assets $1M+No premiums; full control of assetsCatastrophic care need can deplete estate; inflation risk
Traditional LTCiAge 50–60, good healthLower initial premiums; flexible benefit optionsPremiums not guaranteed; major carriers exited market
Hybrid Life/LTC PolicyAges 50–65; wants certaintyGuaranteed level premiums; death benefit if unusedHigher upfront cost; opportunity cost of lump sum
Annuity with LTC RiderAges 60+; lump sum availableDoubles or triples LTC benefit from annuity principalLess liquidity; complex product structure
MedicaidAssets under state limitFull coverage after spend-down; no ongoing premiumsMust spend most assets first; limited facility choices
Family CaregivingMild need; supportive familyNo direct cost; familiar environmentAverage $324,000 in caregiver earnings loss; burnout risk

Most financial planners recommend a hybrid approach: some self-insurance through retirement savings, supplemented by a hybrid life/LTC policy to cap catastrophic exposure. The right combination depends on your specific asset level, health history, and family situation.

When to get professional help with this — and who to talk to

Long-term care planning doesn't lend itself to a quick online quote. The product landscape has changed dramatically — most major traditional LTC insurers have exited the standalone market, hybrid policies have become the dominant new option, and pricing has become complex enough that comparing policies without guidance is difficult. A fee-only Certified Financial Planner who works in retirement income planning, or an independent agent who specializes specifically in long-term care, can model the options objectively and help you understand the real cost of each path: self-insuring, hybrid policies, annuity-based LTC riders, and Medicaid planning.

Start the conversation in your early-to-mid 50s — old enough to take it seriously, young enough that your options are broad and premiums manageable. By 65, some products become unavailable and costs jump substantially. If your family has a history of dementia, Alzheimer's, or Parkinson's, starting in your late 40s isn't too early. An elder law attorney alongside an insurance specialist adds value when Medicaid planning, trusts, or estate protection are part of the picture. A plan built 10–15 years before you need it gives you the most options at the best price.

Written by the FreeInsuranceIQ Editorial Team  ·  Last updated: August 2026

Long-term care cost estimates sourced from Genworth Cost of Care Survey — the industry's most comprehensive annual study of LTC costs by care type and geography.