Most people underestimate what long-term care costs by a significant margin. They think about a year or two. They imagine a modest assisted living situation. They assume Medicare will cover most of it. None of those assumptions are reliable. Medicare covers short-term skilled nursing care after a qualifying hospital stay — typically limited to 100 days, with substantial copays after day 20. It does not cover the custodial care — help with bathing, dressing, eating, and mobility — that dominates long-term care needs. That cost falls entirely on the individual until assets are exhausted down to
According to research from the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE), approximately 70% of people who reach age 65 will need some form of long-term care during their remaining years. That is the headline figure. The more useful number is duration. The average is misleading because it includes many people whose care needs are brief. The critical segment is at the tail: **Projected Length of Paid Long-Term Care After Age 65 (20242026 Data)** Care Duration Total Men Women** Population** No paid care needed 52.7% 58.6% 47.2% Less than 1 year 19.7% 18.4% 20.9% 1.0 to 1.99 years 8.3% 7.9% 8.8% 2.0 to 4.99 years 12.4% 10.3% 14.5% 5 years or more 6.8% 4.9% 8.7% Source: ASPE/HHS — Long-Term Care Services and Supports for Older Americans: Risks and Financing; AALTCI Women face greater exposure at every duration level. Women outlive men by an average of five to seven years, spend an average of 3.2 years in paid long-term care compared to 2.3 years for men, and are 60% more likely than men to require help with basic daily activities at age 75 and older. For planning purposes, women and their families should apply the higher end of any duration estimate.
Long-term care costs vary significantly by the type of care and by geography. The national medians from the 20252026 CareScout and Genworth Cost of Care surveys provide the clearest picture:
Type of Care Monthly Annual **Year-Over-Year Median Median Change** Nursing home — $11,294 $135,528 +1.0% private room Nursing home — $9,842 $118,104 +2.0% semi-private room Assisted living $6,313 $75,756 +5.0% facility Non-medical home $6,673 $80,080 +3.0% caregiver (44 hrs/wk) Adult day health care $2,058 $24,700 -5.0% Source: CareScout / Genworth Cost of Care Survey 20252026; SeniorLiving.org — Nursing Home Costs by State 2026 These are national medians. Where you live changes the numbers dramatically. In 2026, a semi-private nursing home room ranges from $5,808 per month in Texas to $32,220 per month in Alaska. For context:
State Semi-Private Private **Annual (Private (Monthly) (Monthly) Room)** USA — National $9,842 $11,294 $135,528 Median Alabama $8,649 $9,036 $108,432 California $12,407 $16,102 $193,224 Connecticut $15,973 $17,586 $211,032 Florida $11,086 $12,390 $148,680 New York $15,619 $16,506 $198,072 Texas $5,808 $7,519 $90,228 Alaska $32,220 $32,220 $386,640 Source: SeniorLiving.org — Nursing Home Costs by State 2026; CareScout 2026 Regional Data A five-year stay in a private room in California — not an uncommon duration for someone with advancing dementia — could cost more than $966,000 at current rates. That figure exceeds the total retirement savings of most American households.
The Retirement Shield Long-Term Care Gap Report provides
ASPE/HHS — Long-Term Care Services and Supports for Older|CareScout / Genworth Cost of Care Survey 20252026;|SeniorLiving.org — Nursing Home Costs by State 2026; CareScout