70% of people over 65 will need some form of long-term care. The average cost is $60,000–$150,000/year.
Medicare covers almost none of it. This planner helps Partner 1 and
Partner 2 estimate the cost, understand the options, and plan accordingly —
so this doesn't blindside your retirement portfolio.
The number most retirement plans ignore:
The median cost of a private nursing home room in the US is $11,139/month (~$133,700/year).
Home health aides average ~$6,900/month. Medicare covers skilled nursing only after a 3-day hospital stay,
and only for the first 20 days at full cost. After day 100, you're entirely on your own.
Medicaid covers LTC — but only after you've spent down nearly all your assets.
Est. LTC Reserve Needed
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Total for both partners
Monthly Set-Aside
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To self-fund from now
Portfolio Impact
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If unfunded, drawn from savings
Your LTC Planning Assumptions
LTC Cost Analysis
Portfolio Impact: Funded vs. Unfunded LTC
Orange line = with LTC reserve deducted · Teal line = without LTC reserve (optimistic) · Shaded area = the risk gap
Types of Long-Term Care — 2025 National Median Costs
In-Home (Part-Time)
$4,576/mo
Home health aide ~20 hrs/week. Good for early stages. Family provides remaining care.
In-Home (Full-Time)
$6,864/mo
Home health aide 40+ hrs/week. Allows staying in own home. Often preferred option.
Assisted Living
$6,200/mo
Residential community with meals, activities, help with daily tasks. Not skilled nursing.
24/7 skilled nursing, private room. Full control, most privacy. Highest cost.
These are national medians for 2025. Costs vary dramatically by location — urban areas in the Northeast and West Coast run 50–100% higher.
Costs also rise with medical inflation (~4–5%/year), so a $9,000/month nursing home today may cost $15,000+/month in 20 years.
LTC Funding Strategies — What Are Your Options?
Self-Fund (Dedicated Reserve)
Complete control
Unused funds go to heirs
No premiums, no insurer risk
Requires large liquid reserve
Market risk during care period
Best for: High net worth ($2M+), disciplined savers
Traditional LTC Insurance
Transfers risk to insurer
Daily/monthly benefit for care costs
Inflation protection riders available
Expensive — $2,000–$5,000+/yr per person
Use-it-or-lose-it (no payout if no claim)
Insurers have raised premiums significantly
Best for: Ages 55–65, good health, middle wealth
Hybrid Life/LTC Policy
Death benefit if care not needed
Premiums typically guaranteed
Asset-based — not use-it-or-lose-it
High upfront lump sum often required
Lower LTC benefit per dollar than pure LTC
Best for: Those with liquid assets looking to reposition
Home Equity / Reverse Mortgage
Taps into built-up home equity
Can fund in-home care specifically
No monthly payments required
Reduces inheritance for heirs
Complex rules, fees, and restrictions
Best for: High home equity, want to age in place
Family Caregiving
Lowest financial cost
Familiar environment and relationships
Enormous burden on family caregivers
May require one family member to stop working
Not viable for high-acuity care needs
Best for: Early stages, strong family support system
Medicaid (Last Resort)
Covers nursing home indefinitely
No cost to you after spend-down
Must spend down to ~$2,000 in assets
5-year lookback on asset transfers
Limited facility choices, shared rooms
Spouse protections are complex
Relevant for: Very low income/assets — plan before you need it
