Most people plan for retirement as if it were simply a smaller version of their working years — a fixed monthly budget, a beach, a little travel. What that plan usually leaves out is the single largest uninsured risk in American finance: long-term care. A single nursing-home stay can cost more than a year of college, and a three-year spell of home health aide services can erase a quarter of a lifetime of savings. This long-term care calculator projects what care will actually cost you, based on the type of care you expect, when you expect to need it, and how fast prices rise, and then estimates the annual premium you would pay to insure against that risk.
Long-term care is not medical care in the usual sense. It is help with the basic activities of daily living — bathing, dressing, eating, toileting, transferring, and continence — the kind of assistance that follows a stroke, a diagnosis of dementia, or simply the slow decline of very old age. Original Medicare does not cover most of it, and regular health insurance does not either. The three options are usually out-of-pocket savings, family care, or a dedicated long-term care insurance policy. This calculator quantifies the bill so you can choose between them with numbers rather than hope.
How to Use
- Enter your Current Age. This is the anchor for both the projection timeline and the insurance premium band — LTC insurance gets dramatically more expensive the longer you wait to buy it.
- Set your Expected Age Care Begins. The average American needs care around age 80, but roughly one in five people never needs formal care at all, and another five percent need it well before 70. Test a range (75, 80, 85) to see how sensitive your number is.
- Pick the Type of Care. Home health aide care is the cheapest per month but often the longest in duration; a nursing home semi-private room is the most expensive per month but usually the shortest stay.
- Enter the Expected Duration of Care. The national average is about three years, but women average closer to four and men closer to two. People with cognitive decline tend to need care the longest.
- Set the Annual Care-Cost Inflation. Long-term care prices have historically climbed 3–5% per year, faster than general consumer inflation, because the industry is labor-intensive. Three percent is a reasonable default; five percent is a stress case.
- Add your Retirement Savings & Investments to see what share of the projected bill your existing assets would cover. If that number is below 50%, insurance or pre-planning is worth a serious look.
The result card shows today's median monthly cost for your chosen care setting, the projected monthly cost at the year you expect to need it, the total lifetime cost of that episode of care, and the estimated annual and monthly premium for an LTC policy sized to cover that pool of money.
How the Projection Works
The calculator starts from the median monthly prices published annually in the Genworth Cost of Care Survey: about $5,948 per month for a home health aide working 44 hours a week, $5,900 per month for a private one-bedroom in an assisted living community, and $8,684 per month for a semi-private room in a nursing home.
It then compounds today's price forward to your expected care-start age at your chosen inflation rate. If you are 55 today and expect to need care at 80, that is 25 years of compounding. At 3% inflation, prices roughly double over 25 years — so a home health aide that costs $5,948 today costs about $12,450 per month by the time you actually need it.
To get the total lifetime cost, the calculator multiplies that projected monthly cost by 12 and sums over every year of the care episode, with inflation continuing to apply during the care itself. The closed-form sum is the geometric series: total = monthlyAtStart × 12 × (((1+r)ᴰ − 1) / r), where D is the expected duration in years and r is the annual inflation rate as a decimal. When inflation is set to zero, the formula collapses to a simple multiplication.
The premium estimate uses a simple age-band rule of thumb: roughly 1.5% of the total care pool at age 45 or younger, 2.5% at ages 50–59, 4% at ages 60–69, and 6% at 70 or older. Real LTC insurance pricing depends heavily on health underwriting, gender, marital status, benefit period, inflation rider, and elimination period, so treat this as a planning benchmark, not a quote.
Examples
Example 1 — A 55-year-old planning ahead. Maria is 55, expects to need home health aide care starting at 80 for about three years, and assumes 3% annual inflation. Today's median home-care cost is $5,948 per month; compounded 25 years it is about $12,454 per month. Over three years with continued inflation, the total lifetime bill comes to roughly $461,921. An LTC policy sized to that pool costs about $11,548 per year, or $962 per month, at her current age band. Her $500,000 retirement savings would cover about 108% of the projected bill on its own — but that leaves nothing for the other 25 years of retirement.
Example 2 — The zero-inflation reference case. If you turn off inflation (set it to 0%) and assume assisted living for three years starting at 80, the math is transparent: $5,900 per month × 12 × 3 = $212,400 total, with an annual premium of about $5,310. This case is useful as a sanity check — it is the floor; any realistic inflation assumption pushes the number well above it.
Example 3 — A high-cost nursing-home scenario. Robert is 60, expects a five-year nursing-home stay starting at 85, and uses 4% inflation. Nursing-home care compounds from $8,684 today to about $23,150 per month by 85, and a five-year episode totals roughly $1,504,662. The estimated annual premium is about $60,187. With $2 million in assets his savings cover roughly 133% of the bill, but for most households this scenario is exactly why LTC insurance exists — a seven-figure uninsured tail risk.
Example 4 — Buying too late. A 72-year-old with otherwise identical assumptions to Maria faces the 6% premium band instead of 2.5%. The same projected $640,000 care pool costs $38,414 per year to insure rather than $16,000 — and many insurers will not even offer coverage after 75 without a clean health history. That gap between the 55-year-old and the 72-year-old is the real cost of waiting.
FAQ
How much does long-term care cost per month?
Based on the most recent Genworth Cost of Care Survey, the national median is about $5,948 per month for a home health aide (44 hours per week), $5,900 per month for a private one-bedroom in an assisted living community, and $8,684 per month for a semi-private room in a nursing home. A private nursing-home room runs closer to $9,700 per month. Prices vary widely by region — urban California, New York, and Hawaii run 30–60% above the national median.
Does Medicare cover long-term care?
Original Medicare covers only short-term, skilled care after a hospital stay — up to 100 days in a skilled nursing facility, and only while you are recovering. It does not cover custodial care: help with bathing, dressing, eating, or supervision for dementia. That is the vast majority of long-term care costs, and it must come out of savings, family care, or a private LTC insurance policy.
When should I buy long-term care insurance?
The sweet spot is your mid-50s. Premiums roughly double every 10 years of issue age, and after 70–75 you become much more likely to be declined for health reasons. A healthy 55-year-old can buy a meaningful benefit for around $2,000–$3,000 per person per year; the same policy at 65 often costs 50–80% more, and at 75 it may not be available at any price.
How long will I actually need care?
The national average is about three years, but the distribution is wide: roughly 20% of people never need formal care, 40% need it for two years or less, and about 20% need it for more than five years. Women average closer to four years, men closer to two. People whose care is driven by Alzheimer's or other dementias tend to need the longest support — often five to eight years.
Is long-term care insurance worth it?
It depends. If your net worth is below about $200,000 excluding home equity, you are unlikely to be able to self-insure, but Medicaid will eventually cover nursing-home care after you spend down. If your net worth is above $2 million, you can usually self-insure and the premium is a poor bet. The middle zone — roughly $500,000 to $2 million of investable assets — is where LTC insurance or a hybrid life/LTC policy tends to make the most sense, because it protects a legacy you would otherwise risk spending on care.
What is the difference between home care, assisted living, and a nursing home?
Home care sends a paid aide to your house for a set number of hours each week; it is the least disruptive but the least intensive option, and it only works while your home can be made safe. Assisted living is a residential community that provides meals, medication management, and help with daily activities in a group setting. A nursing home provides 24/7 skilled nursing care and is appropriate when medical needs are high, such as after a major stroke or in late-stage dementia.
What happens if I run out of money for care?
If you spend down most of your assets, you may qualify for Medicaid, the joint federal-state program that is by far the largest payer of long-term care in the United States. Medicaid eligibility requires very low income and assets (typically under $2,000 in countable assets for a single person), and it generally only pays for care in Medicaid-certified facilities. Planning ahead with LTC insurance, an irrevocable trust, or a hybrid life-insurance policy is how people avoid that spend-down cliff.
Disclaimer
This long-term care calculator is provided for informational purposes only and does not constitute financial, insurance, legal, tax, or medical advice. Cost projections are based on national median figures from the Genworth Cost of Care Survey and the inflation rate you enter; actual prices vary by geography, provider, and market conditions and may differ significantly from the estimates shown. Premium estimates are rule-of-thumb benchmarks and are not insurance quotes; actual LTC insurance premiums depend on health underwriting, gender, marital status, benefit amount, benefit period, elimination period, and inflation rider, and are available only from licensed producers. Medicaid eligibility rules vary by state and change frequently. Always consult a qualified financial planner, insurance agent, or elder-law attorney before making long-term care decisions.