Short answer

Before choosing any long-term care plan, find out how likely care is for you, what it would cost locally, what Medicare won't pay, what each option costs and pays, who you can trust, how long you have to decide, and who in your family would actually give the care. This page is educational. The Dependency Series sells nothing.

Risk and need

1. How likely is it that I, or my spouse, will need long-term care, and for how long?

Someone turning 65 today has almost a 70% chance of needing some long-term care. Women need it for 3.7 years on average and men for 2.2 years (ACL). For a couple, plan as if at least one of you will need care.

2. Which chronic conditions in my health or family history make long-term care more likely?

Most long-term care traces back to a short list of conditions: dementia, stroke, Parkinson's disease, falls and fractures, arthritis, lung disease, diabetes, heart failure, kidney disease, cancer, vision and hearing loss, and autoimmune disease. Each is explained in The Series, and you can compare them side by side in 12 Conditions Compared. Ask your doctor which ones you're at risk for and how each tends to progress.

3. What does care actually cost where we live, at home, in assisted living and in a nursing home?

In 2025 the national median was $129,575 a year for a private nursing home room, $74,400 for assisted living, and $35 an hour for a non-medical caregiver at home, about $80,080 a year at 44 hours a week (CareScout 2025 Cost of Care Survey). Local costs can be well above or below these medians, so look up your own area.

4. What will Medicare, a Medicare Supplement or my health insurance actually pay?

Medicare doesn't pay for long-term custodial care, meaning help with bathing, dressing or eating when that's the only care you need (Medicare.gov). It can cover a short skilled nursing stay after a qualifying hospital stay, up to 100 days (Medicare.gov). Medicare Supplement plans follow the same rules.

Insurance costs

5. What would long-term care insurance cost at my age and health, and what drives the price?

Age and health when you apply set the price. In the 2026 AALTCI Price Index, a healthy 55-year-old man pays about $950 a year for $165,000 of level benefits, and a 60-year-old woman averages about $4,450 a year for $165,000 in initial benefits (AALTCI). Ask for prices with and without inflation protection.

6. Can my premium go up after I buy, and what is this insurer's rate-increase history?

On many traditional policies, yes. Premiums are usually not guaranteed, and many older policies have had increases. Ask whether the premium is guaranteed and ask for the insurer's rate-increase history in your state. The NAIC Shopper’s Guide explains what to look for.

7. Will I qualify medically, and what are my options if I'm declined?

Most policies are medically underwritten. AALTCI data shows 38% of applicants ages 65 to 69 and 47% of those 70 to 74 are declined (AALTCI). If you're considering genetic testing, read Long-Term Care Insurance and Genetic Testing: Why the Order Matters first.

How coverage works

8. Traditional, hybrid or annuity-based coverage: what happens to my money if I never need care?

With traditional coverage, premiums are not returned. A hybrid life and long-term care policy pays a death benefit if care is never needed. Annuity-based coverage repositions savings you already have. Ask each provider to show you three outcomes: you need care, you don't, or you die early.

9. What triggers benefits, and how long is the waiting (elimination) period?

Tax-qualified policies generally pay when you can't do two of the six activities of daily living for at least 90 days, or have a severe cognitive impairment (IRS Publication 502). Ask how many days you must pay yourself first and whether home care days count toward it.

10. Will the benefit keep up with rising care costs?

Care costs rise most years. Ask what the benefit will be worth in 10 and 20 years with and without inflation protection, and compare that with what care is likely to cost then.

11. What tax advantages can lower the real cost?

Premiums for tax-qualified policies can count as a medical expense up to an age-based IRS limit, for example $4,960 per person for ages 61 to 70 in 2026 (IRS). Ask a tax professional what applies to you.

Trust

12. Is the insurance company financially strong, and how does it handle claims?

A policy is a promise that may be paid 20 or more years from now. Ask for the company's financial strength ratings and how it handles claims, and check with your state insurance department for complaints.

13. Is the person advising me licensed, and do they compare more than one company and more than one type of plan?

Verify any agent's license with your state insurance department, and ask whether they compare several insurers and more than one type of plan. For free, unbiased counseling, contact your State Health Insurance Assistance Program through the Eldercare Locator.

14. Is the policy Partnership-qualified in my state, and should a trust be part of the plan?

In most states, a Partnership-qualified policy can protect assets equal to the benefits it paid if you later need Medicaid. Ask whether a policy qualifies in your state. Trusts used for Medicaid planning have to be set up well ahead of time, so talk with an elder law attorney early.

Results

15. If care started tomorrow, how much would the plan pay, how much would I pay, and for how long?

Ask for the daily or monthly benefit, the total pool of benefits and the gap between that and local costs. For perspective, $250,000 covered only about 2.8 years of care nationwide in 2025, down from 3.8 years in 2020 (Forbes Advisor, citing CareScout).

16. Can the plan pay for care at home, and can it pay a family member?

Most people want to stay home. Ask whether home care is covered from the first day, whether family caregivers can be paid, and whether the policy pays cash or reimburses bills.

Timeline

17. What does waiting one year, or five years, cost me?

Every birthday raises the price, and a new diagnosis can make coverage unavailable. If someone in your family is already showing symptoms, read You’re Suddenly in Charge. Now What?

18. If Medicaid is my backstop, how do the five-year look-back and spend-down affect my home and my spouse?

Medicaid reviews gifts and transfers made in the five years before you apply, and rules for the home, a spouse at home and estate recovery vary by state (Medicaid.gov). Get advice before you move any assets.

Alternatives

19. How does insurance compare with paying privately, Medicaid planning, VA benefits or using the home?

Insurance is one tool among several. Compare all of them before you decide. Our companion site, FundingDependency.com, lays out 10 ways families pay for care.

20. Who will actually provide and coordinate the care, and what will it cost that person?

63 million Americans are family caregivers (AARP), and the emotional toll is often as heavy as the financial one. Name the person, ask whether they can realistically do it, and measure the load with the Caregiver Load Check-In.

Looking at the money side next? FundingDependency answers the same 20 questions through the 10 ways families pay for care: 20 Questions Before You Choose How to Pay for Long-Term Care.

Educational content only, not medical, legal, tax or financial advice. Figures are national medians or published averages and will differ by state, insurer and health. Sources (all accessed October 2026):