What Aging Actually Costs: The Long-Term Care Numbers Every Family Should See

A private room in a U.S. nursing home now costs a median of $129,575 a year — $355 a day, every day — according to CareScout's 2025 Cost of Care Survey, released in March 2026. For comparison, KFF reports that the median Medicare beneficiary has an income of about $36,000 a year and roughly $103,800 in savings. That gap, between what care costs and what most households have, is the single most underestimated number in retirement planning. Most families discover it mid-crisis — a parent falls, a spouse's memory slips — and someone ends up comparing facility price sheets under pressure. The data below is meant to move that discovery earlier, while there are still choices to make.

Key statistics at a glance

• $80,080/year — median cost of a non-medical in-home caregiver at 44 hours a week, at $35/hour (CareScout, 2025)
• $120,900 — average future long-term care cost for an American turning 65, in today's dollars; families pay about 37% of it out of pocket (HHS ASPE, 2022)
• 61% — share of the $415 billion the U.S. spent on long-term services and supports in 2022 that was paid by Medicaid, versus 17% out of pocket (KFF, 2024)
• 63 million — Americans who provided unpaid care to an adult or child with complex needs in the past year, nearly 1 in 4 adults (AARP/NAC Caregiving in the U.S., 2025)

What each care setting costs in 2025

CareScout (a Genworth company) has tracked care prices for over two decades; its 2025 survey collected more than 25,000 provider rates across all 50 states between July and November 2025. The national medians:

Two things stand out. First, "staying at home" is not the cheap option once needs become substantial: at 44 hours a week, in-home help already costs more than the median assisted living community, and round-the-clock home care costs multiples of that. Second, even slower price growth compounds on a high base — assisted living rose 5% in a single year.

Your odds of needing care are higher than you think

The most-cited figure in this field comes from an HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) analysis by the Urban Institute's Richard Johnson: about 70% of adults who survive to age 65 develop severe long-term care needs before they die, and 48% receive some paid care.

ASPE's 2022 microsimulation update, which uses a stricter definition (needing help with at least two activities of daily living for 90+ days, or severe cognitive impairment — the threshold long-term care insurance uses), still puts the risk at 56% of Americans turning 65 today. The same 2022 brief projects an average of $120,900 in future care costs per person in today's dollars.

Duration is where the risk gets lopsided. Per the ASPE data, most paid-care episodes are relatively short — only about a quarter of older adults receive more than two years of paid care, and just 15% spend more than two years in a nursing home. But roughly 22% of adults will live with a serious disability for more than five years, and 14% will spend at least $100,000 out of pocket on care. Long-term care is a classic tail-risk problem: many people pay little, while an unlucky minority faces catastrophic costs.

Where you live can triple the bill

The national medians hide enormous geographic spread. From CareScout's 2025 state tables:

A semi-private nursing home room in Alaska costs nearly five times what it does in Texas, and Connecticut's median private room ($200,750) runs almost double Illinois's ($110,595). If you plan to retire near family in another state, price the care market there, not where you live now.

Who actually pays — and the Medicare misconception

The most expensive planning mistake is assuming Medicare will cover this. It won't. As KFF's 2024 analysis of long-term services and supports (LTSS) explains, Medicare covers at most 100 days of skilled nursing facility care after a qualifying hospital stay, plus limited intermittent home health — it does not pay for ongoing custodial care, the daily help with bathing, dressing, and eating that makes up most long-term care.

Who does pay? Of the $415 billion the U.S. spent on LTSS in 2022, KFF reports Medicaid covered 61%, households paid 17% out of pocket, and other public and private payers covered the rest. But Medicaid is means-tested: it becomes available only after a person has spent down most of their assets. That is the standard trajectory ASPE describes — families pay out of pocket (about 37% of lifetime care costs, on average) until savings are exhausted, then Medicaid takes over. Fewer than 6% of Americans age 50+ held a private long-term care insurance policy as of 2018, per the ASPE brief.

The trillion-dollar line item nobody invoices

Most care in America is never billed at all. AARP and the National Alliance for Caregiving's 2025 Caregiving in the U.S. study counted 63 million Americans — nearly 1 in 4 adults — providing ongoing care to an adult or a child with complex needs, up 20 million since 2015. AARP's 2026 Valuing the Invaluable update estimates that family caregivers of adults provided 49.5 billion hours of care in 2024, worth $1.01 trillion at an average value of $20.41 per hour — more than all paid long-term care spending combined.

ASPE's 2022 analysis puts the same reality in per-family terms: for an older adult with significant disabilities who receives family help, that unpaid care is worth about $204,000 on average — more than the expected cost of all their paid care. "We'll just take care of Mom ourselves" is a real plan, but it is not a free one; it is typically financed with a daughter's or spouse's income, retirement savings, and health.

Five numbers to plan around

1. Price your likely market, not the national median. Pull the cost of an in-home caregiver and assisted living for the state where you (or your parents) will actually age. The range is $52,425 to $145,155 a year for assisted living alone.
2. Plan for a 2–3 year window, insure the tail. Most paid-care spells are under two years, but 22% of people need help for more than five. Cover the probable case with savings and income; think about how you would handle the catastrophic one.
3. Build a care income floor. Guaranteed lifetime income can fund an $80,000/year home-care bill without forcing asset sales in a down market — this is one of the core use cases for retirement annuities.
4. Ring-fence final expenses separately. Long-term care routinely drains the savings families assumed would cover a funeral (a single year in a semi-private nursing home room now runs $114,975). A small final expense policy keeps that obligation off your children's credit cards no matter what care ends up costing.
5. Put it in writing before the crisis. Decide, while everyone is healthy, who would coordinate care, which home could be sold or borrowed against, and what monthly budget is realistic. Families who decide in an emergency pay crisis prices.

The math favors the early planner

Every figure in this article points the same direction: the risk is common (70% lifetime), the cost is high ($74,400–$129,575 a year), the default payer is your own savings until Medicaid, and the fallback is 49.5 billion hours of unpaid family labor. None of that is a reason for despair — it is a reason to run the numbers at 55 instead of 75, while insurance, income products, and housing choices are all still on the table. If you want help stress-testing your own plan, you can start a coverage conversation in a few minutes.

Frequently asked questions

Does Medicare pay for nursing home care?

Not for ongoing stays. Per KFF's 2024 analysis, Medicare covers at most 100 days of skilled nursing facility care following a qualifying hospital stay, plus limited part-time skilled home health. It does not cover custodial care — the ongoing help with bathing, dressing, and eating that most nursing home residents actually need.

How much does long-term care cost per year in 2025?

CareScout's 2025 Cost of Care Survey puts national medians at $74,400 for assisted living, $80,080 for a 44-hour-a-week in-home caregiver, $114,975 for a semi-private nursing home room, and $129,575 for a private room. State medians range from roughly half to nearly triple those figures.

What are the odds I'll actually need long-term care?

High. HHS ASPE research finds about 70% of adults who reach 65 develop severe care needs before they die, and 56% will meet the stricter disability threshold used by long-term care insurance. Most paid-care episodes last under two years, but about 22% of adults will need help for more than five years.

Who pays for most long-term care in the U.S.?

Medicaid — it covered 61% of the $415 billion in U.S. long-term services and supports spending in 2022, per KFF, with 17% paid out of pocket. But Medicaid only steps in after a person has spent down their assets, and ASPE estimates families pay about 37% of lifetime care costs themselves. The largest contribution of all is unpaid: family caregiving worth an estimated $1.01 trillion in 2024, per AARP.

Sources

• CareScout/Genworth — CareScout Releases 2025 Cost of Care Survey Results (2026)
• CareScout — Cost of Care Survey 2025: Median Cost Data Tables (2026)
• HHS ASPE / Urban Institute — What Is the Lifetime Risk of Needing and Receiving Long-Term Services and Supports? (2019)
• HHS ASPE — Long-Term Services and Supports for Older Americans: Risks and Financing (2022)
• KFF — 10 Things About Long-Term Services and Supports (2024)
• AARP — New Report Reveals Crisis Point for America's 63 Million Family Caregivers (2025)
• AARP Public Policy Institute — Valuing the Invaluable 2026: Family Caregivers' Contribution Reaches $1 Trillion (2026)