Long-term care is the bill that arrives late, after decades of saving, and in dollars that have been inflating the whole time. This calculator takes today's national median care prices, grows them to the year you expect to need care, totals a multi-year stay, and then runs your nest egg through it month by month to answer the only question that matters: how many months of care can your savings actually pay for?
Long-term care planning is a race between two compounding rates. On one side, care inflation pushes the price of a semi-private room or an assisted living apartment higher every year you wait. On the other, your earmarked savings compound. Which side wins decides whether the money is there when you need it, and the uncomfortable truth is that care inflation has historically run close to, and in some years above, typical portfolio returns. The CareScout survey recorded a 5 percent single-year jump in assisted living medians in its latest edition, against a long-run stock market return near 10 percent but a cautious retiree allocation closer to 4 or 5.
The second trap is the averages quoted in most articles. Yes, the average stay is around three years. But averages hide a distribution where half of retirees need little or no paid care and a stubborn minority needs five years or more at six figures a year. Planning to the average means planning to be surprised in exactly the years you are least equipped to absorb it.
Variables in plain terms. C0 is today's annual median cost for the setting you picked. The inflation rate g compounds it for every year D between now and the day care starts, and keeps compounding year over year inside the stay itself, which is why a three-year stay costs more than three times its first year. The nest egg E grows at your expected return r until care begins. From that month the simulation pays care monthly and lets the remaining balance keep earning r. Months covered counts how many months the balance survives the full planned stay; the shortfall prices the rest in future dollars, not today's.
A 55-year-old earmarks $150,000 for care, expects an assisted living stay of three years beginning at 75, and assumes 4 percent care inflation against 5 percent portfolio growth. Today's assisted living median is $74,400 a year. Twenty years of 4 percent inflation lifts the first year of the stay to $163,019.56, and the three years together bill $508,881.86 in future dollars, $232,247.04 expressed in today's money. The $150,000 egg grows to $397,994.66 by the time care starts. Month by month, the balance survives 31 of the 36 months; funding the remaining five months takes $73,467.48 more.
| Default scenario component | Amount |
|---|---|
| Cost today (assisted living median, 2025) | $74,400.00 |
| Projected first-year cost at age 75 | $163,019.56 |
| Total cost of the 3-year stay (future dollars) | $508,881.86 |
| Same stay in today's dollars | $232,247.04 |
| Nest egg at care start ($150,000 at 5% for 20 years) | $397,994.66 |
| Months of care the savings cover | 31 of 36 |
| Shortfall to fund the rest | $73,467.48 |
Move the earmark up or down and the outcome flips fast. The same stay funded at the same rates needs roughly $172,758 set aside at 55 to end at zero. A $200,000 earmark finishes the stay with $69,258.48 left over.
Scale the setting and the duration up, and the numbers outrun intuition. A five-year stay in a private nursing home room starting at 75 bills $1,537,774.03 in future dollars, its first year alone $283,914.78. Even a $500,000 earmark, grown to $1,326,648.85 by then, covers 59 of the 60 months and still ends $27,678.34 short. That is the tail the average-based planning never shows you.
| Egg set aside at 55 | Months covered (of 36) | Outcome |
|---|---|---|
| $100,000 | 21 | $218,707.04 short |
| $150,000 | 31 | $73,467.48 short |
| $200,000 | 36 | $69,258.48 left over |
| $300,000 | 36 | $377,431.64 left over |
Push the start of care later and both sides of the race get stronger. Costs compound longer, but so does the egg. At a 5 percent return against 4 percent care inflation, time quietly works in the saver's favor on coverage even as the sticker price climbs.
| Care begins at | First-year cost | Total 3-year stay | Egg at care start | Months covered |
|---|---|---|---|---|
| 65 | $110,130.17 | $343,782.35 | $244,334.19 | 28 |
| 70 | $133,990.20 | $418,263.80 | $311,839.23 | 29 |
| 75 | $163,019.56 | $508,881.86 | $397,994.66 | 31 |
| 80 | $198,338.22 | $619,132.60 | $507,953.24 | 32 |
| 85 | $241,308.77 | $753,269.47 | $648,291.36 | 34 |
Read that table carefully before drawing comfort from it. Coverage improves by one to two months per five-year delay, but the absolute bill grows by over $400,000 from 65 to 85, and the shortfall that does remain lands on a much older household with no earning years left to recover with. Delaying care is a pleasant thought experiment, not a plan. The variable this table hides is the inflation rate: drop g to 2.5 percent, in line with the survey's own note that 2025 care inflation roughly tracked the 2.7 percent CPI average, and coverage jumps; push g to 6 percent and every row turns into a shortfall. When you run your own numbers, stress-test g before you trust anything else.
Four sources pay for long-term care in America, and three of them are unreliable in predictable ways. Medicare does not pay for custodial care, the help with daily living that defines this page. Medicaid does, but behind a means test that forces a spend-down of savings and, in many states, recovery from the estate after death. Family caregivers pay in unpaid labor, which AARP prices at an average $21,500 a year in lost earnings for the caregiver. That leaves private savings and private insurance, and the calculator above prices the savings route directly.
If the shortfall line in your run is large, the standard responses, in the order most planners weight them: buy coverage earlier while it is priced on your health rather than your age; shift the care setting, since adult day health care at $24,700 a year buys enormous family relief per dollar; plan a home-care mix where family hours substitute for paid ones below the 30 to 35 hour crossover; and protect the tail with Medicaid planning done years ahead of need, since look-back rules punish last-minute transfers. What the numbers argue against is the most common default, which is assuming the need will never arrive. A 70 percent lifetime probability deserves a line in the budget.
To see how a care-sized withdrawal fits into the rest of retirement, run the retirement withdrawal calculator with the stay priced in. The Social Security estimator shows the monthly income that keeps arriving no matter where you live, which is the floor your care plan stands on. And because the earliest years of a care need often arrive as a burst of home modifications and part-time help rather than a facility move, the emergency fund calculator sizes the buffer that keeps the first month of bad news from unwinding the whole plan.
No. Medicare pays for skilled, medically necessary care after a hospital stay, limited to 100 days in a skilled nursing facility with days 21 through 100 carrying a daily coinsurance. The care this calculator prices, help with bathing, dressing, eating, and other activities of daily living, is custodial care, and Medicare explicitly excludes it. Medicare Supplement (Medigap) policies do not cover it either. Medicaid does pay for long-term care, but only after you meet your state's income and asset limits, which for most people means spending down savings first. The default assisted living stay on this page would exhaust far more than any state's countable asset limit.
The Administration for Community Living's planning figures: someone turning 65 today has almost a 70 percent chance of needing some type of long-term care services. Women need care longer, 3.7 years on average, against 2.2 years for men. About one third of today's 65-year-olds may never need paid or unpaid support, while 20 percent will need it for longer than five years. Roughly two thirds of lifetime care happens at home and one third in a facility, which is why the care setting you pick in the calculator moves the total more than any other input.
The CareScout Cost of Care Survey, which collected more than 25,000 provider rates between July and November 2025, puts the 2025 national medians at $6,200 a month for assisted living ($74,400 a year), $9,581 for a semi-private nursing home room ($114,975 a year), $10,798 for a private room ($129,575 a year), $35 an hour for a non-medical home caregiver ($80,080 a year at 44 hours a week), and $95 a day for adult day health care. At the calculator's 4 percent care inflation over 20 years, the $74,400 assisted living median becomes $163,019.56 for the first year of a stay beginning at 75. The inflation assumption dominates everything: it compounds for as many years as you have until care.
Center for Retirement Research at Boston College analysis built on the Milliman 2025 Long-Term Care Index estimates that an average 65-year-old needs about $135,000 set aside and invested, about $171,000 for women and $98,000 for men. But the distribution is brutally skewed: nearly half of men will need no paid care at all, while 14 percent of women will need five or more years of paid care at an average cost of $665,000. Run the default case here and a $150,000 egg set aside at 55 covers 31 of 36 months of assisted living starting at 75, leaving a $73,467.48 gap; roughly $172,758 set aside at the same growth rate funds the full stay.
It depends entirely on hours, and the crossover arrives earlier than most families expect. At the CareScout median of $35 an hour, 20 hours of weekly home care costs $36,400 a year, less than half the $74,400 assisted living median. But 44 hours a week costs $80,080, more than assisted living, and round-the-clock home care runs well past $200,000 a year. The financial crossover sits near 30 to 35 hours a week. Home care also skips the room-and-board component that is baked into facility pricing, so if your housing cost is already paid, the comparison shifts in home care's favor. If a family caregiver covers most hours, paid costs can stay low while the hidden cost, an average $21,500 a year in lost earnings per AARP research, moves to someone else.
The insurance answer is a risk decision this calculator deliberately leaves open. Traditional long-term care policies and hybrid life-plus-LTC policies typically pay a daily or monthly benefit for two to five years, which maps almost exactly onto the average 3-year need, and premiums depend heavily on age at purchase, health, and benefit design. The way to price a policy against this page: treat the benefit pool as reducing your effective care cost, then rerun the stay. If a policy would cover $150 a day for three years, your out-of-pocket share of the default assisted living stay drops by roughly $164,250 in future dollars. Insurance shines for the tail, the 20 percent who need more than five years, and self-funding works when the estate is large enough to absorb the worst case without help.