What Three Years of Care Might Cost, and Where the Money Could Come From
Medicare pays for that, doesn't it?
Picture a couple named Norbert, 76, and Gladys, 74. Their daughter visited and asked a plain question. "If one of you needed help for a few years, how would it be paid?"
Norbert answered fast. "Medicare pays for that, doesn't it?"
Gladys had thought so too. They looked it up together, starting with how likely care is.
The Administration for Community Living, a United States government agency, says almost 7 in 10 people turning 65 will need some long-term care, for about 3 years on average. About a third will not need it, and about one in five will need it for more than 5 years. Three years is an average and not a forecast.
| Care, national median in 2025 | Per month | Three years |
|---|---|---|
| Non-medical caregiver at home, 44 hours a week at US$35 an hour | About US$6,670 | About US$240,000 |
| Assisted living | About US$6,200 | About US$223,000 |
| Nursing home, private room | About US$10,800 | About US$389,000 |
(CareScout Cost of Care Survey 2025. Totals are our arithmetic. Prices vary by city and by country.)
Then they listed the places the money could come from.
| Source | What it could do | What to know |
|---|---|---|
| Savings | Pays any of the above | The reserve in the surplus article could be sized from this table |
| Long-term care insurance | Pays a daily amount up to a limit, after a waiting period | Cost depends on age and benefit, and premiums can rise. Whether a private policy pays for care abroad is a question for the insurer, in writing |
| The house | Could be sold, rented, or both | A home can be a large part of what a couple owns |
| Medicare | Up to 100 days of skilled nursing or rehabilitation after a hospital stay | It does not cover custodial care when that is the only care needed. From day 21 in 2026 there is a daily charge of US$217. It generally does not cover care outside the United States |
| Medicaid | A state program that may pay when other money is gone | It looks back 60 months at gifts, which is the caution below |
The Administration for Community Living adds that most people pay for care with a mix of insurance, income and savings.
Gladys read the Medicare page aloud, and then she put the pen down. "Medicare is not what I pictured," she said.
"Neither is the price," Norbert said. He did not say it unkindly.
One caution before they closed the laptop. Medicaid looks back 60 months at gifts and transfers. A gift to the children, or a house signed over, within that window may mean a period when Medicaid will not pay for long-term care. The period starts once the person would otherwise qualify and is in care. Rules differ by state. A lawyer who works with Americans abroad, or one in the state that would pay, could explain it before any gift is made.
You could…
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Price the three levels of care in the town where you live, and compare them with the table.
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Ask an insurer in writing what a policy pays, where, and after how long.
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Ask a lawyer about the 60-month rule before giving anything large.
How did your family plan to pay for care? Share it here. Someone reading may be about to answer the same question from a daughter.
Figures are estimates for planning, based on public data. Sources: Administration for Community Living; CareScout Cost of Care Survey 2025; Medicare.gov; Centers for Medicare and Medicaid Services guidance on the Deficit Reduction Act.
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