Who looks after you at 85, and where is that easier?
Suppose you are 85 and need help getting dressed in the morning. Or someone you love is 85. Who would come, and what would it cost?
How likely is it to happen? One federal estimate says about 70% of adults who live to 65 will need long-term care at some point. It is attributed to the Department of Health and Human Services. Other summaries give lower figures, from 56% to 60%.
One industry summary says women need about 3.7 years of long-term care on average and men about 2.2. It also says about 20% of people over 65 need it for more than five years.
Needs look different in other places. In Japan, more than 75% of people 65 and older reported no limitations with daily activities. About 17% were in the public long-term care system, more than five million people.
What does care cost in the United States? These are national medians from the CareScout survey of providers, collected from July to November 2025.
Cost of care in the United States, 2025 national medians (CareScout)
| Type of care | Per month | Per year |
|---|---|---|
| Adult day health care, five days a week | $2,058 | $24,700 |
| Assisted living, private one-bedroom | $6,200 | $74,400 |
| In-home care, 44 hours a week | about $6,673 | $80,080 |
| Nursing home, semi-private room | $9,581 | $114,975 |
| Nursing home, private room | $10,798 | $129,575 |
The monthly figure for in-home care is our division of the annual figure by 12.
Who pays? Medicare does not cover custodial care, which is help with bathing, dressing and eating. It covers skilled nursing for a limited time after an illness or injury. Medicaid is the main public payer for long-term custodial care, for people who qualify.
One summary reports that only about 2% to 3% of Americans have long-term care insurance. Another notes that most such policies cover care only in the continental United States. A policy's own wording would say.
Japan took a different route. It made public long-term care insurance mandatory in 2000.
What do other places charge? These figures come from relocation guides, which have an interest in showing low prices. They are indicative, and quality is not measured.
Monthly cost reported for care abroad, in US dollars
| Place | Assisted living | Nursing home | Care at home |
|---|---|---|---|
| United States (CareScout) | 6,200 | 10,798 private | about 6,673 |
| Mexico | 1,000 to 2,450 | not found | 500 to 1,500 |
| Costa Rica | 2,000 to 2,500+ | not found | not found |
| Thailand | not found | 1,500 to 3,000 | not found |
| Philippines | not found | not found | 400 to 700, live-in nurse |
Sources for each row are listed below.
A 2018 national statistics report counted fewer than 900 assisted living communities in Mexico. About 85% of them were private.
In Costa Rica, residents on the pensioner visa declare a minimum pension of $1,000 a month. They typically pay about $120 to $150 a month into the public health system.
At a US private nursing home room, one year costs $129,575. That is 1.35 times the $96,000 a year in the $8,000-a-month example in our money calculator.
Price is one part of the answer. Language, family nearby, and staff who can care for dementia may weigh as much. We have no data on quality in these places.
Care raises three questions: how much help is needed, who pays, and who is near.
Where do you picture being cared for, and by whom? Tell us in the comments. Someone may be asking the same question for a parent.
Sources we read
CareScout, 2025 Cost of Care Survey, national medians. https://www.carescout.com/cost-of-care
CareScout press release, March 2, 2026 (assisted living, nursing home rates). https://d1io3yog0oux5.cloudfront.net/_cd110019bec0d6e9c39ee43fb17e67b0/genworth/news/2026-03-02_CareScout_Releases_2025_Cost_of_Care_Survey_1054.pdf
Caresifter, Senior care costs 2026 (adult day care and in-home care figures from the same survey). https://caresifter.com/what-senior-care-costs
Medical News Today, Does Medicare cover long-term care? (Department of Health and Human Services estimate of 70%). https://www.medicalnewstoday.com/articles/does-medicare-cover-long-term-care
Buddy Insurance, Understanding the cost of care in 2026 (56% figure). https://buddyins.com/learning-center/planning/understanding-the-cost-of-care-in-2022
Humana, Does Medicare cover long-term care? (60% figure). https://www.humana.com/medicare/medicare-resources/does-medicare-cover-long-term-care
JRC Insurance Group, Long-term care statistics 2026 (years of care and insurance coverage). https://www.jrcinsurancegroup.com/long-term-care-statistics/
Medicare Interactive, Medicare and long-term care basics. https://www.medicareinteractive.org/understanding-medicare/medicare-covered-services/limited-medicare-coverage-long-term-care-services/medicare-and-long-term-care-basics
Wikipedia, Long-term care insurance (note on coverage inside the continental United States). https://en.wikipedia.org/wiki/Long-term_care_insurance
Fu and Iizuka, Long-term care in Japan, National Bureau of Economic Research. https://www.nber.org/system/files/working_papers/w31829/w31829.pdf
Population ageing and wellbeing: lessons from Japan's long-term care insurance policy, The Lancet. https://www.sciencedirect.com/science/article/abs/pii/S0140673611611768
Mexico Relocation Guide, Assisted living facilities in Mexico. https://mexicorelocationguide.com/assisted-living-facilities-in-mexico/
Casa Mar Senior Living, Memory care cost in Mexico compared to the United States. https://casamarseniorliving.com/cost-of-memory-care-in-mexico/
Wellness Shepherd, Nursing homes Mexico (2018 national statistics report on assisted living communities). https://wellnessshepherd.com/category/nursing-homes-mexico/
Expat Focus, Costa Rica elderly care. https://www.expatfocus.com/costa-rica/guide/costa-rica-elderly-care
Retire Finder, Assisted living and elder care abroad (Thailand and Philippines). https://retirefinder.com/care-abroad/
Tell us in the comments