Long Term Care Costs Are Exploding
Our annual compendium of long-term care statistics on usage, cost, insurance, and caregivers.
Christine Benz:
I’m obsessed with the topic of long-term care.
That’s mainly because the topic is personal for me: Both of my parents required long-term care later in their lives. They received high-quality care at home, in line with their wishes, and they had the funds to cover it. But it was still a terribly hard process for them, my siblings, and me.
And when it comes to the financial dimension of long-term care, truly good solutions are few and far between. Long-term care insurance premiums have shown signs of steadying, as insurers have gotten more realistic about pricing policies. But horror stories still pop up: In January, for example, Blue Cross Blue Shield of Florida long-term care insurance policyholders were notified that their annual premiums would increase by an average of 94% through 2021. (Thank goodness for small favors: The company had requested an increase of 280%!) The long-term care insurance marketplace is also changing quickly, with hybrid life/long-term care products gaining popularity at the expense of stand-alone long-term care insurance policies.
To help you arrive at a plan for how you’ll manage your own long-term care costs, I’ve assembled a now-annual compendium of statistics on long-term care. How likely are you to need long-term care and for how long? What does long-term care cost, and what does it cost to insure against it? Who’s providing care, and what toll is that taking on the caregivers?
Each statistic includes a link through to the original source of the information; I’ve aimed to use the most current figures I could find from objective sources, wherever possible.
Usage of Long-Term Care
47.8 million: Number of Americans over age 65, 2015.
87.9 million: Number of Americans who will be over age 65, 2050.
6.3 million: Number of Americans over age 85, 2015.
18.9 million: Number of Americans who will be over age 85, 2050.
52%: Percentage of people turning age 65 who will need some type of long-term care services in their lifetimes.
8%: Percentage of people ages 65-74 who need long-term care services, 2018.
17%: Percentage of people ages 75-84 who need long-term care services, 2018.
42%: Percentage of people older than age 85 who need long-term care services, 2018.
47%: Estimated percentage of men 65 and older who will need long-term care during their lifetimes.
58%: Estimated percentage of women 65 and older who will need long-term care during their lifetimes.
33%: Percentage of people turning 65 who will need nursing-home care at some point in their lifetimes.
70%: Percentage of people in nursing homes who are women.
80: Average age of admission for women in long-term care settings.
2.5 years: Average number of years women will need long-term care.
1.5 years: Average number of years men will need long-term care.
48%: Percentage of people receiving long-term care who need care for less than one year.
19%: Percentage of people receiving long-term care who need care for between one and 1.99 years.
21%: Percentage of people receiving long-term care who need care for between two and 4.99 years.
13%: Percentage of people who will need long-term care for longer than five years.
22%: Percentage of individuals over 65 in the highest income quintile who will have a long-term care need of two years or longer.
31%: Percentage of individuals over 65 in the lowest income quintile who will have a long-term care need of two years or longer.
The Role of Dementia
10%: Percentage of Americans over age 65 who have Alzheimer’s dementia.
38%: Percentage of Americans over age 85 who have Alzheimer’s dementia.
64%: Percentage of Americans with Alzheimer’s dementia who are women.
145%: Percentage increase in the number of people who died from Alzheimer’s dementia, 2000-17.
-9%: Percentage decrease in the number of people who died from heart disease, 2000-17.
8-10 years: Average life expectancy following an Alzheimer’s diagnosis.
2.8 years: Average length of time between when symptoms begin and when an Alzheimer’s dementia diagnosis is made.
Cost of Care
$137 billion: Long-term care expenditures in the U.S., 2000.
$208 billion: Long-term care expenditures in the U.S., 2015.
63%: Estimated percentage of individuals age 65 today who will have no out-of-pocket long-term care costs during their lifetimes.
13%: Estimated percentage of individuals age 65 today who will incur out-of-pocket long-term care costs of between $0.01 and $50,000 during their lifetimes.
11%: Estimated percentage of individuals age 65 today who will incur out-of-pocket long-term care costs of between $50,000 and $150,000 during their lifetimes.
4%: Estimated percentage of individuals age 65 today who will incur out-of-pocket long-term care costs of between $150,000 and $250,000 during their lifetimes.
9%: Estimated percentage of individuals age 65 today who will incur out-of-pocket long-term care costs of more than $250,000 during their lifetimes.
$350,174: Estimated lifetime cost of care for someone with dementia.
$19,500: Median annual cost for adult day care (five days/week), 2019.
$48,612: Median annual cost for assisted-living facility, 2019.
$52,624: Median annual cost for a home health aide (44 hours/week; 52 weeks/year), 2019.
4.55%: Change in annual cost for a home health aide since 2018.
$102,200: Median annual nursing-home cost, private room, 2019.
1.82%: Change in annual nursing-home cost since 2018.
$161,148: Average annual nursing-home cost, private room, Manhattan, 2019.
$58,400: Average annual nursing-home cost, private room, Monroe, Louisiana, 2019.
$24.224: Median annual income from all sources for individuals who are 65 or older.
$41,125: Median annual income for households headed by people 65 or older.
19%: Percentage of long-term care costs that were paid out of pocket, 2013.
8%: Percentage of long-term care costs that were paid by private insurance, 2013.
Caregivers
34.2 million: The number of Americans who have provided unpaid care to an adult 50 or over in the past 12 months.
15.7 million: The number of caregivers for someone with Alzheimer’s or other dementia.
$470 billion: The estimated dollar value of long-term care provided by unpaid caregivers, 2013.
69.4: Average age of care recipient.
49.2: Average age of caregiver.
62.3: Average age of spousal caregivers.
34%: Percentage of caregivers who are age 65 or older.
>75%: Percentage of caregivers who are female.
33%: Approximate percentage of caregivers to people with Alzheimer’s or other dementias who are daughters.
25%: Approximate percentage of caregivers to people with Alzheimer’s or other dementias who are “sandwich generation” caregivers, providing care to children as well as older adults.
33%: Percentage of people providing care to people age 65 or older who describe their own health as fair or poor.
63%: Percentage of dementia caregivers who say their responsibilities have led to working different hours, leaving work unexpectedly, and worrying about finances.
83%: Percentage of care provided to older adults that is delivered by friends or family members.
30%: Percentage of the population aged 65 or older who will rely on family-provided long-term care for two or more years.
34.7: Average number of hours per week worked by unpaid caregivers who have jobs in addition to caregiving.
70%: Percentage of caregivers who suffered work-related difficulties due to their caregiving duties.
44%: Percentage of caregivers who say that their work supervisor is unaware of their caregiving responsibilities.
10%: Estimated percentage of older adults who have suffered from some form of elder abuse.
7%: Estimated percentage of elder-abuse cases that are reported to authorities.
State and Federal Funding
51%: Percentage of long-term care services and supports that were provided through Medicaid, 2013.
21%: Percentage of long-term care services and supports that were provided through other public sources, 2013.
62%: Percentage of nursing-home residents whose care is provided by Medicaid.
20%: Percentage of Medicaid funding that went to pay long-term care costs in 2016.
38%: Expected increase in Medicaid spending for long-term care between 2016 and 2026.
$126,420: Maximum “countable” assets that a healthy spouse can retain for the other spouse to be eligible for long-term care benefits provided by Medicaid, 2019. (Actual amounts vary by state.)
$2,000: Maximum “countable” assets allowable for single individuals who are applying for long-term care provided by Medicaid. (New York state has a higher threshold: $15,450.)
$3,000: Maximum “countable” assets allowable for married couples who are applying together for long-term care provided by Medicaid.
$585,000: Maximum amount of home equity that a healthy spouse can retain, in addition to countable assets, for the other spouse to be eligible for long-term care benefits provided by Medicaid, 2019. (The limit is higher in certain states, such as California.)
$3,160.50: Maximum amount of monthly income that a healthy spouse can receive for the other spouse to be eligible for long-term care benefits provided by Medicaid, 2019. (Actual amounts vary by state.)
100: Days of care in a skilled nursing facility (“rehab”) covered in full or in part by Medicare following a qualifying hospital stay.
Long-Term Care Insurance
11%: Percentage of adults 65 and older who have long-term care insurance coverage, 2014.
57: Average long-term care policy issue age.
55.1%: Percentage of long-term care policies purchased by women, 2018.
20.8%: Percentage of long-term care policies purchased by single people, 2018.
15%: Percentage of long-term care policies that were sold through workplace, 2018.
95.1%: Percentage of just-issued long-term policies that include home-care benefits that are at least equal to the in-facility benefit.
125: Number of insurers offering stand-alone long-term care policies, 2000.
17: Number of insurers offering stand-alone long-term care policies, 2016.
750,000: Number of individual long-term care insurance policies sold, 2002.
56,288: Number of individual long-term care insurance policies sold, 2018.
13.1%: Percentage drop in number of long-term care policies sold, 2017-18.
228,000: Number of hybrid life/long-term care policies sold to individuals, 2015.
461,000: Number of hybrid life/long-term care policies sold to individuals, 2018.
16%: Percentage of life insurance sales that are hybrid life/long-term care policies, 2017.
$1.87 billion: Annual claims on long-term care insurance policies, 2000.
$11 billion: Annual claims on long-term care insurance policies, 2017.
64%: Percentage of long-term care claims that were paid to women.
$2,169: Average annual premium, all in-force long-term care policies, 2018.
0.5%: Percentage of all businesses offering long-term care insurance to their employees.
52.2%: Percentage of long-term care claims paid to claimants between ages 81 and 90.
22%: Percentage of long-term care applicants ages 50-59 who were declined coverage.
30%: Percentage of long-term care applicants ages 60-69 who were declined coverage.
