Educational Reference
Understanding Long-Term Care
A free, non-commercial educational reference for Americans planning ahead — and for adult children helping a parent navigate care options.
Long-term care (LTC) refers to a range of services that help people with chronic illnesses, disabilities, or the frailties of aging perform everyday activities over an extended period. It is not the same as medical care for acute illness. Most long-term care is custodial — help with bathing, dressing, eating, and moving — and is not covered by standard health insurance or Medicare.
Key Statistics
national median cost — nursing home, semi-private room
Genworth/CareScout Cost of Care Survey, 2023What Triggers Long-Term Care
Eligibility for most long-term care insurance benefits — and for Medicaid LTC coverage — is typically determined by a person's ability to perform Activities of Daily Living (ADLs). A benefit trigger is usually defined as needing substantial assistance with two or more of the six standard ADLs.
Washing oneself, including getting in and out of the tub or shower.
Putting on and taking off clothing and fasteners.
Feeding oneself once food is prepared and served.
Controlling bladder and bowel functions.
Getting to and from the toilet and managing hygiene.
Moving in and out of a bed, chair, or wheelchair.
Care Settings Defined
Long-term care is delivered across a spectrum of settings, from a person's own home to a licensed nursing facility. The appropriate setting depends on the level of care needed, personal preference, and financial resources.
- Home Care
- Paid caregivers — home health aides or homemaker companions — provide assistance in the person's own residence. Home care ranges from a few hours per week to around-the-clock live-in care. It is the most common and often preferred setting.
- Adult Day Care
- Community-based programs that provide supervised care, social activities, and sometimes health services during daytime hours. Participants return home in the evenings. Adult day care is typically the least expensive paid-care option.
- Assisted Living
- Residential communities that provide housing, meals, personal care assistance, and social programming. Assisted living is appropriate for people who need help with ADLs but do not require 24-hour skilled nursing care.
- Memory Care
- A specialized form of assisted living designed for people with Alzheimer's disease or other dementias. Memory care units provide secured environments, structured programming, and staff trained in dementia care.
- Nursing Home (Skilled Nursing Facility)
- Licensed facilities that provide 24-hour supervision and both custodial and skilled nursing care. Nursing homes serve people with the highest care needs and are the most expensive setting. They are also the primary setting covered by Medicaid for LTC.
What You'll Find Here
Data on the likelihood of needing care, how long care typically lasts, who provides it today, and how costs have grown over the past two decades.
Read →National median costs by care setting from the Genworth/CareScout Cost of Care Survey, a state-by-state cost table, and inflation projections.
Read →An interactive tool — no email required — that projects your total care cost based on your age, state, care setting, and expected duration.
Read →An even-handed review of eleven funding methods: self-funding, Medicare, Medicaid, traditional LTC insurance, hybrid policies, VA benefits, HSAs, reverse mortgages, and more.
Read →Four worked scenarios with step-by-step math showing how different families have funded long-term care.
Read →A calm, practical checklist of what to evaluate in your 40s, 50s, 60s, and 70s.
Read →Plain-English definitions of the key terms you'll encounter: ADLs, elimination period, spend-down, look-back period, §7702B, and more.
Read →Educational resource only. This site is educational only and is not financial, tax, legal, or insurance advice. Nothing on this site constitutes a recommendation to purchase or forgo any insurance product, investment, or legal arrangement. Consult qualified professionals for advice specific to your situation. Last updated: October 2026.