On a Tuesday morning in early 2026, Tammy La Barbera sat across from her mother's neurologist in a quiet exam room. Ada, now 93, had been living with dementia for nearly a decade. The diagnosis had come slowly, the costs had come faster. Tammy had already quit her job as an event manager to provide full-time care. She had converted her living room into a care station. She had learned to manage medications, coordinate physical therapy visits, and navigate the paperwork that never seemed to end. What she had not done what almost no one does in time was plan financially for the years that followed.
"I don't have help here, and I know it's going to get worse," Tammy told a reporter in 2023, a sentiment that still echoes through living rooms and kitchen tables across the country. Her story is not exceptional. It is the shape of an emerging crisis that millions of families are quietly living inside right now.
The numbers have grown difficult to ignore. According to 2026 cost benchmarks published by A Place for Mom's annual long-term care report, the national median monthly cost for an assisted living community now stands at $6,200. Non-medical in-home caregivers average $35 per hour. Skilled nursing provided in the home runs $90 per hour. At those rates, a single month of part-time home care can approach $3,000, and full-time residential care can exceed $10,000 before a family fully understands what is happening.
These figures are not abstractions. They are the arithmetic of care and they are reshaping how middle-class families think about retirement, savings, and the conversations they should have before a crisis arrives.
The Scale of the Problem
Long-term care is one of the most underestimated financial risks in American retirement planning. Most people understand that healthcare costs rise with age. Fewer understand that the care most likely to be needed help with bathing, dressing, eating, or managing dementia is not covered by traditional health insurance, Medicare, or most employer benefits.
According to a 2022 report from the U.S. Department of Health and Human Services and the Urban Institute, more than half of Americans who turn 65 today 57 percent will eventually develop a disability serious enough to require long-term care. That care might last months or years. The average future cost of long-term care for someone turning 65 today is estimated at roughly $122,400, according to the same report, cited in a CNBC analysis from May 2025. But that figure represents an average. For families dealing with dementia, stroke recovery, or chronic illness, lifetime costs can reach into the hundreds of thousands of dollars.
"People don't plan for it in advance," said Carolyn McClanahan, a physician and certified financial planner based in Jacksonville, Florida, in that same CNBC report. "It's a huge problem."
The structural gap is well documented. Health insurance generally does not cover long-term care services. Medicare covers only limited skilled nursing and home health care following a hospital stay, and it does not cover custodial or personal care. Medicaid, the largest payer of long-term care, requires families to spend down assets to near-poverty levels before qualifying. And long-term care insurance the product designed precisely for this risk remains owned by a small minority of households.
"It's pretty clear [workers] don't have that amount of savings in retirement, that amount of savings in their checking or savings accounts, and the majority don't have long-term care insurance," said Bridget Bearden, a research and development strategist at the Employee Benefit Research Institute, in the same CNBC report.
What the Numbers Look Like in 2026
The A Place for Mom 2026 cost report draws on data from the organization's nationwide network of partner communities and agencies to establish current benchmarks across care settings. The figures reflect national medians, though actual costs vary significantly by geography, care level, and provider.
Here is how the 2026 national median costs break down across the most common care types:
| Care Type | 2026 National Median | Rate Basis |
|---|---|---|
| Non-Medical In-Home Caregiver | $35 | Per Hour |
| Skilled Nursing in the Home | $90 | Per Hour |
| Adult Day Health Care | $95 | Per Day |
| Assisted Living Community | $6,200 | Per Month |
| Nursing Home (Semi-Private Room) | Available via CareScout | Varies by State |
The year-over-year increase for assisted living communities was 5 percent from 2024 to 2026, reflecting a consistent upward trend that has outpaced general inflation for several years running. Adult day health care showed a slight decrease, dropping from $100 per day in 2024 to $95 in 2026, though this setting serves a narrower population of families seeking daytime supervision rather than full-time care.
For families doing rough math, the implications are straightforward: a year of assisted living at current median rates costs roughly $74,400. Add in periodic skilled nursing visits or memory care upgrades, and the annual figure can approach or exceed $100,000. At that level, a decade of care could consume the entire retirement savings of a household that entered retirement with a comfortable but not exceptional nest egg.
State-by-State Reality
National medians mask enormous geographic variation. The cost of a nursing home room in New York or California bears little resemblance to the same level of care in Mississippi or Oklahoma. CareScout's Cost of Care tool, which has tracked these variations for more than two decades, allows families to explore median costs by state and care type, providing a more precise planning anchor than national averages alone.
For families considering where a parent might relocate, or for adult children trying to estimate what their own future costs might look like in a particular state, these regional differences can be consequential. A family that relocates a parent to a lower-cost state may reduce annual care expenses by tens of thousands of dollars but that decision also involves tradeoffs around proximity to family, access to specialists, and quality of life that no spreadsheet can fully capture.
The CareScout data also highlights how costs have shifted since the organization began its Cost of Care Survey in 2004. Over two decades, the trajectory has been consistently upward across nearly every care category and region. The aging of the Baby Boom generation 10,000 of whom turn 65 every day until 2030, according to CareScout's own reporting ensures that demand will continue to outpace supply for the foreseeable future.
Why Preparation Is So Difficult
The gap between awareness and action in long-term care planning has several roots. One is psychological: most people find it difficult to imagine themselves as the person who needs help with daily activities. Another is financial: even families who understand the risk intellectually often do not know where to begin allocating savings for a cost that may or may not materialize, and that may come in a year or in twenty.
A third factor is structural. Long-term care insurance products have a complicated reputation, shaped by premium rate increases in the early 2010s that left some policyholders paying significantly more than they had anticipated. Some families view these products with suspicion as a result. Others simply never encounter them at the right moment during a financial planning conversation, at a time when health status still qualifies for coverage, before a parent has already moved into care.
The KFF's 2023 survey on the affordability of long-term care provides useful context for understanding public attitudes. The survey found that millions of older adults in the U.S., as well as some younger people with disabilities, require assistance with activities of daily living that may be provided in residential facilities or in their homes. The survey also found significant gaps between what people expect to pay and what they have actually set aside.
Fidelity's own long-term care planning resources note that the question families should be asking is not whether they will need care the odds suggest they will but how they will pay for it when the time comes. The answer typically involves some combination of savings, insurance, family caregiving, and, for those who qualify, Medicaid. Each option has its own timeline, tradeoffs, and requirements.
The Family Caregiver Dimension
No discussion of long-term care costs is complete without acknowledging the unpaid caregivers who sit at the center of the system. According to the CNN report on senior care costs, millions of family members have stepped into roles that once belonged to paid professionals and many are doing so at significant financial and personal cost.
Tammy La Barbera's story is representative in its demands. She had already cared for two children, a brother, and a father through cancer diagnoses before taking on full-time care for her mother. The decision to leave her job was not made lightly. It was made necessary. And it came with a cascade of consequences: lost income, reduced retirement contributions, isolation from professional networks, and the physical and emotional weight of around-the-clock caregiving.
Families often do not account for these indirect costs when they estimate how they will manage. The direct costs of care the monthly fees, the hourly rates, the equipment and home modifications are visible. The opportunity costs of a family member reducing work hours or leaving the workforce entirely are easier to overlook until they appear on a bank statement.
What This Means for SubmitArticle Readers
For readers who research practitioners, frameworks, and ideas the core audience of SubmitArticle the long-term care cost landscape offers a useful context for understanding a category of financial planning that intersects with health, aging, family dynamics, and economic policy. Whether you are evaluating a financial advisor who specializes in aging clients, comparing senior living communities for a parent, or building a content strategy around personal finance and retirement, the numbers in this article provide a grounded starting point.
The key insight is not that long-term care is unaffordable it is that it is unaffordable without a plan. Families who understand the cost ranges, who explore insurance options while they are still accessible, and who have honest conversations before a crisis are better positioned to make choices rather than accept defaults. That is a practical advantage worth knowing about, and worth sharing with anyone who is approaching a decade in which these decisions will become unavoidable.
Where to Read Further
For families ready to explore cost estimates specific to their state and care type, the CareScout Cost of Care tool offers an interactive calculator that projects costs forward using customizable inflation assumptions. The A Place for Mom 2026 report provides additional context on assisted living and home care benchmarks across major metropolitan areas.
For a broader view of public attitudes and the affordability gap, the KFF survey on long-term care affordability offers detailed polling data on what households know, expect, and have prepared. The CNBC analysis from May 2025 provides expert commentary and context for why the gap between costs and preparation remains so wide.
Fidelity's long-term care planning overview walks through the basic questions households should consider coverage options, savings targets, and the role of family caregiving in plain language suited for readers who are new to the topic.
FAQs
What is the average cost of long-term care in 2026?
According to the A Place for Mom 2026 cost report, the national median monthly cost for an assisted living community is $6,200. Non-medical in-home caregivers average $35 per hour, and skilled nursing in the home runs $90 per hour. These figures represent national medians; actual costs vary significantly by state and care setting.
Does health insurance or Medicare cover long-term care?
Health insurance generally does not cover long-term care services, and Medicare does not cover most long-term care expenses, particularly custodial or personal care. Medicare covers limited skilled nursing and home health care following a hospital stay, but it does not cover ongoing personal assistance with daily activities. Medicaid covers long-term care but requires families to meet strict income and asset eligibility thresholds.
How many people will need long-term care?
According to a 2022 report from the U.S. Department of Health and Human Services and the Urban Institute, 57 percent of Americans who turn 65 today will develop a disability serious enough to require long-term care. About 1 in 7 Americans will spend at least $100,000 out of pocket for long-term care, as reported by CNBC in May 2025.
What options do families have for paying for long-term care?
Families typically draw on a combination of personal savings, long-term care insurance, family caregiving, and, for those who qualify, Medicaid. Some also explore hybrid life and long-term care insurance products, reverse mortgages, or veteran benefits. Starting the conversation early while health status still allows for insurance eligibility gives families more options than waiting until care is already needed.
Why don't more people plan for long-term care costs?
Several factors contribute to the planning gap. Many people underestimate the likelihood of needing care, find insurance products confusing or distrustful due to past premium increases, or simply do not know where to start. Financial advisors who specialize in aging clients can help families evaluate options, estimate future costs based on their health history and family situation, and build a plan that accounts for the range of possible outcomes.