Long-Term Care

As people age or become ill, they sometimes need help doing daily tasks like getting dressed, bathing and more. Long-term care (LTC) provides people with those services—but it’s expensive.

As people age or become ill, they sometimes need help doing daily tasks like getting dressed, bathing and more. Long-term care (LTC) provides people with those services—but it’s expensive.

Long Term Care is the type of care received either at home or in a facility, when someone needs assistance with activities of daily living, such as bathing and dressing due to an accident, an illness or advancing age. Rising life expectancy means that the potential need for “long-term care” grows with every passing year of your life.

The likelihood is that you or a member of your family will need long-term assistance due to a prolonged illness, a disability, or general deterioration of your health and ability to perform routine daily activities.

Most long-term care expenses are not covered by Social Security or Medicare, Medicare Supplement (“Medigap”), or private health insurance. Medicaid pays for nearly half of all nursing home care, but you must meet federal poverty guidelines and may have to “spend down” most of your assets on health care.

  • Long-term care is assistance with everyday activities such as bathing, dressing, eating, transferring from bed to chair, and using the bathroom. It is often called “custodial care” and is typically ongoing rather than temporary medical treatment.

  • Most traditional health insurance plans do not cover long-term care services. While they may cover medical treatment or hospitalization, they generally exclude ongoing custodial care services.

  • Medicare does not cover custodial long-term care. It may cover short-term skilled nursing care after a hospital stay of at least three consecutive days, but coverage is limited. Medicare typically pays in full for only the first 20 days and partially for days 21–100. There is no coverage beyond 100 days, and it does not cover ongoing assistance with daily living activities.

  • Skilled care involves medical or rehabilitative services provided by licensed professionals, often following a hospital stay. Custodial care refers to help with daily living activities and personal care needs. Medicare may cover limited skilled care but does not cover custodial care.

  • Medicare may cover home health services only if skilled care is also being provided. It does not cover home health aide services for bathing, dressing, or personal care when those are the only services needed.

  • Medicaid may cover long-term care, but only for individuals who meet strict income and asset limits. In most cases, individuals must spend down most of their assets before qualifying. When Medicaid pays for care, options for facility selection and provider choice may be limited.

  • Many people purchase long-term care insurance to help protect their savings and maintain greater control over where and how they receive care. It can provide financial support for services that are not covered by Medicare or traditional health insurance.

Frequently Asked Questions