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Long-Term Care Calculator

Project what long-term care will cost when you need it. Compare self-insure vs buying an LTC policy with breakpoint analysis, and build a funding strategy with HSA tax advantages. Based on 2026 Genworth Cost of Care Survey data.

Average onset ~80. 70% of people >65 need LTC
2026 Genworth national medians
Regional cost multiplier vs national median
%
LTC costs rise ~5%/yr, faster than general CPI

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How to Use This Calculator

Cost Projector tab

The default tab. Select your care type (nursing home, assisted living, or home health aide), enter your current age and planned care age. The calculator projects what that care will cost when you need it, using LTC-specific inflation (~5%/yr). Expand "More options" to adjust your region and inflation rate. Today's $116,800/yr nursing home could cost $500,000+ in 30 years.

Self-Insure vs Policy tab

Compare two strategies head-to-head: buying an LTC insurance policy vs. investing the premium amount yourself. See total premiums paid to age 85, policy coverage value with inflation rider, and the self-insure fund you would build by investing premiums instead. Includes breakpoint analysis showing when each strategy wins.

Funding Strategy tab

Build a concrete savings plan. Enter your current savings earmarked for LTC, monthly contribution, and expected return. See your projected fund size, how it compares to projected care costs, and the coverage gap. Includes HSA funding option with age-based LTC premium deduction limits.

Share your result

Every input is encoded in the URL. Click Share to send your exact scenario to a spouse, financial advisor, or elder law attorney.

The Formula

Long-term care costs grow faster than general inflation. The core projection formulas:

Projected Annual Cost = Today's Cost × (1 + LTC Inflation)^Years × Regional Multiplier

Total Care Cost = Sum of (Annual Cost × (1 + Inflation)^year) for each year of care

Self-Insure Fund = Annual Premium invested at Return% for N years (compound growth)

Policy Coverage = Daily Benefit × (1 + Rider%)^Years × 365 × Benefit Period

LTC Fund = Current Savings × (1 + r)^n + Monthly × ((1 + r)^n - 1) / r

LTC costs have historically inflated at ~5% per year, significantly faster than the ~2-3% general CPI. A nursing home costing $116,800/yr today could cost $505,000/yr in 30 years at 5% inflation. This is why early planning matters — the compounding works both for your investments and against you on costs.

Example

Barbara & Tom — both 55, planning in the Northeast

They want to understand LTC costs 25 years from now and compare insurance vs self-insuring. Northeast region (1.15x multiplier).

Cost Projector

Nursing home (private, NE)$134,320/yr today
At 5% inflation, 25 years out$454,600/yr
3-year care total$1,432,000

Self-Insure vs Policy

LTC policy: $4,000/yr premium$120,000 total premiums
Policy coverage ($200/day, 3% rider, 3 yr)$471,000 at age 85
Self-insure: $4,000/yr at 6%$219,600 fund at 85
Policy leverage3.9x premiums paid

The policy provides $471K in coverage for $120K in premiums — 3.9x leverage. Self-insuring yields $220K, which Barbara keeps if she never needs care. The trade-off: the policy protects against catastrophic 5+ year care needs where self-insurance would be depleted.

Hybrid LTC / life insurance alternative

A hybrid policy combines life insurance with LTC benefits. If Barbara needs care, the LTC benefit pays out. If she never needs care, Tom receives a death benefit. Premiums are typically fixed and guaranteed. These policies have become increasingly popular as standalone LTC carriers have raised rates 40-60% on existing policyholders.

FAQ

Long-term care (LTC) is assistance with daily living activities like bathing, dressing, eating, and mobility. It includes home health aides, assisted living facilities, and nursing homes. LTC is custodial care, not medical treatment. Medicare does NOT cover long-term custodial care. According to the Department of Health & Human Services, 70% of people over 65 will need some form of LTC. Average duration: 3 years for women, 2.2 years for men.
National medians from the Genworth Cost of Care Survey: nursing home (private room) $116,800/yr (~$320/day), assisted living $64,200/yr (~$176/day), home health aide $75,500/yr (~$207/day for 44 hrs/week). Costs vary dramatically by region: the Northeast is ~15% above national median, the West Coast ~25% above, and Alaska/Hawaii ~40% above. LTC costs inflate at ~5% per year, significantly faster than general CPI.
It depends on your assets, risk tolerance, and family history. LTC insurance provides leverage (typically 3-4x premiums in coverage) and protects against catastrophic long-term care needs. Self-insuring lets you keep the money if you never need care, but leaves you exposed if care extends beyond 3-5 years. Many advisors recommend a hybrid approach: partial self-insurance combined with a smaller LTC policy. Hybrid life/LTC policies have become popular because they return premiums as a death benefit if care is never needed, and premiums are guaranteed not to increase.
Yes. HSA funds can pay for qualified long-term care services and LTC insurance premiums up to age-based limits (IRC §213(d)(10)). For 2026: age 51-60 can deduct up to $1,930/yr, age 61-70 up to $5,110/yr, and age 71+ up to $6,390/yr in LTC premiums. This makes the HSA a triple tax advantage for LTC: tax-deductible contributions, tax-free growth, and tax-free withdrawals for qualified LTC expenses. If you have an HDHP, maximizing HSA contributions for future LTC needs is one of the most tax-efficient strategies available.
Medicaid covers ~60% of all nursing home residents, but qualifying requires spending down your assets to roughly $2,000 in countable assets (varies by state). There is a 5-year look-back period for asset transfers, meaning gifts or transfers within 5 years of applying can trigger penalties. Medicaid primarily pays for nursing home care with limited coverage for assisted living and home care. An elder law attorney can help with Medicaid planning strategies such as irrevocable trusts and spousal protections.

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