> ## Content Index > Fetch the complete content index at: https://www.smartseniordaily.com/llms.txt > Use this file to discover other available public pages before exploring further. # Most Seniors Won’t Need Long-Term Care — But Those Who Do May Pay Dearly - URL: https://www.smartseniordaily.com/many-seniors-will-never-need-paid-long-term-care-but-the-ones-who-do-could-face-huge-bills/ - Published: 2026-03-15T13:24:34.000Z - Updated: 2026-03-15T13:24:34.000Z - Description: Got $665,000? If you're a woman, it might cost that much... - Author: Smart Senior Daily Staff - Tags: Longterm Healthcare, Assisted Living, Health, Senior Living A new analysis suggests many Americans may worry about long-term care costs unnecessarily — but for those who *do* need care, the price can be significant. According to the [**2025 Long-Term Care Index from Milliman**](https://www.milliman.com/en/insight/2025-milliman-long-term-care-index?ref=smartseniordaily.com), the average **65-year-old should plan to set aside about $135,000** to cover future high-intensity long-term care. But that “average” hides a wide range of outcomes. [**Harry S. Margolis**](https://crr.bc.edu/person/harry-s-margolis/?ref=smartseniordaily.com), an elder-law attorney who contributes to the [**Center for Retirement Research at Boston College**](https://crr.bc.edu/how-much-will-your-long-term-care-needs-cost-it-depends-on-how-average-you-are/?ref=smartseniordaily.com), explains: > “While an average figure can be a helpful anchor point, costs vary substantially,” wrote Margolis. --- Myth #1: Most Seniors Will Need Long-Term Care Not necessarily. Research cited by **Harry S. Margolis** of the Center for Retirement Research at Boston College shows that a surprisingly large number of Americans never require paid long-term care. According to the Milliman Long-Term Care Index: - Nearly **half of men** will never need paid care - About **four out of ten women** will avoid it as well Many seniors receive help from spouses or family members instead of paid caregivers. --- ## Many People Never Need Paid Care One of the more surprising findings: **a large share of Americans never need paid long-term care at all.** According to Milliman’s analysis: - **Nearly half of men** will never need paid long-term care. - **About four out of ten women** will also avoid paid care entirely. - Another **25% of men will need less than one year of paid care.** Women face greater financial risk because they tend to live longer and are more likely to spend extended periods needing assistance. Milliman estimates the average [long-term care](https://www.smartseniordaily.com/long-term-care-insurance-is-back-on-seniors-radar/) cost for **women is about $171,000**, compared with **$98,000 for men**. About **41% of women will need more than one year of paid care**, and **14% may require five years or more**. In those cases, costs can average **around $665,000**. [Seniors and Investing: What’s Hot TodayFrom annuities to housing, here’s how retirees are putting money to work—and what they’re weighing carefully.![](https://storage.ghost.io/c/d9/1a/d91a71e8-ed81-4ec8-8028-ec14ba129b35/content/images/icon/SSD-FavIcon1-337.png)Smart Senior DailySmart Senior Daily Staff![](https://storage.ghost.io/c/d9/1a/d91a71e8-ed81-4ec8-8028-ec14ba129b35/content/images/thumbnail/Investment4.png)](https://www.smartseniordaily.com/seniors-and-investing-whats-hot-today/) ## Families Provide Much of the Care The Milliman estimates assume that all care is paid. In reality, family members often provide a large portion of assistance. [Research](https://crr.bc.edu/how-much-will-your-long-term-care-needs-cost-it-depends-on-how-average-you-are/?ref=smartseniordaily.com) from the **Center for Retirement Research at Boston College** suggests families provide **at least half of** [**caregiving**](https://www.smartseniordaily.com/tag/caregiving/) **hours**, even when someone has significant care needs. The report also does not specify how much care is paid out of pocket versus covered through **Medicaid**. --- Myth #2: Medicare Will Pay for Long-Term Care This is one of the biggest misunderstandings in retirement planning. **Medicare generally does not cover long-term custodial care**, such as help with bathing, dressing, or other daily living needs. It may pay for short-term rehabilitation or skilled nursing after a hospital stay, but ongoing care is usually paid through: - Personal savings - Long-term care insurance - Medicaid for those who qualify That’s why many financial planners say preparing for possible long-term care costs is an important part of retirement planning. --- ## Where You Live Makes a Big Difference Long-term care costs vary dramatically depending on location and the type of care needed, such as home health services, assisted living, or nursing home care. The **most expensive states tend to be on the West Coast and in the Northeast**, where care costs can be roughly **twice the national average**. Lower costs are more common in parts of the **South-Central United States**. [Five States Where Seniors Can Slow Down and Still Get a Good Deal on a HouseWhy rising price cuts are quietly reshaping retirement moves![](https://storage.ghost.io/c/d9/1a/d91a71e8-ed81-4ec8-8028-ec14ba129b35/content/images/icon/SSD-FavIcon1-336.png)Smart Senior DailyGary P Guthrie![](https://storage.ghost.io/c/d9/1a/d91a71e8-ed81-4ec8-8028-ec14ba129b35/content/images/thumbnail/Moving-Across-the-US-1-5.png)](https://www.smartseniordaily.com/five-states-where-seniors-can-slow-down-and-still-get-a-good-deal/) ## Investment Returns Change the Picture The $135,000 estimate assumes savings earn an average **4.35% annual return**. If returns were higher — around **7%** — the average 65-year-old would need about **$74,000** set aside. If returns fall to **3%**, the amount rises to roughly **$187,000**. --- Myth #3: Long-Term Care Always Costs Hundreds of Thousands While some people do face very high costs, many do not. The Milliman study estimates the average 65-year-old should plan for about **$135,000** in potential care expenses. But outcomes vary widely: - Some seniors never need paid care - Others may only need a few months of assistance - A smaller group may require several years of care Women are more likely to face higher costs because they tend to live longer and may spend more years needing assistance. --- ## The Bigger Concern: Most Retirees Don’t Have Much Saved Even the lower estimates could be difficult for many retirees to cover. Data from the **Federal Reserve** shows the **median retirement savings for Americans ages 65–74 is about $200,000**, while those age 75 and older have about **$130,000** saved. That means a significant long-term care need could quickly consume much of a retiree’s savings. For that reason, some experts say the U.S. may eventually need broader long-term care [insurance](https://www.smartseniordaily.com/tag/medicare-insurance/) programs to help spread the risk across the population. --- **Disclaimer:** This article is for informational purposes only and is not financial, legal, or medical advice. Long-term care needs and costs vary widely depending on personal health, location, and family circumstances. Readers should consult a qualified financial planner, elder-law attorney, or healthcare professional when making decisions about long-term care planning.