Long-Term Care Insurance Calculator

How to Use the LTC Calculator

Long-Term Care — The Largest Unfunded Risk in US Retirement

Medicare stops at 100 days, and seven in ten will need more

Frequently Asked Questions

• Does Medicare pay for long-term care?+
  No, beyond a very narrow window. Medicare Part A covers up to 100 days of skilled-nursing care if you were first hospitalized for 3+ days AND require ongoing skilled medical care (NOT just custodial care like help with bathing or eating). Days 1-20 are covered in full; days 21-100 carry a USD 217/day coinsurance in 2026. After 100 days: nothing. This narrow window is the single most common Medicare misunderstanding — most retirees believe Medicare covers LTC, it doesn't.
• What's Medicaid LTC and the spend-down?+
  Medicaid is the only US public program that pays for ongoing LTC, but eligibility requires almost no assets: USD 2,000 of countable assets under the federal SSI standard most states use (some states set their own). A community spouse keeps the home and a resource allowance that each state sets within federal minimum and maximum limits adjusted every January (CMS). To qualify, you must "spend down" assets via medical bills, home modifications, prepaid funeral, etc. Lookback period 5 years for asset transfers — gifting kids USD 100K then applying for Medicaid 4 years later triggers a penalty period. Once on Medicaid: limited facility choice, bed shortages common.
• When should I buy LTC insurance?+
  Sweet spot is ages 55-65 — premiums are still reasonable, underwriting still accepts healthy applicants. Younger means more total premium paid over the policy life; older means much higher annual premium and tighter underwriting. After age 70 many carriers won't issue; after 75 most won't. Any significant health event (cancer, stroke, early dementia) can disqualify you regardless of age — buying before such events is the standard advice.
• Traditional vs hybrid LTC — which?+
  Hybrid LTC + life is the modern preferred choice for middle-and-upper-middle income families: locked-in premium, death benefit if unused (no "wasted premium" concern), and modest LTC coverage. Traditional LTC remains cheaper per dollar of pure LTC coverage but premium can rise mid-policy and benefit is "use it or lose it". Hybrids have taken a growing share of new LTC-related sales as traditional carriers raised rates on in-force policies.
• Should I just self-fund LTC?+
  Reasonable if you have USD 2M+ specifically earmarked for LTC (separate from retirement spending budget). Risk: a longer-than-expected LTC episode + market downturn during care can drain the portfolio. The "1.5× expected cost" buffer is a common floor — your earmarked assets should cover roughly 4-5 years of high-cost care, not just the median 2-3 years. High-net-worth families ($5M+) routinely self-fund; middle-net-worth typically benefit from hybrid coverage.
• What about state LTC programs?+
  Washington's WA Cares Fund is the first US public LTC program: workers have paid a 0.58% payroll premium since July 2023, and benefits of up to USD 36,500 (inflation-adjusted) became available in July 2026 to those who qualify. Useful supplement but nowhere near comprehensive. Other states have studied similar programmes but none has enacted one. Don't rely on state programs as primary coverage — benefits are modest compared to actual costs, and rules can change.
• Are LTC premiums tax-deductible?+
  Federal: premiums for tax-qualified LTC policies count as medical expenses (deductible above the 7.5%-of-AGI threshold if you itemise), up to an age-banded cap that the IRS indexes each year in Publication 502. Some states offer additional deductions or credits. Check Publication 502 for the current year's caps and your state's revenue department for state treatment.
• What triggers a claim?+
  Most policies use "ADL trigger" — inability to perform 2 of 6 Activities of Daily Living (bathing, dressing, transferring, toileting, eating, continence) WITHOUT assistance. Or cognitive impairment (Alzheimer's, dementia). Elimination period (typically 90 days) must elapse before benefits start — you pay out-of-pocket during that window. Periodic re-assessment by claims doctors is standard. Claims processes vary by carrier — check complaint records with your state insurance department before buying.
• Can my spouse and I share a policy?+
  Yes — "shared benefits" or joint policies pool the lifetime benefit between spouses. If one spouse uses only 1 year of a 3-year benefit, the other has 5 years available (3 own + 2 transferred). Joint policies are typically cheaper per dollar than two single policies and address the statistical reality that one spouse is much more likely to need care than the other. Available from most carriers; check the shared-care rider.
• What if I'm a non-US person planning LTC for US retirement?+
  If retiring in the US: same coverage options apply as for US citizens — visa-holders can typically purchase LTC if otherwise insurable. If returning to ASEAN or Europe for retirement: care costs in most home countries are a fraction of US levels, but many US policies pay only for care from US-licensed providers or pay a reduced international benefit — read the policy's territorial terms. If your retirement plan is uncertain, hybrid LTC + life with international-care rider is the most portable option.

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