Paying for long-term care: the main options (US)

What Medicare does not cover

The National Institute on Aging says Medicare does not cover assisted living or long-term care. It generally does not cover long-term stays in a nursing home, although it may pay for some related costs such as doctor services. This guide is US-specific.

The main ways people pay

• Out of pocket: personal savings, a pension or retirement fund, investment income, or the sale of a home (NIA).
• Medicaid: a joint federal and state program for people with limited income that covers some long-term care. Who qualifies varies by state (NIA).
• Long-term care insurance: covers help with daily activities at home, in assisted living or in a nursing home. Check exactly what your policy covers (NIA).
• PACE: some states offer this combined Medicare and Medicaid program, which helps many people who qualify keep living at home (NIA).
• Veterans benefits: the VA covers long-term care at home or in a facility for some veterans (NIA).

Family caregivers

The NIA notes that many states offer some form of pay for family caregivers, most often through Medicaid programs. Contact your state Medicaid agency to learn more.

Next steps

• List the care needed now and what may be needed later.
• Check what any insurance policy really covers before you rely on it.
• Contact your State Health Insurance Assistance Program (SHIP), which offers one-on-one counseling on Medicare, Medicaid and related programs (NIA).