Why women need to plan for long-term care costs after retirement

For women, living longer than men on average comes with economic risks, including outliving a spouse and requiring long-term care services, experts say.

According to a 2022 report from the Department of Health and Human Services, approximately 57% of Americans who reach age 65 will develop a disability severe enough to require long-term care. Approximately one in four women (26%) will require such care for more than five years, compared with 17.5% of men. The average length of caregiving for women is 3.6 years, compared to 2.5 years for men.

“Women are not only more likely to need care, they’re more likely to need care for a longer period of time,” says Laura Mattia, a certified financial planner and senior vice president and financial advisor at Atlas Team at Wealth Enhancement in Sarasota, Florida.

“In many cases, marital assets are initially used to pay for the husband’s care, and then the woman enters the riskiest phase of her life with fewer resources and no partner to share the burden,” Mattia said.

Long-term care is generally defined as assistance with bathing, dressing, feeding, and other daily living tasks that a person cannot perform on their own. It can be provided in a facility, such as a nursing home or assisted living facility, or in a person’s home.

Women live longer than men on average. According to the Centers for Disease Control and Prevention, the average life expectancy for a U.S. male at birth is 76.5 years in 2024. For women, the average age is 81.4 years.

The gap narrows once you reach age 65, according to CDC data. At that point, life expectancy for men will increase by another 18.4 years to 83.4 years. For women, that average is 20.8 years, or 85.8 years.

Medicare, the federal health insurance program for individuals age 65 and older, typically does not cover long-term care. This could result in future expenses that are a big unknown, but experts say you should plan for.

Some people who need long-term care rely on unpaid caregivers, such as family members or friends, and may be able to qualify for Medicaid if they have minimal assets or income. Some people are self-insured. That means you have enough assets to cover your potential costs. Additionally, some people rely on some form of insurance.

“There’s no one-size-fits-all answer,” says CFP Patty Black, a financial advisor at Savant Wealth Management in Birmingham, Alabama. “It depends on their resources, what kind of income they have.”

The cost of long-term care also depends on the type of services needed, which can make a big difference. For example, for home assistance, the national median hourly wage for non-medical caregiver services in 2025 was $35 an hour and for private nurses $90 an hour, according to a March report from insurer Genworth Financial.

In 2025, the median daily wage for a semi-private nursing home room was $315 per day, or $114,975 per year, and for a private room, it was $355 per day, or $129,575 per year, Genworth said. Nursing homes cost $6,200 per month or $74,400 per year.

When it comes to insurance coverage, there are standalone long-term care insurance options or hybrid options that combine long-term care insurance with life insurance or an annuity.

“You don’t need something to cover all the money you’re going to spend in a nursing home or have someone come to your home,” says CFP Jeff Judge, managing partner at Chesapeake Financial Planners in Forest Hill, Maryland. “You just need to bridge the gap between guaranteed income, such as pensions, annuities, and Social Security, and expected costs.”

As of 2024, about 5.8 million people will have single long-term care insurance through private insurance, according to business consulting firm Milliman. The average age of new policyholders in 2023 was 57 years old.

However, these insurance policies can be expensive depending on your age, health, and amount of insurance purchased. And women generally pay higher premiums than men.

For example, a healthy 55-year-old woman with an initial policy worth $165,000 with 3% inflation protection will cost her an average of $3,750 a year, according to the industry group Long-Term Care Insurance Association of America. This equates to $2,200 for a healthy 55-year-old man. For a healthy 65-year-old to purchase insurance, the average cost is $5,290 and $3,280, respectively.

Either way, these premiums are likely to rise, like most types of insurance, experts say. Black said there have been significant price increases in the past.

“We need to consider our options and understand the history of premium increases and what will happen in the future,” Black said.

Additionally, if you wait to buy insurance until you already have a health problem, your insurance company may deny coverage, he said.

According to LIMRA, an insurance and financial services industry research and professional organization, hybrid insurance (life insurance with long-term care benefits) has been a popular option compared to standalone insurance since around 2014. These policies typically provide coverage if care is needed and a death benefit to the beneficiary if not.

“These will still be expensive, but at least there will be some benefit, whether it’s long-term care or death benefits,” Black said. In other words, if you buy a stand-alone policy and don’t use any benefits, you won’t pay out.

It is also possible to purchase shared insurance, which could lead to cost savings, the judge said. These policies have separate benefits for each spouse that may be available to the other if you exhaust your benefits. Coverage may also include common benefits that are available to either party.

“A joint pool of insurance with her husband provides minimal coverage at a reasonable price,” the judge said. “It may be a better choice for clients who are budget-conscious or have young husbands.”

However, she said it’s important to remember that her husband may need care first and deplete the shared pool.

Nevertheless, the judge said this “is an appropriate solution for most customers, as opposed to no coverage.” “They just need to understand what can happen and accept the trade-off in exchange for lower monthly premiums.”

Black said the most important thing is to start considering your options long before you need them.

“No one wants to talk about, ‘Oh my god, what if I need help going to the bathroom or getting dressed in the future?’ But it’s really important to think about it,” Black said. “I encourage you to step up, have the conversation, and consider your options. Your family will thank you in the future.”