Long-Term Care Insurance: Do You Really Need It?

Long-term care insurance helps cover the costs of services that regular health insurance or Medicare will not. Think nursing homes, assisted living, in-home health aides or even adult day care. These services are expensive, and the odds of needing them are higher than many women realize.

According to the U.S. Department of Health and Human Services, 70 percent of people over 65 will need some form of long-term care during their lifetime. Yet only about 7 percent of adults 50 and older currently hold long-term care insurance policies (Source: American Association for Long-Term Care Insurance, 2025).

Without coverage, you are paying out of pocket. The average annual cost of a private room in a nursing home was $116,800 in 2024 and is expected to climb higher in 2025 (Source: Genworth Cost of Care Survey). Assisted living facilities average $64,200 annually, while in-home health aide services run about $75,500 per year. Costs can wipe out savings quickly, especially for women who live longer.

For single women, long-term care is an especially important planning issue. You may not a person who is available to provide care or housing support. If you need paid care, costs can quickly erode retirement savings, so knowing your options matters.

Who has long-term care insurance today, and how common is it?

Very few people buy private long-term care insurance. Estimates vary but the market share is small. Industry research quoted by KFF and LIMRA shows only about 3 to 4 percent of Americans age 50 and older currently hold a long-term care policy. Other industry organizations estimate slightly higher ownership rates, roughly 6 to 8 percent, depending on the data and definitions used.

Why so few? Policies can be expensive, underwriting can exclude many older buyers and people often prefer to self-fund or rely on Medicaid as a last resort.

Who needs long-term care insurance most?

No one knows exactly if or when they will need care, but some groups are at greater risk. For single women with no children, the reality is clear: you may not have a spouse or adult child to step in. That means relying more heavily on paid help, which comes with steep price tags. How big are the costs you might face without insurance?

Long-term care costs are already high and rising. Genworth’s Cost of Care survey shows national median annual costs in 2024 and 2025 roughly as follows: private nursing home room about $127,750 per year, assisted living about $70,800 per year and an in-home health aide about $77,792 per year. Those figures rose year over year and are likely to keep rising.

Put bluntly, a few years of care can cost several hundred thousand dollars. That is why even modest insurance benefits can matter for protecting retirement savings.

What types of long-term care insurance exist?

Type of Policy	How It Works	Best For	Watch Outs
Traditional LTC Insurance	You pay annual premiums. If you need long-term care, the policy pays out up to a set daily or monthly amount.	Women in their 50s or early 60s who want affordable premiums.	Premiums can rise, and if you never use it, the money is gone.
Hybrid LTC + Life Insurance	Combines a life insurance policy with long-term care benefits. If you never use LTC, your heirs get the life insurance payout.	Those who want flexibility or worry about “wasting” premiums.	Costs more than traditional policies.
Employer or Association Plans	Some jobs or professional groups offer LTC as a benefit.	Women still in the workforce, especially in their 40s or 50s.	Limited options, and you may lose coverage if you leave the job.

Sources: American Association for Long-Term Care Insurance, NCOA.

How much does it cost?

Premiums vary widely based on age, health, and type of policy. According to the American Association for Long-Term Care Insurance (2025):

• A healthy 55-year-old woman can expect to pay around $2,700 per year for a traditional policy with $165,000 in total benefits.
• By age 65, the same coverage can cost $4,500 per year or more.
• Hybrid policies cost more upfront but guarantee that benefits are used in some way.

Who is eligible and when should you buy?

Eligibility is mostly about health. Insurers underwrite policies. Chronic conditions can lead to denials or higher premiums. Age matters too. Buying in your 50s or early 60s usually gets substantially lower premiums than buying later. Industry examples show a healthy 55-year-old woman might pay roughly $1,500 a year for a modest traditional policy with $165,000 total benefits, while buying the same benefit at 65 can cost several thousand dollars a year. Exact prices vary by health status, benefit size, inflation protection and insurer.

For many experts, the sweet spot to consider buying is the 50s. That balances lower premiums with realistic odds of needing care later.

When should you start planning?

Most experts recommend shopping for long-term care insurance in your early to mid-50s. Wait too long and premiums skyrocket, or you may not qualify due to health conditions. Buy too early and you pay premiums for many years before likely needing care.

What if you decide not to buy?

Some women skip long-term care insurance and instead plan to self-insure. That means saving and earmarking a significant portion of assets for future care costs. To give a sense of scale: if nursing home care costs $116,800 annually, you would need $350,000 to $400,000 saved just for three years of coverage.

Self-insuring works if you have a large enough portfolio, but it requires discipline. For many women, especially those who are single, insurance provides peace of mind.

What are the risks of not planning at all?

If you do nothing, the risk is clear: out-of-pocket costs drain savings and limit options for quality care. Some women may end up relying on Medicaid, which can be a problematic fallback plan. Medicaid will pay long-term care only for people who meet strict income and assets limits but eligibility often requires spending down most of your assets. That can mean less choice in facilities or care providers.

How do you evaluate whether a policy is worth it for you?

Ask these questions:

• How likely am I to need care based on family history and health? (Women tend to need care longer than men.)
• How much can I realistically set aside to self-insure without compromising retirement goals?
• How much benefit do I want the policy to pay each month and how long should benefits last?
• Do I want inflation protection on benefits so payouts keep pace with rising care costs?
• What is the underwriting lookback for preexisting conditions and how might that affect price?

A financial planner or fee-only advisor who understands LTC can run scenarios with you. Hybrid policies are worth considering if you worry about “wasting” premiums.

What does this mean specifically for single women?

As a single woman you may be more likely to rely on paid care if you need help. That makes the cost issue more acute and the case for at least evaluating insurance stronger. If you prefer to preserve a legacy for heirs or charity, a hybrid policy gives both care protection and death benefits. If you prefer to keep assets fully liquid, plan a robust self-insurance strategy that earmarks funds for care and protects other retirement income streams.

Keep in mind:

• Independence requires planning. Without a spouse or child to step in, your care will likely come from professionals.
• Premiums may feel steep, but so are the costs of care. Paying $2,700 per year at 55 could save you from spending six figures later.
• Flexibility matters. Hybrid policies can be attractive if you want the reassurance of life insurance benefits.
• Talk to a professional. Long-term care insurance is complicated. A financial advisor can help you find the right fit.

What are the benefits and drawbacks of long-term care insurance?

Pros of buying LTC insurance now

• Shields retirement savings from catastrophic care costs.
• Gives more choice about where you receive care.
• Hybrid policies protect heirs.

Cons of buying now

• Premiums add to annual budget.
• Policies must be underwritten, so health issues limit eligibility.
• If you never need benefits, premiums are not refunded for traditional policies.

How the numbers can look in practice

Below are sample, realistic scenarios using national median costs and a sample policy benefit level from industry data. These are examples only, not predictions.

Care setting	Annual cost (median)	3 years	5 years	10 years
Nursing home private room	$127,750	$383,250	$638,750	$1,277,500
Assisted living	$70,800	$212,400	$354,000	$708,000
In-home health aide	$77,792	$233,376	$388,960	$777,920

(Source: Genworth Care Cost Survey 2024/2025)

Example with insurance: a traditional policy that pays $165,000 total in benefits would reduce out-of-pocket by that amount. If you pay a sample premium of $1,500 a year for 10 years, your premium cost is $15,000 while benefits could offset much larger care bills. Premiums and benefit structures vary widely, so run your own numbers.

How do you buy a policy and what should you watch for?

1. Start early and shop around. Compare quotes, benefits, elimination periods, and inflation riders.
2. Consider a hybrid policy if you want a death benefit for heirs.
3. Review the insurer’s financial strength ratings. Choose companies rated highly by A.M. Best or Moody’s.
4. Ask about rate increase history. Some carriers have raised premiums on older blocks of business. 
5. Talk to a fee-only financial planner or independent broker, not someone paid solely on commission.

Long-term care is one of the largest single expenses that can appear in retirement. For single childfree women, it is a planning priority because paid care is likely to play a major role if you need help.