How To Pay For Long-Term Care, Chapter 7: The Cost of Long-Term Care

The U.S. Census indicates that 10,000 Baby Boomers turn 65 every single day from now until 2030, and the vast majority of them will need some form of long-term care at some point.

Yet very few of those families know what that care actually costs, and almost none have a plan for paying for it. That gap, between the care that is coming and the cost no one has priced out, is where the panic starts. I have sat at kitchen tables from the Treasure Coast to South Florida long enough to know the exact moment a family realizes care is not something you pick up at the pharmacy. It is a house payment, a tuition bill, sometimes a mortgage and a tuition bill stacked together.

Most families are blindsided by the astronomical costs of care and panic about how they’ll pay for it, and by then they are making their hardest decisions in a hurry. I have been there myself. As a Certified Real Estate Planning Advisor and The Life Transition Specialist, my job is to walk families through these numbers before the crisis, not after. Knowing the cost is the first step to helping a family plan, which is why this chapter is the one I hand to families long before anyone needs a bed.

This companion post covers the same ground as Chapter 7 of my book, How to Pay for Long-Term Care , in a few minutes of reading: the median annual costs by level of care and type of setting, the three factors that drive those prices, and the questions families ask me most. If you are just joining the series, Chapter 1, The Facts , is the place to start.

The median annual cost of long-term care in the United States ranges from about $19,240 a year for adult day health care to $105,850 a year for a private room in a nursing home, according to the 2020 Genworth Cost of Care Survey.

Between those two numbers sit homemaker services, home health aides, assisted living, and semi-private nursing home rooms, and every one of them is a line item a family needs to plan around. Here are the 2020 median annual costs by level of care and type of setting:

There is a wide range of costs for care across the United States. A median is the middle number in a long line of prices, so your community may come in well above or below these figures depending on where you live and the level of care you need. That is exactly why the next question matters.

Three main drivers shape what a family pays for care: the level of care, the geography, and the amenities chosen.

The higher the level of care a loved one needs, the higher the cost. That is the first and most obvious driver, and it is also the one families have the most time to plan around. Planning ahead lets families search for communities that offer a full continuum of care on the same campus, so a move does not have to start over from zero when needs change. A loved one who does not currently need daily assistance but would benefit from meals prepared or housekeeping could start in independent living and pay less now, then transition to higher levels of care later in familiar surroundings, with continuity of care and staff who already know them.

Costs of care are affected by location, the same way costs of living are. Per Genworth’s 2020 Costs of Long-Term Care by State report, 12 months of care in a private one-bedroom assisted living facility averages $80,280 in Delaware versus $36,000 in Missouri, and that gap repeats in every care setting across the country. To bring monthly costs down for senior living or skilled nursing, families might consider communities outside the city, in nearby towns, or even in a different state if that is feasible. It is a hard conversation to have, but price differences of tens of thousands of dollars a year are a real, honest lever.

Amenities are the area where families have the most control, because they are typically add-ons to the standard monthly cost. Common add-ons include:

• The size of the living space, a studio or a one-bedroom instead of a two-bedroom
• Pet fees, which are usually additional fees to bring a pet into the community
• Concierge services, which families could instead cover by having family or friends help with shopping, errands, house sitting, or pet services
• Private transportation, which most communities include for scheduled shopping and errands and offer free or for a nominal fee

Most senior living communities include scheduled transportation for shopping and errands in the standard monthly cost, and private transportation is offered free or for a nominal fee by most communities. Whatever the add-on, the rule is the same: ask what is bundled before you assume what is extra.

The families who plan are the families who never panic.

Know the Cost, Build the Plan

Let’s put real numbers on long-term care for your family

Michael Wisniewski, The Wizard of Real Estate and Life Transition Specialist with The Complete Real Estate Team powered by Dalton Wade Real Estate, helps Florida families from the Treasure Coast to South Florida plan for the real cost of care. Book your free 15-minute strategy call, or call him directly at (561) 441-8420 .

Book Your Free 15-Minute Strategy Call Contact Michael

Prefer to read first? How to Pay for Long-Term Care is free on our website, and Chapter 7 on the cost of long-term care lays out every number. Have a specific question? Contact Michael directly.

If your family is facing the cost of long-term care, you do not have to guess.

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