How this calculator works
It starts from the 2025 national median cost of the care type you pick, taken from the CareScout Cost of Care Survey (the survey Genworth published for two decades, based on roughly 16,000 provider responses collected July–November 2025). It then inflates that cost forward to the year care might begin, keeps inflating it through each year of care, and adds the years up. Because these are national medians — half of real prices are higher — the headline answer is a range of ±15% around the projected total, rounded outward. Note one change in the 2025 survey: homemaker services and home health aides converged in price, so CareScout now reports them as a single in-home care category (a "non-medical caregiver," priced at a median $35/hour for 44 hours a week).
The three inputs that matter most are honest guesses, and that's fine — this is a planning number. HHS research says the average person needing care needs it for about 3 years (2.2 for men, 3.7 for women), and long-term care costs have historically outrun general inflation: semi-private nursing home rates rose about 138% over 2004–2024 (roughly 4.4% per year) against 71% general inflation, which is why the inflation field defaults to a suggestion of 4%.
The formula
Today's annual median is the 2025 survey figure for your care type, i is annual care-cost inflation, Y is years until care begins, and N is years of care (costs keep inflating during the care period — the second formula is the standard growing-sum shortcut for whole years; fractional years add the matching fraction of the next year). The headline range is the total ±15%, rounded outward to the nearest $1,000.
Worked example
A semi-private nursing home room ($114,975/year at the 2025 median), needed in 15 years, for 3 years, with costs rising 4% per year.
Projected annual cost when care starts: 114,975 × 1.0415 = 114,975 × 1.8009 = $207,063. Projected total for 3 years: 207,063 × (1.04³ − 1) ÷ 0.04 = 207,063 × 3.1216 = $646,369. The ±15% range, rounded outward: $549,000 – $744,000.
The numbers nobody budgets for
Most retirement plans have a line for travel and none for this, even though the median private nursing home room already costs $129,575 a year — and that's the national midpoint, not the coastal-city price. Three years of care at today's medians runs from about $74,000 (adult day care) to about $389,000 (private room), before a single year of inflation. The reason this catches families off guard is simple and worth saying plainly: the two programs people assume will pay, mostly don't — or only after conditions most people don't expect.
What Medicare does not cover. General information, not advice for your situation: Medicare does not pay for long-term custodial care — the extended help with bathing, dressing, eating, and moving around that makes up most long-term care. It covers short-term skilled care: up to 100 days in a skilled nursing facility after a qualifying hospital stay (with daily coinsurance after day 20), plus limited home health visits. The widespread belief that "Medicare will handle the nursing home" is probably the most expensive misconception in American retirement planning, because families discover the truth at the moment they can least afford it.
What Medicaid covers, and when. Medicaid does pay for long-term care — it's the largest payer of nursing home care in the country — but only for people with very limited income and assets. Most families reach it through "spend-down": paying privately until savings fall below their state's threshold (often around $2,000 in countable assets for a single person, with rules protecting a spouse still at home). Medicaid rules, look-back periods on gifts, and covered services vary significantly by state, so this is an area where an elder-law attorney earns their fee.
The planning levers
Four honest options, none of them magic. Traditional long-term care insurance exists precisely for this risk; per the American Association for Long-Term Care Insurance's 2025 price index, a 55-year-old couple buying a $165,000 benefit pool each (growing 3% yearly) pays roughly $5,000–$6,300 a year combined — real money, with the caveats that premiums can rise after purchase and health underwriting gets harder every year you wait. Hybrid policies (life insurance or annuities with long-term care riders) cost more but lock in premiums and pay heirs something if care is never needed. Self-funding works if the projected range above fits inside your assets without sinking a surviving spouse. And family care — the plan most families default into — is genuinely valuable but not free: it typically costs the caregiver lost wages, lost retirement contributions, and health strain, so budget respite care and count those costs honestly rather than at zero.
Your state changes everything
National medians hide a 2–3x spread. The same semi-private nursing home room that costs around $8,000 a month in parts of the South can exceed $15,000–$20,000 in Alaska, Hawaii, or the Northeast, and in-home care rates swing nearly as widely with local labor markets. If you know where you're likely to receive care, look up that state's figures in the CareScout regional survey data and mentally shift this page's range accordingly — a national median is a starting point, never a quote.