The concerning math behind aging-in-place

Though more than half of Americans believe Medicare will cover long-term care expenses (58%), coverage is actually limited and short-term. Many families will need to adapt to rising healthcare costs, and it is a particular challenge as they seek to age-in-place in their home.

That’s according to insurance company Nationwide‘s 2025 Nationwide Retirement Institute Long-Term Care survey of U.S. adults age 29+ with household income north of $75,000.

Per the survey, 41% of Americans doubt they will live long enough to use long-term care insurance, even though nearly 70% of Americans turning 65 today will need LTC. (The number of centenarians is projected to quadruple by 2054.)

Nationwide said 58% of those surveyed are concerned about their ability to pay for their or their partner’s LTC. And 59% said they plan to use Medicaid to help pay for the expenses, which suggests many expect to spend down savings so as to qualify for the program.

Potential cuts to Medicaid could significantly impact LTC options for an aging population.

According to Nationwide, many see aging at home as a way to avoid rising cost. While 77% of Americans would prefer to receive long-term care in their own home, 41% say their current home may not be safe or accessible for aging in place, and nearly half, 47%, say they expect modifying their home for aging in place to be unaffordable.

Buying presents its own challenges, despite the equity position many seniors have. Per the survey, 54% believe today’s real estate market makes it difficult for them to move or find an ideal home for retirement. As a result, 42% of baby boomers and older (age 61+) plan to remain in their current homes without making renovations or changes once they retire – despite the potential risks that accompany that decision.

Such financial pressures over LTC are affecting multiple generations. Half of Americans say LTC costs will diminish their children’s inheritance, and many are already bearing the burden of caregiving, Nationwide said. Caregivers report spending an average of nearly $400 a month on non-reimbursed, out-of-pocket expenses such as prescriptions, transportation, and home necessities ($372/month). As such, 42% of caregivers believe it will likely eat up the inheritance they had hoped to leave to their own children. 

“Too many Americans are entering the most vulnerable stage of life with a false sense of security,” said Holly Snyder, president of Nationwide’s life insurance business. “We underestimate how long we’ll live, how likely we are to need long-term care, how much that care will cost, and how we’ll pay for it, leaving a growing number of Americans – and their families – unprepared for the financial and emotional toll that often comes with aging.”

In a recent Redfin survey, over 33% of boomers surveyed said they have no intention of selling their home within the next decade. More than two-thirds have lived in their home for 16-plus years and 55% said they like their home and have no reason to move.