Too many families are unaware that Medicare only pays for short-term skilled care, creating a family crisis.

Fewer than half of adults age 50 and older, just 43 percent, believe they are likely to need long-term care at any point in the future, even though federal data shows most eventually will. At the same time, 48 percent of older adults say they are worried about their future extended care needs, and an equal share report they do not know how to plan for them.

Matt McCann, CLTC, a nationally known long-term care planning expert, says this gap between concern and preparation leaves many families vulnerable, especially when they discover too late that Medicare does not cover the most common forms of long-term care.

That's not all: McCann notes that the University of Michigan National Poll on Healthy Aging finds that 62 percent of adults age 50 and older incorrectly believe Medicare covers the cost of a permanent nursing home stay. It does not; Medicare falls short when it comes to long-term care

"This disconnect between what people fear and what they prepare for is exactly why so many families end up in crisis," McCann said.

"People worry about long-term care, but they don't plan for it — and then they're blindsided when they learn that Medicare doesn't pay for the kind of care most of us will eventually need." — Matt McCann, CLTC.

He added that the misunderstanding is widespread and costly.

"When so many people assume that Medicare will cover long-term care it creates a false sense of security," McCann said. "It's one of the most expensive myths in retirement planning. Families make decisions for years based on that assumption, only to discover too late that Medicare pays nothing for long-term custodial care."

What Medicare Actually Covers

McCann points out that Medicare's long-term care coverage is limited, narrow, and temporary.

• Short-term skilled nursing facility care only: Medicare covers up to 100 days of skilled nursing facility care after a qualifying three-day hospital stay.
• Coverage ends entirely after day 100: Beyond that point, all costs fall to the individual or their family.
• Custodial care is not covered: The type of long-term care most older adults eventually need — help with bathing, dressing, eating, mobility, and supervision due to cognitive decline — is not covered by Medicare at all.

Financial Impact of Long-Term Care is Significant

McCann notes that the financial stakes are substantial. According to long-term care cost data from the LTC News Caregiver Directory, published as part of the LTC News Cost of Long-Term Care Services Calculator, home care can easily reach $6,000 a month or more, depending on where you live — and that is only for basic support at home, where most people prefer to receive care.

McCann says the cost of long-term care varies dramatically depending on where someone lives — a reality that often catches families off guard. In the San Jose, California, region, for example, in-home care now averages $7,912 per month, compared with $5,147 per month in Knoxville, Tennessee, according to LTC News data.

"The difference between one ZIP code and another can mean thousands of dollars a month," McCann said.

"Families assume care costs are roughly the same everywhere, but they're not. Where you live — where you retire to in the future, or where your parents live — can determine how much of a shock it will have on your family and finances." — Matt McCann, CLTC.

Individuals who need more hands-on assistance often transition to assisted living, where base rates average $5,000 to $6,000 per month, with additional care fees that can add up to $2,000 more each month. For those requiring 24-hour skilled nursing care, costs in many regions now exceed $11,000 per month.

Over a multi-year care need — and most care episodes last longer than families expect — out-of-pocket costs can reach $350,000 or more, depending on the length of care, geographic location, and the timing of the need. It could be double that, or more, for a couple. For individuals living with dementia or Alzheimer's, long-term care often stretches on for years, requiring intensive, round-the-clock supervision that drives costs even higher and places an extraordinary burden on families.

"Long-term care costs rise every year, meaning today's 50-somethings should include long-term care in their retirement plans that account for escalating expenses and the profound financial and emotional impact an extended care event can have on the people they love." — Matt McCann, CLTC.

Why the Myth Persists

The University of Michigan survey also found:

• 48% of adults 50+ say they do not know how to plan for long-term care.
• 57% do not believe they will ever need long-term care.

Federal data tells a different story. The U.S. Department of Health and Human Services reports that 56 percent of Americans turning 65 today will need some form of long-term care during their lifetime.

"Too many people put off long-term care planning the same way they put off writing a will — they know it matters, but they convince themselves it can wait," McCann said.

"The problem is, aging doesn't wait. And by the time families realize they need a plan, their options are fewer, the costs are higher and the stress is enormous." — Matt McCann, CLTC.

Perception vs Reality

He said the disconnect between perception and reality is one of the biggest risks facing aging Americans.

"When half of older adults don't know how to plan for long-term care — and most don't believe they'll ever need it — they walk straight into a financial and family crisis," McCann said. "The truth is, more than half of us will need care. The only question is whether we prepare for it or leave our families scrambling."

How Long-Term Care Insurance Works

Long-Term Care Insurance is designed to pay for all levels of care, skilled, semi-skilled, or custodial and supportive services that Medicare does not cover. Policies typically include:

• Benefits to pay for your choice of quality care, including home care, adult day care, assisted living, memory care, and nursing homes
• Care coordination services to help families navigate providers and care options
• Inflation protection to keep benefits aligned with rising care costs

Plus, McCann says that you can design the plan that matches your needs, concerns, and budget.

LTC Insurance Covers In-Home Care, Easing Family Burden

Modern LTC Insurance policies emphasize home-based care, allowing individuals to remain in familiar surroundings for as long as possible.

"Families are often surprised by how affordable LTC Insurance coverage can be when purchased before retirement," McCann said. "Premiums are based in part on age and health. Waiting too long can mean higher costs — or becoming uninsurable altogether."

Without a plan, McCann says the responsibility for care almost always falls on adult children, who must juggle full-time jobs, raising their own families, and the sudden demands of caregiving. Many end up coordinating medical appointments, managing medications, providing hands-on help with daily activities, and navigating a complex care system they never expected to face.

At the same time, individuals who cannot rely solely on family support must pay thousands of dollars each month for professional care — whether at home, in assisted living, or in a nursing facility.

The impact of long-term care without a plan creates a physical, emotional, and financial burden that strains families and drains retirement savings.

When to Add a Long-Term Care Policy

McCann, like other experts, generally recommends exploring LTC Insurance:

• In your mid-40s to early to mid-60s, when premiums are lower and health underwriting is more favorable. However, plans are available at most ages
• After major life changes, such as marriage, divorce, or becoming an empty nester
• When caring for aging parents, which often reveals the emotional and financial strain of long-term care firsthand

"Planning for the future costs and burdens of aging protects income, assets and — most importantly — family," McCann said. "Long-term care is both a cash-flow problem and a family problem. Long-Term Care Insurance addresses both."

If an Older Parent Needs Care Now

For families already facing an immediate care need, McCann recommends:

• Understanding available extended care options — home care, adult day services, assisted living, memory care, or nursing homes
• Search for care providers with the LTC News Caregiver Directory, the largest database of caregivers and long-term care facilities in the country
• Reviewing their records to determine whether they own a Long-Term Care Insurance policy
• Evaluating Medicaid eligibility for low-income individuals or those who have exhausted their assets

"Crisis planning is stressful, but families don't have to navigate it alone," McCann said. "The key is acting quickly, gathering information and making decisions that protect both the individual needing care and the family supporting them."

About Matt McCann, CLTC

Matt McCann, CLTC, has spent nearly 30 years helping families prepare for the financial and emotional realities of aging. As one of the nation's most respected long-term care planning specialists, he is licensed in all 50 states and the District of Columbia and represents the industry's leading insurance carriers.

McCann's approach is personal, transparent, and pressure-free. Clients can consult with him by phone at their convenience while he shows them his computer screen, creating a simple, convenient experience. He walks families through their options at their own pace—no office visit required.

You can start the process and get free and accurate quotes from all the top companies — plus professional recommendations — by visiting Free and Accurate LTC Insurance Quotes.

Media Availability

Matt McCann is a trusted, frequently quoted voice on aging, caregiving, and long-term care. With nearly three decades of experience, he brings clear, practical insight to conversations about how families can prepare for the financial and emotional realities of extended care.

McCann is available for interviews, expert commentary, radio, podcasts, webinars, and panel discussions. He regularly collaborates with journalists, producers, and conference organizers seeking authoritative perspectives on long-term care trends, policy developments, caregiving challenges, and the future of aging in America.

Contact McCann through his website for information.