By Michael Barrett, CA License #4311333. Last updated November 12, 2026.
Understanding long-term care
What is long-term care?
Long-term care is help with everyday activities, such as bathing, dressing, eating, getting around or managing memory loss, when you can’t do them on your own. It’s provided at home by a caregiver, in an assisted living community or in a nursing home.
Most long-term care isn’t medical treatment. That’s why health insurance and Medicare generally don’t pay for it.
What are the odds I’ll need long-term care?
Nearly 7 in 10 adults age 65 and older will need long-term care services at some point (ElderLawAnswers). Some need a few months of help at home after a fall or surgery; others need years of dementia care.
For a married couple, the question is less whether one of you will need care and more who will pay for it.
Does Medicare pay for long-term care in California?
No. Medicare doesn’t pay for long-term custodial care, the day-to-day help with bathing, dressing and eating that makes up most long-term care. It can cover a short skilled nursing stay after a qualifying hospital stay.
Medicare Supplement and Medicare Advantage plans don’t fill this gap either (Medicare.gov).
Does Medi-Cal pay for long-term care, and what happens to my savings?
Medi-Cal pays for long-term care only if you meet its financial limits. Starting January 1, 2026, California reinstated an asset limit of $130,000 for an individual, plus $65,000 for each additional household member (Justice in Aging).
Medi-Cal can also look back up to 30 months at assets given away for less than their value, and those transfers can make you ineligible for Medi-Cal long-term care for a period of time (Justice in Aging). Your home and some other assets are treated differently, so talk with an elder law attorney before moving money.
Long-term care insurance lets you pay for care without spending down to Medi-Cal’s limits. A California Partnership policy goes further; see below.
How much does long-term care cost in California?
California is one of the most expensive states for care. Median annual costs in California from CareScout’s 2025 Cost of Care Survey:
| Type of care | California median, per year |
|---|---|
| Private nursing home room | $182,135 |
| Non-medical in-home caregiver | $91,520 |
| Semi-private nursing home room | $146,000 |
| Assisted living (residential care facility) | $84,000 |
Source: CareScout 2025 Cost of Care Survey, California median costs, as also reported by Santa Monica Daily Press. Nationally, the medians are $129,575 for a private nursing home room and $74,400 for assisted living (CareScout). Costs run higher in the Bay Area and coastal Southern California.
Comparing options
What’s the difference between traditional and hybrid long-term care insurance?
Traditional long-term care insurance is a stand-alone policy: you pay premiums, and it pays benefits if you need care. If you never need care, nothing is paid out, and premiums aren’t guaranteed.
A hybrid policy combines life insurance (or an annuity) with long-term care benefits. If you need care, it pays for care; if you don’t, it pays a death benefit to your heirs. Hybrids usually cost more up front, often as one payment or a set number of payments, and many guarantee the premium.
The right choice depends on your age, health, budget and whether leaving money to heirs matters to you.
What is a California Partnership long-term care policy?
A California Partnership policy is a state-certified long-term care policy that protects your assets from Medi-Cal dollar for dollar. For every dollar the policy pays in benefits, you can keep a dollar of assets above Medi-Cal’s limit and still qualify for Medi-Cal if you ever need it (California Department of Insurance).
Every Partnership policy must include built-in automatic inflation protection, and protected assets are also shielded from Medi-Cal estate recovery (California Department of Insurance). Only agents with extra state training can sell them: 8 hours of general long-term care training plus 8 hours of live classroom training on the Partnership (CDI).
Is short-term care insurance worth it?
Short-term care insurance pays for care for a limited time, typically a year or less, and is usually easier to qualify for than traditional long-term care insurance. It can make sense if you can’t pass traditional underwriting or want lower-cost protection for a shorter need, such as recovering at home after a fall.
It won’t cover a multi-year need such as dementia care, so think of it as partial protection.
Should I self-fund long-term care instead?
Self-funding can work if you have enough to cover several years of care without hurting a spouse’s lifestyle. At California’s 2025 medians, two years in a private nursing home room costs about $364,000, and three years of assisted living about $252,000 (CareScout figures above).
Insurance makes sense when a long care need would drain savings meant for a spouse or heirs. Many clients split the difference: insure part of the risk and self-fund the rest.
How does long-term care insurance work for couples?
Many carriers offer couples discounts and shared-care options, where one spouse can draw on the other’s benefits. Compare a shared policy with two separate ones, since a shared pool can run out if both spouses need long care.
Buying a policy
What’s the best age to buy long-term care insurance?
The younger and healthier you are when you apply, the lower your premium and the better your chance of approval.
For reference, a single 55-year-old woman buying a new policy in 2025 paid about $3,750 a year, according to the American Association for Long-Term Care Insurance (GoodRx).
Can I get long-term care insurance after 65 in California?
Often, yes, though premiums are higher and health questions are stricter. Hybrid and short-term care policies can be options when traditional coverage is out of reach.
Can I get coverage with diabetes, high blood pressure or another condition?
Often, yes, if the condition is well controlled. Each carrier underwrites differently, so a condition that gets you declined at one company may be accepted at another. That’s why it helps to work with an independent agent who compares carriers before you apply.
A current dementia diagnosis, or already needing help with daily activities, usually means you can’t qualify.
Are long-term care insurance premiums tax-deductible?
Partly, for tax-qualified policies. The IRS counts premiums as a medical expense up to an age-based limit, and medical expenses are deductible only above 7.5% of adjusted gross income if you itemize (GoodRx).
| Age at end of 2026 | Maximum premium counted, per person |
|---|---|
| 40 or under | $500 |
| 41 to 50 | $930 |
| 51 to 60 | $1,860 |
| 61 to 70 | $4,960 |
| 71 and over | $6,200 |
Source: ElderLawAnswers. Self-employed people may be able to deduct eligible premiums without itemizing (GoodRx). Ask your tax preparer how this applies to your federal and California returns.
Will my premiums go up?
They can. Traditional long-term care premiums aren’t guaranteed; insurers can raise rates for a whole class of policyholders with approval from the California Department of Insurance. Many hybrid policies guarantee the premium.
California’s own guidance suggests asking whether a company has ever raised premiums on its long-term care policies (DHCS).
Does it cost more to buy through an agent?
No. Premiums are set by the insurer and filed with the state, so you pay the same premium for the same policy whether or not you use an agent. The insurer pays the agent.
Choosing an agent
How do I choose a long-term care insurance agent in California?
Choose someone who specializes in long-term care, compares several carriers and can clearly explain how Medicare, Medi-Cal and long-term care insurance fit together. That last point comes straight from California’s guidance on choosing an agent (DHCS).
Ask any agent: Are you trained to sell California Partnership policies? How many long-term care policies have you placed? Have the carriers you recommend raised rates before?
What’s the difference between an independent broker and a captive agent?
A captive agent sells one insurance company’s products. An independent broker works with several carriers and can compare them side by side. In long-term care, where price and underwriting vary widely by carrier, that comparison matters. Michael is independent and works with [carriers].
Using a policy
What is an elimination period?
The elimination period is the waiting time between when you start needing care and when the policy starts paying, like a deductible measured in days. You pay for care yourself during that time, and a shorter elimination period costs more.
How do I file a long-term care insurance claim?
A tax-qualified policy generally starts paying when a licensed health care practitioner certifies that you need help with at least 2 of 6 activities of daily living for at least 90 days, or that you have a severe cognitive impairment. You call the insurer, submit the plan of care, and the elimination period begins.
Feedback
Exploring long-term care insurance options can be confusing. See how Michael Barrett has helped others understand their choices, find the right coverage, and plan confidently for the future.
