February 11, 2026  – A newly released industry analysis estimates that Americans turning 65 in 2025 will need an average of $135,000 to cover future long-term care expenses if paying out of pocket at commercial market rates and without relying on Medicaid.

The estimate comes from the inaugural Milliman Long-Term Care Index, published by consulting and actuarial firm Milliman, Inc. The report provides a benchmark designed to help policymakers, insurers, and individuals better understand and plan for the financial impact of aging.

According to the index, projected long-term care costs differ sharply by gender. Women face significantly higher expected expenses, with a benchmark of $171,000 compared to $98,000 for men. Researchers attribute much of this gap to women’s longer life expectancy and higher likelihood of requiring extended care services later in life.

The report indicates that approximately 60% of women and 53% of men will use formal, paid long-term care services at some point after turning 65. However, the duration of care varies widely. Individuals who require less than one year of paid care may incur costs under $30,000. At the other end of the spectrum, those who need care for five years or longer could face expenses exceeding $665,000.

Extended care needs are not uncommon, particularly among women. The analysis projects that about 14% of women will require paid long-term care for five years or more, compared to roughly 6% of men. These longer durations significantly increase lifetime financial exposure and highlight the variability of long-term care risk.

Geography also plays a major role in determining overall costs. The index found that average daily long-term care expenses are highest in states such as Alaska, Connecticut, Massachusetts, Vermont, and Maryland. In contrast, lower average daily costs were reported in Texas, Oklahoma, Louisiana, Alabama, and Mississippi. These regional differences can substantially affect retirement planning strategies and insurance decisions.

Long-term care services typically include assistance with daily activities such as bathing, dressing, eating, mobility, and supervision for individuals with cognitive impairments. Medicare generally does not cover extended custodial long-term care, and private long-term care insurance remains relatively uncommon. As a result, many individuals must either pay out of pocket, rely on family caregivers, or eventually qualify for Medicaid by spending down their assets.

Milliman officials said the index is intended to serve as a reference point for stakeholders navigating rising health care expenses and demographic shifts. The firm, which advises clients across insurance, financial services, health care, and employee benefits sectors, developed the benchmark to illustrate the financial implications associated with aging and long-term care risk.

The 2025 Milliman Long-Term Care Index was released on January 21, 2026. The authors noted that while the $135,000 figure represents an average benchmark, actual costs can vary considerably depending on individual health status, longevity, and state of residence.