Don't Rely on Medicare or Medicaid for Your Long-Term Care

Takeaways

• Many Americans misunderstand Medicare and Medicaid's limited coverage for long-term care, often overestimating their reliance on these programs.

• The cost of long-term care insurance is also frequently overestimated, leading many to forgo crucial coverage.

• Proactive planning, including exploring private insurance, home modifications, and consulting professionals, is essential for addressing future long-term care needs.

Americans are living longer than ever, and this trend is expected to continue. According to the U.S. Census Bureau, the number of Americans aged 100 and older is expected to quadruple over the next 30 years, from an estimated 101,000 in 2024 to about 422,000 in 2054.

With this increase in longevity comes an increase in the need for long-term care, as well as the need for it for a longer period of time. Though long-term care services are often associated with nursing homes and assisted care facilities, they can help seniors live in their homes longer, which most prefer to do.

Long-Term Care Services

Long-term care (LTC) services can include assistance with activities of daily living (ADLs) such as bathing and dressing but can also include help with medical-related tasks, such as managing complex daily health care regimes. Older adults often use LTC services for housekeeping tasks as well, such as doing laundry, cooking, and shopping. LTC services are often essential for many older adults who want to continue living on their own and can help delay or avoid institutionalization in a nursing home.

Paid professionals or unpaid family members or friends may provide LTC services. Most older adults rely heavily, or exclusively, on unpaid support.

Although some people who need LTC services rely on them for a short time, such as when recovering from surgery, many older adults rely on them for an average of three years, with 20 percent needing them for more than five years. Even though many older adults rely on unpaid LTC provided by family members or friends, many others must rely on paid help for some or all of their long-term care services.

Counting on the Wrong Safety Net for LTC

The 2025 Nationwide Retirement Institute Long-Term Care survey reveals the startling misconception that 58 percent of Americans believe Medicare will cover the costs of long-term care—despite it covering only limited, skilled or post-hospitalization care for up to 100 days. Medicare doesn’t pay for extended custodial care, which includes activities like bathing and dressing that older adults often need, and daily co-pays begin after just 20 days.

As a result of the increasing cost of LTC, 59 percent of survey respondents said they think they will rely on Medicaid to help pay for LTC expenses. This suggests that either some people don’t fully understand the requirements for qualifying for Medicaid or they intend to spend down their savings to poverty level so they will qualify for Medicaid. Unfortunately, funding for Medicaid is under threat.

The Threat to Medicaid

The Trump Administration’s budget, dubbed the "One Big Beautiful Bill," proposes nearly $800 billion in Medicaid cuts over the next decade. This would not only reduce Medicaid spending but would also result in 10.3 million fewer people enrolled in Medicaid by 2034, including 1.3 million people who are also eligible for Medicare.

Nursing home operators warn that Medicaid cuts could force nursing homes to lay off staff members or close their doors. These drastic measures would reduce the quality of care or, potentially, remove this care option from some areas. This means that individuals planning to rely on Medicaid for long-term care in a nursing home may find that safety net significantly undercut.

The Coverage Gap: Long-Term Care Insurance

According to Nationwide’s survey, 22 percent of Americans 29 years old and older say they have long-term care insurance (LTCI). However, data show that actual ownership of such coverage is much lower. People often mistakenly believe their health insurance or long-term disability insurance will cover any long-term care costs they incur. Alarmingly, it is estimated that only 3 to 4 percent of Americans aged 50+ have actual long-term care insurance.

Many people cite cost as a barrier to purchasing LTCI. Of those surveyed, 38 percent said the perceived high cost was the main deterrent to getting LTCI. However, many overestimate LTCI premiums. Nearly two‑thirds of those surveyed believe it costs more than it actually does.

Aging in Place vs. Moving

In addition to wanting to age in their own homes, many people view staying in their homes for as long as possible as a way to save money. Though 77 percent of Americans would prefer to receive long-term care in their homes, 41 percent think their current home is probably not safe or accessible enough for them to age in place. Nearly half of those surveyed think that modifying their home so that they can age in place safely would be too expensive.

Moving to a home that would be better suited for aging in place seems like a viable option, but this path can also have obstacles. Fifty-four percent of those surveyed believe the current real estate market makes it too difficult to move or find an ideal home for retirement. Based on the survey, it can be projected that Americans 61 and older are planning to remain in their current homes without making aging-related modifications after they retire, despite the risks involved.

Strategies for LTC Planning

Some things you can do to plan to cover your long-term care needs include the following.

• Get clear on Medicare: Medicare does not cover long-term custodial care. Think of it as a short-term post-acute solution rather than a long-term care solution.

• Consider getting private LTC insurance early: Premiums are more affordable and coverage more accessible before health issues arise. A good age range to start a long-term care insurance policy is 50 to 55.

• Explore hybrid solutions: Some life-insurance and annuity products come with LTC riders that offer flexibility while addressing both retirement income and long-term care funding.

• Tap home equity sensibly: Reverse mortgages or home equity lines of credit can help fund home modifications or in-home care, but they come with risks. Consult with an advisor before borrowing against your home.

• Boost savings and diversify: Maximize retirement contributions early, build emergency funds, and diversify across account types (taxable, Roth, HSA) for flexibility.

• Delay retirement: Working longer improves income and care options, reducing reliance on savings.

• Remodel for safety early: Investing in accessible home features such as ramps and no-step showers now can avoid future major expenses.

• Consult professionals: Proactive planning with a financial planner and an attorney experienced in elder law and estate planning can prevent pitfalls and extra costs.

Start Planning for Long-Term Care Now

Consider it likely that you will need long-term care at some point in your life. The sooner you start planning for it, and especially how you will pay for it, the better. You shouldn’t rely on Medicare or even Medicaid to cover your LTC costs.

For additional reading about Medicare, Medicaid, and long-term care planning, check out the following articles:

• Turning Age 65? What to Know About the 4 Parts of Medicare

• Medicare Coverage Basics: What You Need to Know

• Understanding Medicaid: What Does the Medicaid Program Cover?

• Cuts to Medicaid Benefits May Harm Millions of Older Adults

• What You Should Know About Long-Term Care

Scam Email Targets Social Security Recipients

A new phishing attack is targeting Social Security recipients with email messages pretending to be from the Social Security Administration (SSA), prompting them to download fake Social Security statements.

• These malicious downloads give hackers access to sensitive personal information, including bank account credentials.

• Individuals should be cautious of emails requesting statement downloads and verify the sender’s address to protect their Social Security account from potential compromise.

If you or a loved one are among the 71.6 million people receiving Social Security benefits, be careful of downloading email attachments. You could receive a dangerous email from hackers pretending to be the Social Security Administration (SSA), and the email looks convincing.

This official-looking email prompts recipients to download a fake Social Security statement. The download contains technology that allows hackers to take over the victim’s computer and access sensitive information such as  bank account login credentials, per MalwareBytes Labs. The hackers seem to be targeting financial information, but the scam could also be used for identity theft.

Knowing what to look out for and understanding how the scam works can help you protect yourself and your loved ones.

What Are Phishing Scams?

Phishing is a form of fraud. In phishing scams, cybercriminals often pretend to be from a known organization or individual to gain a person’s trust and access personal information.

Phishing typically occurs through technology that allows predators to hide their identity. Their messages, including emails, texts, and phone calls are like bait as they seek information and access.

Unfortunately, phishing emails are common, with more than 3.4 billion sent each day, per AAG IT Support. Every day, Google blocks 100 million phishing emails. While email services can filter and block spam, some phishing emails can get past these security measures and into your inbox.

The National Council on Aging (NCOA) reports that scams often target older adults. Scammers may believe that older adults have more wealth than other populations. Elder community members can be particularly vulnerable to online scams, with $3.4 billion in total fraud loss reported by Americans 60 and older in 2023.

What to Look Out For

Look out for an email that appears to come from the Social Security Administration. Typically, it says that “your statement is now available.” The email may look legitimate, with convincing font, formatting, and colors. While there are variations in these messages, the email typically says that your Social Security statement is available, thanks you for opting to receive electronic statements, and tells you to download the attachment.

This alert from the SSA Office of the Inspector General (OIG) shows what the scam email can look like. The OIG warns Social Security recipients to beware of scam emails asking to download statements. The warning notes that while these emails closely resemble official correspondence, they lack the .gov email address that indicates a genuine government sender.

How the Scam Works

The hackers are using a technology that allows them to control computers from afar. When individuals download the attachment, thinking it is a Social Security statement, they are actually downloading technology.

This technology, called ScreenConnect, is a remote support and access platform. ScreenConnect is commonly used to help IT professionals work on someone’s computer, such as to install software or troubleshoot issues. When used by cybercriminals, it can take complete control of the computer, facilitating access to personal information.

The Email Could Get Through Security Measures

This dangerous email could end up directly in your general inbox, not your spam folder. The Social Security statement email scam may appear legitimate — and bypass security measures — for several reasons, according to MalwareBytes Labs. These include using WordPress sites that appear legitimate, embedding content as an image to avoid scanning and blocking services, and using normal applications such as ScreenConnect.

Receiving a Suspicious Email

If you receive a phishing email, consider deleting it and blocking the sender. Never clink on a link or download files or attachments that appear in a potentially suspicious email message.

Unsure if an email is phishing? Always pause. Try running a Google search for scams and asking a trusted family member or friend for a second opinion. Review the SSA scam alerts. Take a careful look at where the email came from. To be genuine, it must have a .gov address, per the SSA OIG.

You can also report phishing to the Federal Trade Commission.

Your elder law attorney can also help you navigate correspondence with the SSA and understand how to look out for scam emails. If you are the victim of a scam, connect with an elder law attorney today for assistance so that you can do whatever possible to protect your finances and identity.

Why Aren't More Older Adults Thinking About Long-Term Care?

Many older adults underestimate their likelihood of needing sustained, day-to-day care in their later years, and a significant portion of adults aged 50 and older are not adequately planning for long-term care.

After decades of handling our daily personal care needs without giving them a second thought, it is hard to imagine needing help with these tasks. However, research shows that about one in seven adults aged 65 or older will need help with daily care. Help with daily personal care is referred to as long-term care and too many adults assume they won’t need it.

A recent survey of American adults aged 50 to 94 by the University of Michigan’s National Poll on Healthy Aging explored older adults' preparedness for long-term care. The findings indicate that many are unprepared for the financial and logistical aspects of care in a nursing home, assisted living facility, or similar type of setting, with widespread misconceptions about coverage options.

Key Survey Findings

The survey, which was conducted in August 2024, revealed some worrying data.

Perceptions and Planning:

• Only 43 percent of adults aged 50 and older think they will need long-term care.

• Forty-eight percent are unsure how to plan for long-term care needs.

• Forty-five percent said the potential need for long-term care seemed too far off to plan for.

• Just 27 percent have designated a durable power of attorney for medical care, and only 24 percent have identified potential caregivers.

• Only 11 percent have purchased long-term care insurance.

Financial Concerns:

• Most respondents said they were not confident they could afford long-term care services: 62 percent said they would not have enough money for nursing home care, 58 percent for assisted living care, and 51 percent for home care.

• Notably, 62 percent mistakenly believe that Medicare covers permanent nursing home care.

Communication Gaps:

• Only 5 percent have discussed care plans for their future with a health care provider.

• Discussions with family about long-term care are also limited, with just 33 percent talking with a spouse or partner and 30 percent talking with children about these topics.

Not surprisingly, older adults who have a health problem or a disability are more likely to think they will need long-term care versus older adults who aren’t experiencing such limitations (57 percent versus 34 percent). The survey also revealed that adults over age 65 were more likely to think they will need long-term care than adults between 50 and 64 (45 percent versus 40 percent).

Paying for Long-Term Care

Half of the survey participants said they would rely on either their or their family’s personal financial resources if they needed to move into a nursing home permanently. Nineteen percent said they would rely on long-term care insurance.

Twenty-nine percent said they would rely on Medicaid, and 62 percent said they expected their long-term care to be covered by Medicare. The large percentage of those surveyed thinking that Medicare will cover their long-term care needs shows there is a widespread misconception about what Medicare and Medicaid cover.

Medicare vs. Medicaid for Long-Term Care Coverage

Understanding the differences between Medicare and Medicaid  is important for planning for long-term care.

Medicare

Introduced in 1965, Medicare is a federal health care program primarily for Americans who are 65 or older, as well as many individuals with disabilities. There are four basic parts that cover different areas of health care or dictate what is covered and how.

Medicare’s Part A includes coverage of hospital stays and some limited care in a skilled nursing facility under certain circumstances. However, Medicare does not cover long-term care in a nursing home, for example.

Medicaid

Medicaid is a federal- and state-level program that provides comprehensive coverage for low-income adults, children, and individuals with disabilities. Since each state manages its own Medicaid plan, covered services vary across the country. Generally, coverage includes nursing home care, home and community-based services, e.g., personal care assistance, adult day care, and, in some states, assisted living facility costs.

Medicaid eligibility is based on a person’s income and assets. Individuals must often spend down assets well ahead of applying for benefits to qualify.

Care Preferences and Decision-Making

When asked about where they would prefer to receive support with daily activities, survey respondents expressed a range of options, including:

• Their home with family or family caregivers (52 percent)

• Their home with paid caregivers (21 percent)

• Their home without help (14 percent)

• The home of a family member or caregiver friend (6 percent)

• An assisted living facility (6 percent)

• A nursing home (1 percent)

When asked about making decisions about their long-term care, 39 percent said they would let their family make decisions for them, but 61 percent said they would not let their family make decisions for them.

Implications of Survey

This survey found that many older Americans do not think they will need long-term care and have not made plans for how to meet and pay for long-term care needs. This suggests that there is a large portion of the population that is behind on planning for long-term care.

Additionally, many older adults think that the possibility of long-term care is too far off to plan for, and many don’t know how to plan for it. Only about a third of the adults surveyed have discussed long-term care with their spouses or children.

One of the most worrying finds of the survey is that nearly two-thirds of those surveyed think that Medicare will cover their long-term care costs. This likely contributes to many over-50 adults not having an adequate plan in place for how to pay for potential long-term care.

Planning for Long-Term Care

The University of Michigan’s National Poll on Healthy Aging highlights a critical need for increased awareness and proactive planning among older adults regarding long-term care. Understanding the limitations of Medicare and the eligibility requirements of Medicaid is essential to avoid unexpected financial burdens.

Engaging in early discussions with family and health care providers, exploring insurance options, and becoming informed about available resources can better prepare individuals for future long-term care needs. Contact an elder law attorney in your area to learn about your options for long-term care planning.

For additional reading about long-term care planning, check out the following articles:

• Discussing Long-Term Care With Older Adults in Your Life

• 2024 Survey Shows Costs of LTC Continue to Rise

• What a Good Long-Term Care Insurance Policy Should Include

• The Role of an Elder Law Attorney in Medicaid Planning

• Medicare Advantage: An Alternative to Original Medicare

How Mental Health Apps Can Help Older Adults

What Are Mental Health Apps?

Mental health apps are mobile applications that provide support for emotional well-being. For older adults, these apps are often tailored to address age-specific challenges, such as loneliness, grief, chronic illness, and cognitive decline, which can all contribute to depression. The most effective apps combine psychological tools, behavioral health strategies, and easy-to-use interfaces.

Examples of some of the apps that are helpful for older adults include:

• MoodTools. Designed in collaboration with mental health professionals, MoodTools (available via the Apple Store) offers multiple tools, including a thought diary, safety plan, and guided activities with a mood tracker.

• Headspace and Calm. Headspace and Calm are mindfulness apps that include meditation exercises, sleep support, and stress-management strategies.

• Woebot Health. Informed by Cognitive Behavioral Therapy (CBT), Woebot Health offers a conversational chatbot that checks in on users and provides coping suggestions and tools.

• MyStrength. MyStrength offers a digital program with modules for depression, stress, sleep, and chronic pain.

How Do They Work?

Mental health apps use evidence-based techniques to help users manage their moods and thoughts. Here’s how many of them function:

• Daily Check-ins. Users are prompted to log their emotions, thoughts, and stress levels. This helps identify patterns and triggers.

• Guided Activities. Exercises such as journaling, breathing, and meditation are built into the apps to support mood regulation.

• Education. Short lessons teach users about depression and how to manage it through behavioral strategies.

• Reminders and Notifications. Gentle prompts help users stay engaged with their mental health plan.

• Social Connection Tools. Some apps help users schedule calls or virtual support sessions with loved ones or mental health professionals.

Are Mental Health Apps Covered by Insurance?

As more emphasis is put on mental health and as the desire for more accessible resources increases, health insurance providers are increasingly covering the use of mental health apps. But before paying for a mental health app, contact your health insurance provider to make sure it is covered.

Medicare

At the beginning of 2025, Medicare began covering certain FDA-approved digital mental health applications when prescribed as medically necessary. This includes apps designed for conditions like depression and generalized anxiety disorder. Coverage specifics can vary, so consult with your health care provider or check the Medicare Connected Apps Directory for approved applications.

Medicaid

Medicaid coverage for mental health apps varies by state. Some states have added telehealth services, including mental health apps, to their Medicaid programs. Check with your state's Medicaid office or health care provider for specific coverage details.

Private Health Insurance

Many private insurers are now beginning to cover mental health apps and online therapy platforms. For instance, Talkspace partners with several major insurance providers, including Cigna, Optum, Aetna, and others, to offer covered therapy services. Similarly, platforms like Amwell are included in the coverage plans of over 40 insurers. Be sure to consult your insurance provider to determine which apps and services are covered under your plan.

Why Are These Apps Especially Valuable for Older Adults?

To be useful for older adults, these apps need to accommodate their needs and usage preferences. They accomplish this in different ways.

Accessibility

Seniors may face barriers to in-person care, such as limited mobility, transportation challenges, or long wait times. Apps allow for support at home, at any time.

Cost-Effectiveness

Many mental health apps are free or low-cost, making them a budget-friendly alternative to traditional therapy sessions. In addition, some health insurance providers cover the use of certain mental health apps.

Privacy

Some older adults may be hesitant to discuss mental health conditions openly. Using an app offers a private and stigma-free way to explore emotions and seek help.

Ongoing Support

Depression can be a recurring condition. Apps provide tools that seniors can use daily, helping reinforce healthy habits between doctor or therapist visits.

What Older Adults and Caregivers Should Consider

Though mental health apps can be beneficial, they aren’t a replacement for professional care. Users should look for apps that are backed by clinical research and offer user-friendly interfaces with large fonts and simple navigation. It is also important to only use apps that have a privacy policy that protects personal health information. Finding an app that can be used alongside a professional treatment plan can make for a more seamless and effective user experience.

It’s also a good idea to consult with a health care provider before using any new mental health tool, especially for individuals with complex medical or psychiatric conditions.

Additional Resources

Mental health apps are becoming valuable tools for older adults, including those dealing with depression. By blending technology with psychology, these tools empower seniors to better understand their emotions, develop coping strategies, and maintain a sense of control over their mental health. In a world that can sometimes feel isolating, these digital tools offer connection, comfort, and hope.

Contact an elder law attorney in your area to learn about government-provided health benefits and how you can get the most out of them.

For additional reading about mental health as well as technology, check out the following articles:

• Plan Your Treatment Before a Mental Health Crisis

• The Loneliness Epidemic: Helping Seniors Stay Connected

• Report: U.S. Suicide Rate Highest Among Older Men

• How Does Telehealth Work, and What Are the Benefits?

• In-Home Senior Care Technology and Elder Law

Lawmakers Propose Well-Being Insurance for Older Adults

As the United States population ages, the need for affordable and sustainable long-term care solutions has become increasingly urgent. Many older adults prefer to age in place – that is, live independently in their homes and communities as they grow older. However, the high cost of long-term services and supports, such as home health aides or assisted living, remains a barrier.

In response to this growing issue, policymakers and advocates have been exploring innovative approaches to help seniors remain at home with dignity and independence. One such proposal is the bipartisan Well-Being Insurance for Seniors to be at Home (WISH) Act, introduced in Congress by Representatives Tom Suozzi (D-NY) and John Moolenaar (R-MI).

“Right now, our country is facing a looming long-term care crisis,” said Rep. Suozzi in a press release.

“Ten thousand Americans turn 65 every day; in five years, 6,500 seniors will turn 80 every day. Medicaid and nursing homes are already overburdened, and seniors have no other affordable options to pay for the care that they will need. We need to handle this problem before it becomes a crisis, and I believe a federal catastrophic long-term care insurance program coupled with a robust private sector insurance market is the way to do that.”

Home Safety for Aging in Place: A Guide for Older Adults

Aging in place, the ability to live safely and independently in one’s home as long as possible, is a goal for many seniors. However, as we grow older, our homes may require modifications to ensure safety, comfort, and accessibility.

Whether you are planning to live in your home as long as you can or want to help an aging parent stay in their home longer, ensuring home safety is a top priority. Here are some practical steps you can take to create a safer living environment for older adults.

Select the image below for more information.

Protecting Your Parents' Assets From Nursing Home Costs

Takeaways

• Nursing home care costs have been rising over time, with many older Americans who require long-term care unable to afford it.

• With proper planning, seniors may be able to rely on Medicaid to pay for this care – and still retain some of their assets – by exploring several different strategies.

The aging U.S. population means that more people will likely need nursing home care in the coming decades. Meanwhile, the cost of nursing home care is increasing — and expected to keep increasing.

With the exorbitant cost of nursing home care, many families worry about depleting their loved ones’ life savings to pay for the care they need. Private health insurance does not cover nursing home care, and while long-term care insurance is available to cover nursing home costs, these plans are also expensive and may come up short for long-term stays.

This leaves millions of Americans reliant on Medicaid to pay for nursing home care — a far from perfect solution that usually involves spending down assets to qualify. With proactive Medicaid planning, though, it is possible for someone to qualify for Medicaid and still retain some of their assets. The sooner you start planning, the more options you’ll have for protecting your parents’ assets from nursing home costs.

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What To Do if You Were Scammed

Find out what to do if you paid someone you think is a scammer, or if you gave a scammer your personal information or access to your computer or phone.

Click Here: https://consumer.ftc.gov/articles/what-do-if-you-were-scammed

Discover Love and Companionship: Senior Over 65 Dating Guide

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