Nationwide finds Medicare myth on long-term care could cost Americans dearly

As the US population continues to age, a growing number of Americans are ill-prepared for the financial realities of long-term care, according to new findings from Nationwide.

Based on its 2025 Nationwide Retirement Institute Long-Term Care survey, the insurance giant found 58% of adults believe Medicare will cover long-term care costs, despite the program offering only limited, short-term assistance.

The findings, drawn from a Harris Poll survey of 1,324 adults age 29 and older with household incomes of $75,000 or more, expose widespread confusion about how long-term care services are paid for and who bears the responsibility.

Nearly 70% of Americans turning 65 today will require some form of long-term care, according to federal estimates, yet only 41% believe they’ll live long enough to need insurance coverage for it.

The survey also shows financial pressure mounting across generations. More than half of respondents expressed concern about paying for long-term care, and 59% said they plan to rely on Medicaid. That suggests many are counting on spending down their assets to qualify for the government safety net program – even as potential cuts to Medicaid funding loom.

“Too many Americans are entering the most vulnerable stage of life with a false sense of security,” Holly Snyder, president of Nationwide’s life insurance business, said in a statement on Monday. “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.”

At-home care is a preferred option for many: 77% of respondents said they would rather age in place. But that may be easier said than done. More than four in 10 believe their current home is unsafe or inaccessible for older age, and nearly half say making the necessary retrofits to their residence would be unaffordable.

Housing challenges compound the issue. A majority of Americans (54%) believe the still-heady prices in the residential real estate market will prevent them from relocating or downsizing. Among those age 61 and older, 42% plan to remain in their current homes post-retirement without making any changes – a choice that could increase physical and financial risks over time.

Meanwhile, caregivers are already absorbing the costs. Echoing other studies, the survey found they spend an average of $372 a month out of pocket on long-term care expenses for family members. Half believe those costs will reduce their children’s inheritance, and 42% think caregiving responsibilities will diminish what they hoped to pass on to the next generation.

Despite the role long-term care insurance can play in mitigating these risks, only one in 10 survey participants reported owning a policy. A separate study from Nationwide and The American College of Financial Services found that just 32% view long-term care insurance as a helpful resource, with cost being a primary deterrent.

Misunderstandings about pricing are widespread: 64% of adults overestimated the monthly cost of coverage. When shown accurate pricing, 47% said they would be more willing to consider purchasing a plan.

Even among those who work with financial advisors, long-term care planning is often overlooked. Of those who haven’t discussed the topic with their advisor, one in three said it was because their advisor never brought it up.

“Many people don’t realize how comprehensive long-term care insurance can be — it’s not just for nursing homes,” Snyder said. “It can help cover home modifications, compensate caregivers, and even provide tax-free benefits to loved ones if it goes unused.”