Six in 10 Middle-Class Households Are Without an Adequate Plan for Long-Term Care
Sep 2, 2026
Six in 10 Middle-Class Households Are Without an Adequate Plan for Long-Term Care
Sep 2, 2026
ACLI’s September 2026 Financial Resilience Survey highlights an important opportunity to strengthen long-term care (LTC) planning: while 39% of middle-class households expect Medicare to cover LTC expenses, Medicare does not pay for this care. Another 23% have not yet established a plan to cover LTC costs. Together, these findings point to a meaningful opportunity to help just over six in ten middle-class families better understand their options and prepare with greater confidence.
Survey respondents were presented with a hypothetical scenario assuming they will need long-term care at some point in their old age. Only 7% expect to use long-term care insurance, and just 2% plan to lean on family to cover the cost. In other words, many middle-class households are relying on self-funding, a program that requires exhausting assets first, or no strategy at all — and very few have the dedicated protection built for this exact risk.
This gap underscores the need for greater awareness about what Medicare will and won’t pay for. Medicare covers acute, short-term medical needs — a hospital stay, a course of skilled nursing care, or rehabilitation after surgery — but it was never designed to pay for the ongoing, non-medical help most people need as they age, such as assistance with bathing, dressing, or eating. Medicaid can help cover LTC, but only for those who qualify financially, which often means spending down a lifetime of savings first. Without a clear plan in place, families are left to shoulder these costs themselves — often at the very moment they can least afford to.
Long-term care insurance is built to close exactly this gap. By protecting a lifetime of retirement savings and easing the burden on family caregivers, long-term care insurance gives middle-class households a real plan for the road ahead — rather than a reliance on programs that were never meant to cover this need.
Lauryl Dodson
Lauryl Dodson is Vice President, Federal Relations for Financial Income Security and Diversity & Inclusion for the American Council of Life Insurers (ACLI). Prior to joining ACLI in January 2020, she led government affairs strategy for the priorities of the pharmaceutical industry.
