The long-term care cost gap: why $165,000 isn’t the same for men and women

A 65-year-old woman should expect to pay $73,000 more out of pocket for long-term care than a man the same age. The Center for Retirement Research at Boston College estimates the average woman will face $171,000 in costs, compared to $98,000 for men. The gap stems not from pricing differences but from longevity: women live longer, are more likely to outlive their spouses, and therefore face longer periods without access to free, family-provided care. About half of all long-term care hours are unpaid—delivered by relatives. Men are more likely to have a spouse available to provide that support. Nearly half of men will need no paid care at all. A quarter will use less than a year. Just 29% will require more than a year. Women are far more exposed: 41% will need over a year of paid services, and 14% will require five years or more. The national average of $165,000 is a starting point. It should be increased for those in high-cost regions—especially cities in the Northeast and West Coast—where care prices rise and life expectancy extends, compounding duration and cost. Personal health and family history, particularly of dementia or chronic illness, also raise projected needs. In-home care, assisted living, and nursing homes carry different price tags, and the choice often depends on severity and duration. Savings are the primary funding source. Long-term care insurance offers protection, but the market has contracted. The Federal Long Term Care Insurance Program, once a major option for federal employees and retirees, has not accepted new applicants for three years. It is undergoing a financial review after a decade of premium increases eroded its stability.