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What Dementia Care Really Costs and How to Prepare

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Dementia care can deplete wealth built over a lifetime in a matter of years, leaving little to pass on to heirs.

Wealth built over a lifetime may be depleted in a few years, leaving little for a surviving spouse or children.


Long-Term Care Insurance

Long-term care insurance covers extended care costs once you can no longer perform activities of daily living independently.

Some policies pay a daily or monthly benefit toward home care, assisted living, memory care, or a nursing home for a set period, usually two to five years.10

Other policies pay benefits for life up to policy limits, but cap benefits per day.11 For example, your policy might have a $150 limit per day and a $500,000 lifetime limit.

Policy provisions vary widely, so it's a good idea to review the terms carefully with your financial advisor before you buy.

Long-term care insurance shifts the financial risk to an insurer and protects your family’s assets. However, you have to buy a policy before you need it, ideally before age 60.12 Once a dementia diagnosis is in place, buying a policy may be extremely difficult or prohibitively expensive.


Medicaid

For families who have exhausted their savings, Medicaid is the payer of last resort.

To qualify, your income must generally fall below $2,982 per month (individual) or $5,964 (married couple), with minimal assets.13

If your income exceeds that limit, you may still have options. Some states allow you to use a Qualified Income Trust that lets you redirect the excess income into a trust, removing it from Medicaid's calculation.14

Upon your death, the Medicaid agency receives the trust funds, up to the amount it paid for your long-term care.

Other states handle this through a medically needy program.14 You pay the difference between your income and the state's medical income standard on care costs, and Medicaid covers the remaining costs for that period.

Once eligible, Medicaid covers 100% of nursing home costs. But coverage for other settings is limited, and not all nursing homes accept Medicaid. Those that do may have limited availability.

For married couples, the spend-down can leave a healthy spouse financially depleted. Medicaid’s spousal impoverishment rules offer some protection, but they have limits.15


The Best Time to Plan Is Before You Need To

A dementia diagnosis is never easy to think about, but the earlier you have honest conversations with your family and your financial advisor about long-term care, the more options you’ll have when the time comes.

A financial advisor can help you think through what makes sense for your situation, well before a diagnosis makes the decision urgent.

Important disclosure information

This content is general in nature and does not constitute legal, tax, accounting, financial or investment advice. You are encouraged to consult with competent legal, tax, accounting, financial or investment professionals based on your specific circumstances. We do not make any warranties as to accuracy or completeness of this information, do not endorse any third-party companies, products, or services described here, and take no liability for your use of this information.

  1. Alzheimer’s Association, “What is Dementia?” accessed May 12, 2026. Back
  2. Brian Doctrow, Ph.D., "Risk and future burden of dementia in the United States," National Institutes of Health, published February 18, 2025. Accessed May 12, 2026. Back
  3. Alzheimer's Society, "The later stage of dementia," accessed May 12, 2026. Back
  4. Mayo Clinic, “Alzheimer’s stages: How the disease progresses,” published May 9, 2025. Accessed May 12, 2026. Back
  5. Medicare.gov, "Home health services," accessed May 12, 2026 Back
  6. BMG Group, “Study sheds more light on life expectancy after a dementia diagnosis,” published September 1, 2025. Accessed May 12, 2026. Back
  7. Karlijn J. Joling, Olin Janssen, Anneke L. Francke, Robert A. Verheij, Birgit I. Lissenberg-Witte, Pieter-Jelle Visser, and Hein P.J. van Hout, “Time from diagnosis to institutionalization and death in people with dementia,” Alzheimer’s & Dementia, published February 18, 2020. Accessed May 12, 2026. Back
  8. CareScout, “Calculate the cost of long-term care near you,” accessed May 12, 2026. Back
  9. Taylor Shuman and Dr. Abby Altman, “Memory Care Costs in 2026,” SeniorLiving.org, published April 14, 2026. Accessed May 12, 2026. Back
  10. American Council of Life Insurers, “Long-Term Care Insurance: A Plan for the Road Ahead,” accessed May 12, 2026. Back
  11. Insurance Information Institute, "What features of long-term care policies should I focus on?" accessed April 12, 2026. Back
  12. National Council on Aging, “How Much Does Long-Term Care Insurance Cost and Is It Worth It?” published February 13, 2025. Accessed May 12, 2026. Back
  13. Jen Teague, “How Will Medicaid Cover Long-Term Care If I’m Over Income?” National Council on Aging, published March 18, 2026. Accessed May 12, 2026. Back
  14. American Council on Aging, "How Qualified Income Trusts (Miller Trusts) Help Medicaid Applicants Become Eligible for Long-Term Care," updated December 31, 2025. Accessed May 12, 2026. Back
  15. Medicaid.gov, “Spousal Impoverishment,” accessed May 12, 2026. Back