56 Percent Long-Term Care Risk Statistic

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HHS research shows 56 percent of Americans turning 65 will need long-term care under the federal definition. Learn what this means for planning. The 56 percent statistic comes from a 2022 research brief by the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Planning and Evaluation (ASPE). It estimates that 56 percent of Americans turning 65 today will develop a disability serious enough to need long-term services and supports (LTSS), using the federal definition of disability set by the Health Insurance Portability and Accountability Act (HIPAA). 

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You may see different long-term care risk percentages cited across the industry, and the numbers vary because researchers use different definitions of disability. The HHS ASPE brief, titled "Long-Term Services and Supports for Older Americans: Risks and Financing, 2022," relies on the stricter, federally recognized HIPAA standard, which makes the 56 percent figure one of the most defensible numbers available for planning purposes.

The Federal (HIPAA) Definition of Disability

Under HIPAA, a person meets the threshold for LTSS need when they require:

• Help with at least two activities of daily living (ADLs), such as bathing, dressing, toileting, eating, transferring, or continence, for at least 90 days, or
• Substantial supervision due to severe cognitive impairment, such as Alzheimer's disease or another form of dementia

This is the same standard insurance companies use to determine eligibility for benefits under a tax-qualified Long-Term Care Insurance policy, which is why LTC News considers it the most reliable benchmark for planning content.

Key Findings From the HHS Report

Using its DYNASIM4 microsimulation model, HHS researchers project the following for Americans turning 65 between 2021 and 2025:

• 56 percent will develop a significant disability requiring LTSS
• 22 percent will need care for more than five years
• The average person turning 65 can expect to need LTSS for 3.1 years
• Average lifetime long-term care costs total $120,900 per person, with families paying 37 percent out of pocket
• Unpaid family caregivers provide care valued at $204,000 on average for those receiving it, more than the cost of paid care

Risk also varies by gender. Women face a 64 percent chance of needing LTSS, compared with 49 percent for men, largely because women live longer on average.

Why the 56 Percent Figure Matters More Than the "70 Percent" Estimate

You may have seen long-term care risk cited as 70 percent elsewhere. That figure comes from a broader, less precise definition of disability and tends to overstate risk in a way that is harder to verify against a consistent federal standard. LTC News uses the 56 percent HIPAA-based figure because it reflects the same eligibility threshold used by the federal government and Long-Term Care Insurance carriers, giving readers a more accurate picture of when a policy would actually pay benefits.

Why This Matters for Your Planning

A 56 percent chance of needing long-term care is not a small risk, and the cost of that care can affect your retirement savings, your family, and your independence. Long-Term Care Insurance, Medicaid planning, and personal savings are the primary ways to prepare for these costs, since Medicare does not cover most long-term care expenses.