Suze Orman has spent decades urging Americans to buy long-term care insurance. In her AARP column on the subject, she described paying roughly $25,000 a month for her own mother’s late-life care and pushed readers not to repeat the gamble. Her recurring line, repeated on her show and across her social channels, is blunt: “Every parent in their 50s and 60s owes it to their kids to consider long-term care insurance as family protection. I know the premiums are steep.”
For a 65-year-old couple sitting on $2.4 million in retirement assets, that advice is wrong. The premium dollars buy a policy whose worst-case payout the portfolio can already cover, and the math leaves heirs measurably poorer if a claim never comes.
Running the actual numbers
Start with what the policy costs. Per current pricing for a couple at 65, hybrid life-LTC coverage runs $5,000 to $8,000 a year combined. Traditional standalone policies are cheaper, at $3,500 to $5,500 a year for men and considerably more for women. The American Association for Long-Term Care Insurance puts the average standalone annual premium for a healthy 65-year-old woman at $5,290 and for a man at $3,280. Either way, cash leaves the household every year until a claim or death.
Stretch that out 20 years, to age 85, when the typical LTC need arrives. Cumulative premiums total $70,000 to $160,000. Redirect those same dollars into a portfolio earning 6% instead, and they compound to $130,000 to $300,000. The 6% assumption is reasonable: the 10-year Treasury was yielding approximately 4.67% in late July 2026, so a bond ladder alone closes much of the gap, and a balanced portfolio with equity exposure has historically cleared the rest over 20-year stretches.
Now look at the liability side. The 2025 CareScout Cost of Care Survey, the most comprehensive study of its kind, found that nursing home care runs $9,581 per month for a semi-private room and $10,798 per month for a private room. Those figures represent more modest year-over-year increases of 2% and 1% respectively, a significant deceleration from the 7% and 9% jumps recorded in 2024. Assisted living, a step below full nursing facility care, hit a national median of $6,200 per month, itself up 5% from the prior year. The Administration on Aging puts average care duration at roughly 2.2 years for men and 3.7 years for women, putting the total expected lifetime bill somewhere between $200,000 and $475,000 in today’s dollars. Care costs have risen faster than general inflation across nearly every year of the past decade, so the real number for someone entering care a decade from now will be higher still.
The self-insurance pool funds the expected liability. If neither spouse ever needs extended care, the money stays in the estate. Premiums paid to a carrier do not.
The variable that flips the answer
Portfolio size, and almost nothing else, determines whether Orman’s advice helps or hurts. A $300,000 care bill on a $2.4 million portfolio takes a 13% bite. That same bill on a $700,000 nest egg takes 43% and leaves the surviving spouse exposed for decades. The math, not the philosophy, is what differs between households.
That is why the breakeven for traditional LTC coverage sits between $500,000 and $1.5 million in liquid retirement assets. In that range, the premium buys protection against genuine ruin. Above $2 million, the carrier is selling protection against a shock the portfolio already absorbs, and charging 20 years of premiums for the privilege. Context matters here: Milliman data from 2024 shows that only about 5.8 million Americans currently hold standalone LTC coverage, a figure that has stagnated even as care costs climb. The households that benefit most from those policies are not wealthy retirees. They are the families that could be wiped out entirely by a prolonged care event.
What this couple should do instead
- Earmark an LTC sleeve. Set aside $300,000 to $500,000 in a conservative bond ladder dedicated to potential care costs. At the 10-year Treasury yield near 4.67%, the sleeve generates roughly $14,000 to $23,500 a year in interest while preserving principal.
- Price a hybrid before dismissing insurance entirely. A hybrid life-LTC policy pays a death benefit if care is never needed, which removes the “use it or lose it” problem of traditional coverage. For families who want a backstop without the premium-burn risk, this is the version worth a quote.
- Pull the CareScout Cost of Care numbers for your state. Care costs in Connecticut differ sharply from those in Mississippi. The 2025 survey covers data across all 50 states at the Metropolitan Statistical Area level, so plug your state’s actual monthly figure into the same arithmetic above.
- Map the Medicaid look-back. In 49 states, Medicaid reviews the prior 60 months of asset transfers before determining eligibility for long-term care coverage. Couples planning to protect non-portfolio assets need that clock running well in advance of any potential need.
Orman’s advice fits the median household. For the couple sitting on $2.4 million, following it costs six figures over the next two decades.
Editor’s note: This pass updated nursing home and assisted living cost figures to the 2025 CareScout Cost of Care Survey (released March 2026), which shows semi-private room costs at $9,581 per month and private rooms at $10,798 per month, with cost-growth decelerating sharply from 2024 levels. The 10-year Treasury yield reference was also updated to approximately 4.67% as of late July 2026, adjusting the bond-sleeve annual interest estimate accordingly. The article’s characterization of Orman’s mother’s care costs was corrected to align with figures Orman herself has cited publicly.
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