Suze Orman has spent decades urging Americans to buy long-term care insurance. In her AARP column on the subject, she described spending more than $2 million on 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 grow to $130,000 to $300,000. The 6% assumption is reasonable in context: the 10-year Treasury was yielding approximately 4.57% in early 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 Genworth/CareScout 2024 Cost of Care Survey found that nursing home care now runs $9,277 per month for a semi-private room and $10,646 per month for a private room, increases of 7% and 9% respectively in a single year. Assisted living, a step below full nursing facility care, hit a national median of $5,900 per month, itself up 10% year-over-year. The Administration on Aging puts average care duration at roughly 2.2 years for men and 3.7 years for women. That puts the total expected lifetime bill somewhere between $200,000 and $460,000 in today’s dollars. Healthcare costs have been rising faster than general inflation, 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.
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 people who benefit most from those policies are not wealthy retirees; they are households that could be wiped out 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 4.57%, the sleeve generates roughly $14,000 to $23,000 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 Genworth Cost of Care numbers for your state. Care costs in Connecticut differ sharply from those in Mississippi. The 2024 survey covers 431 metro regions, 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 the 10-year Treasury yield to approximately 4.57% as of early July 2026 (revised from 4.47% in mid-June 2026) and adjusted the bond-sleeve annual interest range accordingly. It also corrected the Genworth/CareScout survey’s geographic coverage to 431 metro regions, added current standalone LTC premium benchmarks from the American Association for Long-Term Care Insurance, and incorporated 2024 Milliman data showing approximately 5.8 million Americans hold standalone LTC coverage.
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