A survey found that 39% of middle-class households expect to rely on Medicare for long-term care, even though Medicare generally does not cover ongoing medical and nonmedical assistance for people with chronic illnesses or disabilities. The American Council of Life Insurers survey included 1,404 households with annual incomes of $50,000 to $150,000, and nearly 20% of respondents said they planned to self-fund care. Experts identify Medicaid, long-term care insurance and personal savings as the main funding options. Medicare Part A may cover up to 100 days of skilled nursing facility care per benefit period after a qualifying inpatient hospital stay, but that benefit differs from ongoing nursing or custodial care. A person turning 65 has a nearly 70% chance of needing long-term care services, while a 2025 CareScout survey put the national median annual cost of a semiprivate nursing home room at $114,975. Schroders found that retirees spent 16% of monthly income on healthcare and that 58% were caught off guard by those expenses. Fidelity's 2026 estimate of $185,500 in healthcare costs for a 65-year-old enrolled in Original Medicare Parts A and B and Part D specifically excluded long-term care. Experts recommend beginning to assess Medicaid eligibility, insurance and self-funding capacity in the 50s or 60s.