Long-term care
What if I need long-term care?
Long-term care is one of the biggest costs retirees face, and one of the least understood. Here's what your federal benefits cover, what they don't, and your options.
What you need to know
The short answer
FEHB and Medicare don't cover it
Long-term custodial care (help with bathing, dressing or eating, at home or in a facility) isn't covered. Medicare pays only for limited, short-term skilled care after a hospital stay.
FLTCIP is closed to new applicants
The Federal Long Term Care Insurance Program suspended new applications in December 2022. Existing policies continue. Check OPM for the latest status.
There are other options
Choices include traditional long-term care insurance, hybrid life or annuity policies with long-term care benefits, self-funding, and Medicaid after spending down assets.
Health and age matter
Most coverage requires health underwriting. The longer you wait, the fewer options and the higher the cost.
Avoid these
Mistakes we see most
Assuming Medicare will pay
It generally won't pay for ongoing custodial care.
Waiting until there's a diagnosis
Many people no longer qualify for coverage by then.
Planning for one spouse only
A long care need for one spouse can drain the savings the other depends on.
Not reviewing an existing FLTCIP policy
Premiums have changed. Make sure your coverage still fits.
Go deeper
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Educational information only, based on rules in effect as of October 2026. Benefit rules change. Confirm details with OPM, your agency or the TSP before making decisions.