Employee Perspectives on Long-Term Care

Summary

The Employee Long-Term Care (LTC) Survey, fielded in late 2024, examined employees’ awareness of, access to, and perspectives on LTC financing. Findings from the survey of 2,445 workers ages 20–74 uncovered emerging insights while also reaffirming well-established trends in LTC awareness and preparedness.

Some of the key findings from the survey include:

• Four in 10 workers reported a belief that they will likely need long-term care as they age, but a substantial portion remained unsure (32 percent) or did not think they will need it (24 percent). Awareness of an employee’s personal long-term care needs appeared to be concentrated among two groups:
  • Workers with personal experience receiving care, with a disability, or who have filed a short-term disability claim are significantly more likely to believe they will need LTC in the future.
  • Employees with higher incomes and education levels are more likely to anticipate needing LTC.
• There are gaps in knowledge about access to local long-term care, sometimes also referred to more broadly as long-term services and supports (LTSS). Thirty-seven percent of employees reported low or no knowledge of how to access LTC services in their community.
• Only 24 percent of benefits-eligible employees said their employer offers long-term care insurance, and just 9 percent of those employees were enrolled. Even among those anticipating LTC needs, take-up remains low.
• Awareness and availability of caregiving support programs are limited. A majority of employees were unsure of what employee resource groups (ERGs) exist at their workplace, and only a minority reported access to key caregiving or end-of-life support services.
• A large share of workers were or said they expect to be caregivers. Nearly 60 percent of employees had provided care in the past or were doing so currently. Many said they expect to provide care in the future for aging parents, in-laws, or spouses — often both physically and financially.
• In consideration of a single, specific future care recipient:
  • A significant proportion of future caregivers had not estimated LTC costs. Among those who had estimated the cost of care for a specific individual, many underestimated the cost of LTC, with most expecting expenses to remain under $50,000.
  • Many future caregivers reported an expectation that Medicare (43 percent) or Medicaid (29 percent) will cover LTC costs. A third (32 percent) said they themselves would pay for this care.
• Employees expressed support for their state government in the provision of long-term care insurance (LTCI). A majority supported increased taxes to fund LTC benefits, with 64 percent favoring a state payroll tax, and a plurality (27 percent) said “my state” was best positioned to provide personalized LTCI.
• Cost, benefits, access, and reliability were the most important features for employees if they were to consider purchasing an LTCI contract.
• As part of a series of tradeoffs between different coverage designs and tax implications for a potential LTCI program, employees were asked to choose between front-end and catastrophic coverage options. Fifty-eight percent of employees selected catastrophic coverage, while 42 percent chose front-end coverage.

A significant share of employees either said they expect to need long-term care or had caregiving experience, yet awareness, planning, and benefit take-up remained low, with many workers underestimating costs, unsure how to access services, and mistakenly expecting Medicare or Medicaid to cover future care. Employees’ perceptions of their LTC needs are strongly influenced by personal experience and socioeconomic status, highlighting an opportunity for employer-informed, public-private solutions paired with targeted education efforts.