The likelihood is that you or a member of your family will need long-term assistance due to a prolonged illness, a disability, or general deterioration of your health and ability to perform routine daily activities. Most long-term care expenses are not covered by Social Security or Medicare, Medicare Supplement (“Medigap”), or private health insurance. Medicaid pays for nearly half of all nursing home care, but you must meet federal poverty guidelines and may have to “spend down” most of your assets on health care.