Long-term care for expats: the retirement cost most plans leave out
2nd October 2026
Long-term care is one of the largest retirement costs, and expat financial plans routinely leave it out. Standard international health insurance pays for medical treatment and excludes most day-to-day care, UK state support largely stops when you move permanently outside the EEA and Switzerland, and Thai law has no direct equivalent of a UK lasting power of attorney. Care in Thailand costs far less than in the UK, but someone still has to pay for it and someone still needs the legal authority to arrange it.
What we mean by long-term care
Long-term care is help with the everyday activities of life over an extended period: washing, dressing, eating, moving around, managing medication and, with dementia, constant supervision. It usually arrives in stages. Help at home becomes a live-in carer, a live-in carer becomes a residential home, and a residential home becomes nursing care. Each stage costs more than the last.
Most retirement plans for expats model investment returns, pension income and living costs in detail, and then stop. Care sits at the far end of the timeline and falls between professions. The planner models the cashflow and the insurer covers treatment, and nobody is asked who pays when you can no longer look after yourself.
What care costs in the UK
On one widely used 2026 index of self-funder fees, a UK care home averages £1,298 a week for residential care and £1,535 a week for nursing care. That is about £67,500 and £79,800 a year. Specialist dementia nursing averages £1,564 a week, about £81,300 a year. Other published indices sit somewhat lower or higher, and London and the South East cost more. Live-in care at home typically runs £1,200 to £1,500 a week.
In England you fund your own care in full once your capital exceeds £23,250. Between £14,250 and £23,250 you contribute from capital, and below £14,250 the council pays the fees. Those limits are unchanged for 2026/27 and have not moved since 2010.
The £86,000 cap on lifetime personal care costs was scrapped in July 2024. The Casey Commission now reports by summer 2027, after the Prime Minister brought the timetable forward on 29 July 2026, and the government has not committed to a cap in the meantime. A plan written today has no ceiling to plan around. The House of Commons Health and Social Care Committee cited an estimate in 2025 that one in seven older people face care costs above £100,000.
Long-term care is help with the everyday activities of life over an extended period: washing, dressing, eating, moving around, managing medication and, with dementia, constant supervision. It usually arrives in stages. Help at home becomes a live-in carer, a live-in carer becomes a residential home, and a residential home becomes nursing care. Each stage costs more than the last.
Most retirement plans for expats model investment returns, pension income and living costs in detail, and then stop. Care sits at the far end of the timeline and falls between professions. The planner models the cashflow and the insurer covers treatment, and nobody is asked who pays when you can no longer look after yourself.
What care costs in the UK
On one widely used 2026 index of self-funder fees, a UK care home averages £1,298 a week for residential care and £1,535 a week for nursing care. That is about £67,500 and £79,800 a year. Specialist dementia nursing averages £1,564 a week, about £81,300 a year. Other published indices sit somewhat lower or higher, and London and the South East cost more. Live-in care at home typically runs £1,200 to £1,500 a week.
In England you fund your own care in full once your capital exceeds £23,250. Between £14,250 and £23,250 you contribute from capital, and below £14,250 the council pays the fees. Those limits are unchanged for 2026/27 and have not moved since 2010.
The £86,000 cap on lifetime personal care costs was scrapped in July 2024. The Casey Commission now reports by summer 2027, after the Prime Minister brought the timetable forward on 29 July 2026, and the government has not committed to a cap in the meantime. A plan written today has no ceiling to plan around. The House of Commons Health and Social Care Committee cited an estimate in 2025 that one in seven older people face care costs above £100,000.
What care costs in Thailand
Thailand offers a wide range of care at prices well below the UK. The table converts published 2026 baht price ranges for English-speaking homes at about 44.2 baht to the pound, based on the Federal Reserve rates for 25 September 2026.
Thailand offers a wide range of care at prices well below the UK. The table converts published 2026 baht price ranges for English-speaking homes at about 44.2 baht to the pound, based on the Federal Reserve rates for 25 September 2026.
| Type of care | UK, self-funder average 2026 | Thailand, indicative 2026 range |
|---|---|---|
| Residential or mid-range home | About £67,500 a year | About £5,400 to £13,600 a year (฿20,000 to ฿50,000 a month) |
| Higher-support nursing home | About £79,800 a year | About £13,600 to £48,800 a year (฿50,000 to ฿180,000 a month) |
| Dementia or memory care | About £69,800 residential, £81,300 nursing | About £25,800 to £48,800 a year (฿95,000 to ฿180,000 a month) |
| Live-in carer at home | About £62,400 to £78,000 a year | About £4,900 to £9,500 a year (฿18,000 to ฿35,000 a month) |
These ranges come from published price guides, not quotes, and they sit before hospital bills, one-to-one nursing add-ons and annual price rises. Quality varies widely from home to home, which is one reason to visit before you need one.
Currency adds a second variable. If your portfolio is in sterling and the care bill is in baht, every fall in the pound raises the sterling cost of the same bill. A strong pound helps you and a weak one works against you.
Why your health insurance will not pay
International private medical insurance pays for treatment: hospital stays, surgery, cancer care, specialist consultations. Policy wordings generally exclude custodial care, which means help with washing, dressing and eating, and they exclude admissions or stays for social or domestic reasons. Many also exclude nursing homes and facilities for the elderly, apart from rehabilitation that follows hospital treatment. A policy can pay for a hip operation in Bangkok and contribute nothing to the care home bill that follows. Wording varies by insurer and plan, so read yours.
What the UK will and will not do for you
Attendance Allowance, the UK benefit for people over state pension age who need help with personal care, is generally not paid once you move abroad permanently, with exceptions for the EEA and Switzerland. Thailand is outside both.
Returning to the UK when care becomes necessary does not make it free. Council funding is means tested, and someone arriving with assets is assessed on what they own. A move home at 85 with dementia is also a large upheaval for the person and the family.
Currency adds a second variable. If your portfolio is in sterling and the care bill is in baht, every fall in the pound raises the sterling cost of the same bill. A strong pound helps you and a weak one works against you.
Why your health insurance will not pay
International private medical insurance pays for treatment: hospital stays, surgery, cancer care, specialist consultations. Policy wordings generally exclude custodial care, which means help with washing, dressing and eating, and they exclude admissions or stays for social or domestic reasons. Many also exclude nursing homes and facilities for the elderly, apart from rehabilitation that follows hospital treatment. A policy can pay for a hip operation in Bangkok and contribute nothing to the care home bill that follows. Wording varies by insurer and plan, so read yours.
What the UK will and will not do for you
Attendance Allowance, the UK benefit for people over state pension age who need help with personal care, is generally not paid once you move abroad permanently, with exceptions for the EEA and Switzerland. Thailand is outside both.
Returning to the UK when care becomes necessary does not make it free. Council funding is means tested, and someone arriving with assets is assessed on what they own. A move home at 85 with dementia is also a large upheaval for the person and the family.
The legal gap nobody mentions
A UK lasting power of attorney lets a trusted person manage your affairs if you lose mental capacity. It works for UK assets under UK law. Whether a Thai bank, hospital or land office will act on it is a question for Thai counsel and cannot be assumed.
As far as we are aware, Thai law has no enduring power of attorney. Thai powers of attorney fall under the agency provisions of the Civil and Commercial Code, and under section 826 an agency ends on the incapacity of either party. Where someone loses capacity, the usual route is a court application under section 28 to have them declared incompetent and a guardian appointed. Until the court acts, nobody can operate the Thai bank account, pay the rent or sell the condominium. Thailand does recognise a living will for treatment decisions under the National Health Care Act 2007.
These are general points and a Thai lawyer should confirm how they apply to you. The plan needs a named person in Thailand who holds documents that Thai institutions accept, drawn up while you still have capacity.
Many expats have no relatives within a flight of where they live. Someone has to visit, check the quality of care, speak to doctors and authorise payments. Deciding who that person is belongs in the plan.
Four ways to fund care
Self-funding from the portfolio is the most common route. It works best when the plan carries a defined care reserve, priced at a higher-support home in the country you expect to be living in, rather than leaving care to emerge from general spending.
Insurance is the option people ask about first. In our experience, dedicated long-term care cover that works for someone resident in Thailand is hard to find, underwriting is strict and premiums reflect the risk of a long claim. We would not build a plan around finding one.
Property funds care in the UK because the family home is the main asset. For an expat whose largest asset is a Thai condominium, a sale needs someone with authority to complete it, and the legal gap above applies.
Returning home is possible, and the plan should price it. UK costs apply, and the cash needed to fund them has to come from somewhere other than a Thai property that may take months to sell.
How we plan for it
Brigantia provides fee-based financial advice for expats in Thailand and Southeast Asia. For care, our planning starts with three questions: where would you want care to happen, who would arrange it, and who holds the legal authority to pay for it.
The answers feed the cashflow model. It carries a care cost from an assumed age, priced at a higher-support home in the country you are most likely to be living in, with a second scenario for a return to the UK. We then check the documents against the plan: a UK lasting power of attorney, a Thai will, a living will and a named contact on the ground.
You can book an initial call below.
A UK lasting power of attorney lets a trusted person manage your affairs if you lose mental capacity. It works for UK assets under UK law. Whether a Thai bank, hospital or land office will act on it is a question for Thai counsel and cannot be assumed.
As far as we are aware, Thai law has no enduring power of attorney. Thai powers of attorney fall under the agency provisions of the Civil and Commercial Code, and under section 826 an agency ends on the incapacity of either party. Where someone loses capacity, the usual route is a court application under section 28 to have them declared incompetent and a guardian appointed. Until the court acts, nobody can operate the Thai bank account, pay the rent or sell the condominium. Thailand does recognise a living will for treatment decisions under the National Health Care Act 2007.
These are general points and a Thai lawyer should confirm how they apply to you. The plan needs a named person in Thailand who holds documents that Thai institutions accept, drawn up while you still have capacity.
Many expats have no relatives within a flight of where they live. Someone has to visit, check the quality of care, speak to doctors and authorise payments. Deciding who that person is belongs in the plan.
Four ways to fund care
Self-funding from the portfolio is the most common route. It works best when the plan carries a defined care reserve, priced at a higher-support home in the country you expect to be living in, rather than leaving care to emerge from general spending.
Insurance is the option people ask about first. In our experience, dedicated long-term care cover that works for someone resident in Thailand is hard to find, underwriting is strict and premiums reflect the risk of a long claim. We would not build a plan around finding one.
Property funds care in the UK because the family home is the main asset. For an expat whose largest asset is a Thai condominium, a sale needs someone with authority to complete it, and the legal gap above applies.
Returning home is possible, and the plan should price it. UK costs apply, and the cash needed to fund them has to come from somewhere other than a Thai property that may take months to sell.
How we plan for it
Brigantia provides fee-based financial advice for expats in Thailand and Southeast Asia. For care, our planning starts with three questions: where would you want care to happen, who would arrange it, and who holds the legal authority to pay for it.
The answers feed the cashflow model. It carries a care cost from an assumed age, priced at a higher-support home in the country you are most likely to be living in, with a second scenario for a return to the UK. We then check the documents against the plan: a UK lasting power of attorney, a Thai will, a living will and a named contact on the ground.
You can book an initial call below.
