Advances in medical care, broader preventive screenings, motivation for healthier living, more active lifestyles, and growing sports participation have extended life expectancy and improved quality of life across populations. This progress also means more elderly individuals, and a rising share of those seniors experience cognitive impairment.
In numerous countries private insurance products already exist to provide practical support and medical care for people facing similar health challenges. The time has come to introduce these approaches here as well.
Rosstat’s latest projections show life expectancy reaching 73.1 years in 2023, up from 72.73 in 2022. By 2030 the estimate is 75.79 years, by 2037 about 78 years, and by 2046 roughly 79.83 years. This is a positive trajectory, reflecting improving demographic indicators for the country.
Simultaneously, the proportion of older people is increasing. Among those 60 to 69 and older than 85, cognitive impairment becomes more common, with about 20 percent of people aged 60 to 69 and more than 40 percent of those over 85 showing signs of cognitive disorders. By 2050, the number of people with dementia and related cognitive issues could rise sharply.
Cognitive impairment in individuals over 65 manifests as a range of mental health problems. Post pandemic, the incidence of these conditions rose even further among the elderly.
Such trends are expected to drive greater demand for long‑term care services. In many societies, family members provide most of the care, but research and practice show this approach is not always sustainable. Care recipients require constant professional attention, and caregivers often sacrifice employment and personal well‑being, sometimes facing depression.
Across the globe, very few nations can sustain high‑quality support and medical services for people with cognitive impairment. As a result, long‑term care insurance has long existed in various forms abroad. Some countries operate mixed funding models with employer contributions and personal premiums, while others rely on fully private policies. The core idea remains the same: once a cognitive disorder is diagnosed, the policy covers access to high‑quality medical services and appropriate accommodation in a medical facility at the insurer’s expense.
In Russia, there is currently no equivalent nationwide insurance and the infrastructure for long‑term care is underdeveloped. Options tend to be expensive private facilities or nursing homes that lack licensing, with variable service quality and safety concerns such as fire safety gaps.
The concept of introducing a major long‑term care insurer is appealing. A typical scenario involves a policy for individuals over fifty, with annual costs that are modest compared to the lifetime expense of institutional care in a major city at today’s prices. For example, private medical centers now charge around a million rubles per year for comprehensive care and accommodation. A premium of about fifty thousand rubles annually could secure seven to ten years of care and medical services in case cognitive impairment is diagnosed.
Care models can vary, including permanent facility residence, in‑home nurse services, and other arrangements.
Launching such an insurance product is only the initial step. Russia currently lacks a fully built infrastructure for a long‑term care system and must develop it across regions. This entails establishing hundreds of private medical centers, upgrading equipment, training staff, and more. Implementing this large program will require substantial investment, with insurers potentially contributing part of their reserves to the construction of facilities. Legislative changes would be necessary to allow such investments.
The collective aim is to create a new elder care framework that combines private participation with state backing, culminating in a network of long‑term care institutions that serves the needs of the aging population.