May 28, 2024 Author: Amie Clark | May 28, 2024 |
According to the U.S. Administration on Aging, people over 65 have a 70 percent chance of needing long-term care services such as nursing homes, assisted living, and home care. No matter what type of care is best for you, the costs of long-term care can be astronomical, particularly for those who have not considered this expense. This is where long-term care insurance can become an indispensable component of your financial planning. While Medicare won’t cover custodial long-term care, and Medicaid will only cover a portion, long-term care insurance can help you offset some (if not all) of the costs of a nursing home, assisted living community, or other care services.
Did You Know: To learn more about long-term care insurance, check out our guide to this year’s best long-term care insurance.
There are a few different ways to pay for long-term care costs. Some individuals use their own personal savings and others purchase insurance policies. While Medicare does not cover long-term custodial care, it does cover some types of medical care.
In many cases, people must dip into their retirement funds, pensions, savings, and investment dividends in order to pay for long-term care. Selling assets such as a home –– or taking out a reverse mortgage –– can help cover the costs.
Medicare does not cover long-term care if all you need is assistance with personal care and the activities of daily living. Medicare Part A does cover a short-term (20 days) skilled nursing stay in a Medicare-certified facility or part-time skilled home health care as long as you’ve had a qualifying inpatient hospitalization and obtained a doctor's order for daily skilled care.
Hospice care is also covered by Medicare for terminally ill individuals who require palliative care. Medicare does not cover long-term care so if you need coverage for longer than a few months, you will have to dip into personal funds or explore other options.
Medicare supplemental insurance, sometimes called Medigap, is private insurance that individuals may purchase to fill in some of the gaps that Medicare doesn’t cover. Medicare supplemental plans do not cover long-term stays. It only fills in some of the gaps of Part A. Supplemental plans only cover around 100 days total in long-term care, which means this coverage is not meant for permanent stays.
For low-income individuals, Medicaid will pay for one-third of nursing home care. This program may also help with in-home and community care services. In order to qualify, you have to meet federal and state guidelines based on your income and assets. Some individuals who do not qualify for Medicaid when they enter long-term care may start to qualify when they run low on assets.
Long-term care insurance helps pay for services (both in-home and community-based) that assist with activities of daily living. This type of insurance helps offset the costs of care administered both at home and in senior care communities.
With long-term care insurance, policyholders purchase a “daily benefit” or the price of care per day they would like covered (anywhere between $100 and $500) that the policy will pay out when care is needed.
It’s important to remember, however, that long-term care insurance will not cover medical care. Luckily, in many cases, Medicare will handle this portion of your care costs.
Long-term care insurance covers care administered in the following environments:
Some policies pay for hospice care, respite care, and rehabilitative care following a hospital stay.
Long-term care insurance doesn't cover:
Generally speaking, long-term care insurance is a good idea if you can afford the monthly premiums. Additionally, it’s possible to deduct some long-term care premium payments from your annual taxes as long as the policy is tax-qualified. If your budget is tight, it may not be a good idea to purchase a policy.
You’ll also want to consider your health and family history. Ask yourself:
These questions can help you more thoroughly understand your likelihood of needing long-term care, as well as your options for care.
Individual policies make up the bulk of long-term care policies. These policies are sold directly from an insurance company, and they often require a medical exam. New York Life, Mutual of Omaha, and Lincoln Financial Group are a few insurance companies that offer long-term care insurance policies, and they can often be bundled with other policies for discounted premiums.
If you already have a life insurance policy, you may be able to withdraw from the policy to pay for long-term care. However, taking money out of your life insurance policy may impact the death benefit amount so talk to a trusted financial advisor before doing so. If you no longer need a life insurance policy, you can surrender the policy and use the accumulated cash value to pay for long-term care.
You may also withdraw cash from annuities, a financial product designed to provide cash flow to retirees, to pay for long-term care. There is sometimes a charge but companies may waive this fee if the money is for long-term care.
Some life insurance policies and annuities offer a “rider” or an additional coverage option that helps pay for long-term care. The rider works by allowing people to use their death benefit while they are still living to pay for long-term care. Most companies require that a doctor certify individuals have a chronic illness that requires long-term care in order to access the death benefit.
Some workplaces offer long-term care policies to employees, retirees, or their family members. These policies are often offered at a discounted price and may have tax incentives. Additionally, employees may not have to get a medical exam in order to purchase this type of policy. Most of these policies are voluntary, and employees must pay the entire premium; however, the premium is often less expensive than an individual plan.
Federal and state employees and retirees (including active or retired uniformed service members) and their dependents may access long-term care insurance through the Federal Long Term Care Insurance Program. This program often offers lower premiums than individual policies.
Tax-qualified insurance policies allow individuals to deduct all or some of their monthly premiums as medical expenses in certain circumstances. Many federal and state-based policies are tax-qualified along with some individual plans and riders. Ask your financial advisor or insurance agent about possible tax deductions before purchasing a policy.
Many associations (such as the AARP) partner with insurance companies to offer long-term care policies to their members. These policies are sometimes offered at a discounted price and allow members to choose benefits.
Pro Tip: When choosing a policy through an association, keep membership dues in mind to see if you’re really saving money by purchasing the policy.
According to the American Association for Long-Term Care Insurance, the average yearly cost for long-term care insurance is $1,700 per year for a 55-year-old male and $2,675 per year for a 55-year-old female. Many insurers allow you to pay for your policy either annually or in monthly payments.
Long-term care insurance premiums will vary based on several factors:
Long-term care insurance provides peace of mind and security that you’re covered if you ever need around-the-clock personal care. Out-of-pocket costs for long-term care services are very expensive and insurance can help offset that expense when you have less income coming in later on in life.
On the other hand, premiums are not locked in with every policy. They may rise or fall over time. Additionally, it’s difficult to ascertain what coverage you may need. You may choose a daily benefit of $200 for your care based on the current national averages, and inflation may raise the average price to $400 per day by the time you need the care.
Before you shop for a long-term care insurance policy, assess your budget and current situation. Your health needs and monthly budget will determine what policy is best for you. Additionally, if you qualify for a federal, association, or employer plan, that may influence what plan you purchase.
If you choose between individual policies, make sure to shop around and compare quotes. It may be beneficial to purchase a life insurance policy with a long-term care rider to bundle those costs. Also, with many long-term care insurers folding in the past few years, you want to be sure you choose one with a strong financial rating.
To learn more about our favorite long-term care insurance providers, be sure to check out our provider guides:
