Long Term Care Insurance

The U.S. Department of Health and Human Services estimates that 70% of 65-year-olds will need some type of long-term care in the years to come. As the baby boomer generation gets older, many find themselves considering how they will take care of themselves later in life.
Long-term care — which can include home care, adult day care, assisted living, or a nursing home facility — can be expensive and quickly eat away at your savings, potentially reducing or eliminating your ability to leave something behind for your loved ones.

According to the Genworth Cost of Care Survey, the average cost of even a semi-private room in nursing home is $6,800 per month ($81,600 per year) while a home health aide costs about $3,800 per month ($45,600).

Long-term care insurance is one way to prepare for the high cost of care if you ever need long-term care in your home or a facility. This type of insurance covers many services that aren’t covered by regular health insurance and it can defray the costs of managing a chronic medical condition. Here’s what you should know about long-term care insurance.

How Does Long-Term Care Insurance Work?

Regular health insurance will not cover long-term care but Medicare will not help, either, as it only covers limited types of home health care and short nursing home stays. Long-term care insurance is a form of insurance that covers long-term care services such as help with routine daily activities and medical care.

 When a long-term care policy is activated, it will reimburse you a daily amount for services up to a pre-determined limit. This type of policy can cover the expenses of managing a disability, chronic health condition, or disorder like Alzheimer’s by reimbursing you for care provided in many settings. As a general rule, a comprehensive long-term care policy will cover:

  • Home care in which an individual or agency provides help with daily activities like bathing, cooking, and housekeeping.
  • Assisted living in which residents live in apartment-style units. When needed, services like meal delivery and personal care assistance is provided.
  • Nursing home. Nursing homes are residential centers that offer skilled health care, personal care, daily activities, and rehab around the clock.
  • Adult day care in which you receive daytime support, social, and health services in a supervised setting.
  • Alzheimer’s care.

How to Save on Long-Term Care Insurance

It’s important to educate yourself before purchasing an insurance policy so you are sure you can afford the premiums and understand the type of coverage you will receive. There are a few steps you can take to keep your policy premiums as affordable as possible while maximizing your benefits:

  • Don’t wait too long to buy. The younger you are when you buy long-term care insurance, the lower your premiums will be. Experts recommend buying long-term care insurance when you are in your 50s and in good health. If you wait too long, you’re facing higher premiums and a higher risk of a serious medical condition that can deny you coverage.
  • Read the policy. Long-term care policies vary a great deal in terms of what is covered and what you need to do for coverage. While some companies allow you to hire nonlicensed or independent providers or even family members, others require using services from a certified agency or licensed care professional. Check that your policy covers the types of services and facilities you will want and can access in your community. You will also want to know the policy’s benefit triggers, or the conditions that must be met before you receive benefits.
  • Compare rates. Because premiums for long-term care insurance can vary a great deal, it’s a good idea to do comparison shopping among several carriers.
  • Adjust your coverage. You can make your policy premiums more affordable by adjusting the terms of coverage of the policy. You may want to limit the term of the policy or choose a longer elimination period (or period before coverage kicks in).

Is Long-Term Care Insurance a Good Option?

No one wants to think that they may be frail or unable to care for themselves one day, but it’s a future that many encounter. Even if you have loved ones who are willing to care for you, they may be unable to provide the level of care you need due to insufficient time, living too far away, lacking the technical know-how, or lacking strength and health of their own. Most family caregivers are spouses, but the average spousal caregiver is almost 63 years old, according to AARP.

It’s also unwise to rely on Medicare and Medicaid for the assistance you may need one day. Medicare does not cover long-term care (including nursing home care) if that’s all you need. Many family members and seniors also assume Medicaid will pay for the cost of long-term care, but this coverage only kicks in once you meet functional and financial criteria. Until you are no longer able to perform daily living activities on your own and spend virtually all of your savings, Medicaid won’t help.

Keep in mind long-term care policies take effect immediately should you need the coverage sooner than you expect. Long-term care insurance is a valuable form of protection to get ahead of ever-increasing health care costs and protect your savings.


Carlos Lopez is the director for Disabled Friends. He also handles the department of disability resources for MedicareFAQ, a learning resource center for all seniors and Medicare beneficiaries.