No Easy Answers For Long-Term Care

Sunday, 5 May 2013, 8:46:00 AM

Ron Pollack

Ron Pollack, Families USA Executive Director
Mirror Archives
Ron Pollack, Families USA Executive Director

Tax time has just passed. For many people, that’s a time

to take stock of finances and to start planning for the future. That should

include plans in case you or a family member needs long-term care. It’s a tough

topic. But if you plan ahead, you’re more likely to get the kind of care you

want. Here are some questions and answers to help you jump-start the


If you need long-term care, what are your


Once, long-term care meant staying in a nursing home.

Not anymore. Today, there are assisted living facilities, retirement

communities with many levels of care, and devices that can help you stay in

your home longer. Think about what you

want, and then do as much as you can in advance to plan for it. For example, if

you want to stay in your home, make modifications like adding grab bars and

accessible entryways.

Should you consider buying long-term care


Planning is a good idea, but you may end up needing more

care than you anticipated. That’s where long-term care insurance may help.

Long-term care is expensive: The average cost for a year in a nursing home is

$84,000, and it is not covered by Medicare. Evaluate your finances and see what

you can afford. You might consider buying long-term care insurance, but it

doesn’t make sense for everyone. Policies are expensive, what they cover

varies, and you’ll have to be able to keep up with premium payments for years

or even decades. Talk to a financial planner or an elder care attorney to help

you evaluate what’s best for you. The website, operated by

the U.S. Administration on Aging, can help you find an elder care attorney.

When should you start thinking about buying

long-term care insurance? 

Financial advisors suggest that it is best to purchase

long-term care insurance when you are in your 50s. You can still get a policy

if you are older, but the longer you wait, the more a policy will cost.

What should you look for in a long-term care

insurance policy?

Policies vary a lot. Here are some things you’ll need to

understand before you sign up. First, make sure the policy includes inflation

protection. Policies usually pay up to a certain amount per day and have a

lifetime maximum. You might not need care for decades after you buy the policy,

so you need to make sure that the amount it will pay keeps up with inflation.

Most policies don’t start paying until after you need care for a certain period

of time, which is known as the elimination period. You need to know how long

that is. Also ask how disabled you’ll need to be before coverage begins:

Policies require different levels of disability before they start to pay.

Finally, make sure the policy covers both home care and nursing home care, and

check to see if it excludes coverage for certain conditions. In the end, you

need to balance what a policy costs and covers with what you’re able to pay.

Some experts recommend that you spend no more than 5 percent of your income on

long-term care insurance.

What if you can’t afford long-term care

insurance and end up needing expensive long-term care?

If you don’t have insurance and need care, you generally

have to pay for it yourself, which can eat up your assets. But if that happens,

there is a safety net: Every state’s Medicaid program pays for long-term care.

While it’s best to not have to qualify for Medicaid, it’s there if you need it.

It’s the only reliable long-term care insurance we have right now.  

Are there other

options or resources?

Some states have what’s called “long-term care

partnership programs.” If you buy an approved insurance policy through such a

program, you can qualify for Medicaid when you run out of insurance coverage,

instead of when you use up your assets. Check if your state has a program. Also

visit, a resource clearinghouse for senior services that

includes information on long-term care options.

Are there any

policy changes on the horizon that might help?

Unfortunately, we don’t have anything like Medicare for

long-term care—a national insurance program for everyone. But there is hope for

progress. President Obama and congressional leaders recently appointed members

to a Long-Term Care Commission. Over the next six months, they’ll be developing

a plan to improve consumers’ long-term care choices. Hopefully, you’ll be

reading about their recommendations soon.

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