Long-term care

The retirement risk most people ignore until it is too late

70% of people turning 65 will need some form of long-term care. The average cost exceeds $100,000 per year. Planning now protects everything you have saved.

Long-term care is the largest unplanned expense in retirement

A serious illness, a fall, or cognitive decline can require years of professional care — at home, in an assisted living facility, or in a nursing home. Medicare does not cover custodial care. Medicaid requires spending down most of your assets first. Without a plan, long-term care costs can wipe out a lifetime of savings in just a few years.

70%
of people turning 65 will need long-term care
$108K
average annual cost of a private nursing home room (2023)
3 years
average duration of long-term care need
$0
covered by Medicare for custodial care

Your long-term care coverage options

There is no single right answer — the best option depends on your health, assets, and family situation.

Traditional long-term care insurance

Pays a daily or monthly benefit for qualifying care. Premiums are lower when purchased younger and healthier. The risk: premiums can increase over time, and you may pay for coverage you never use.

Pros

  • Dedicated coverage
  • Tax-deductible premiums (in some cases)
  • Protects assets from spend-down

Cons

  • Use-it-or-lose-it
  • Premiums can increase
  • Underwriting required

Hybrid life / LTC policies

Life insurance or annuity policies with a long-term care rider. If you need care, the policy pays benefits. If you do not, the death benefit passes to your heirs. No use-it-or-lose-it concern.

Pros

  • Death benefit if care not needed
  • Premiums typically fixed
  • Easier underwriting

Cons

  • Higher upfront cost
  • Less flexibility
  • Lower LTC benefit per dollar

Self-insuring

Setting aside a dedicated pool of assets to cover potential care costs. Works best for those with significant assets. Requires discipline and a clear plan for which assets are earmarked for care.

Pros

  • Full control
  • No premiums
  • Assets remain in estate if unused

Cons

  • Requires significant assets
  • Catastrophic care can exceed reserves
  • No leverage

Medicaid planning

For those who cannot afford private insurance, Medicaid covers long-term care — but only after spending down most assets. Medicaid planning with an elder law attorney can protect some assets for a spouse.

Pros

  • Covers care when assets are depleted
  • Spousal protections available

Cons

  • Requires asset spend-down
  • Limited facility choices
  • Complex rules vary by state

Common questions

Protect your retirement from a long-term care event

We will review your current situation and help you evaluate the options that make the most sense for your assets, health, and family.

Schedule a Conversation