In 2024, the median household income in the United States was $83,730. However, the national average annual cost of 24-hour paid long-term care (LTC) for a retiree age 65 and older was more than $125,000, according to the Department of Health and Human Services. Moreover, one in five seniors will require care for more than five years.
Obviously, the math varies by household, but the reality is that the majority of older Americans who rely on paid caregiving will use much of their retirement savings and investments to pay for it. When considering insurance, there are presently two options: Long Term Care Insurance (LTCi) and Hybrid Life Insurance with an LTC component. Be aware that each policy offers a throng of variations and exclusions, so it is important to dig into the details of individual policies before making a decision.
Long Term Care Insurance
Purchasing a long-term care insurance policy can help offset the cost of caregiving for either in-home care (in some cases, even payouts for family caregivers) or care outside the home (e.g., adult daycare services, assisted living, memory care, nursing home). However, it’s important to understand the following about LTCi.
It can be quite expensive.
Premiums can range from $2,000 a year for a man in his 50s to more than $12,000 a year for a woman in her 70s. Furthermore, premiums increase annually until benefits begin (premiums cease while benefits are paid).
It may not cover the full cost of care.
Unless care is needed for only a few hours a day, long-term care policies generally do not cover the full cost of paid caregiving. For example, let’s say a policy pays $150 a day, but the owner needs care for eight hours a day. His in-home caregiver charges $30 an hour. That means his cost is $240 a day, so he’ll have to pay the additional $90 a day out of his own pocket. That’s
up to $2,790 a month or $32,850 a year. So, while LTCi can help defray the cost, someone who needs extensive care must have other assets to cover the rest of the cost. For an elderly person who needs 24-hour home care, the cost can be exponential.
Many new policies cover only a handful of years.
When you purchase an LTCi policy, you choose from various options that increase or decrease your premium. For example, coverage periods may range from two years to five years to life. You may also select a waiting period before coverage begins after purchase, which could range from 30 days to 365 days. The longer the wait period, the lower the premium. If you have an immediate need for coverage, you might be denied coverage altogether. That is why it’s best to purchase coverage when you are younger (50s) and presumably healthy.
You don’t get to choose when to start benefits.
LTCi coverage doesn’t kick in until you qualify, which generally means you are no longer able to independently conduct some or all of the prescribed daily living activities. The five primary qualifiers are bathing, going to the toilet, dressing yourself, feeding yourself, and the ability to move from bed to chair/wheelchair. Qualification to begin taking LTCi benefits usually requires physician verification.
The downside of a standalone LTCi policy is that it is a “use-it-or-lose-it” type of contract, much like auto or homeowner’s insurance. In other words, you may pay for it for decades but never actually use it, so all the premiums paid are lost.
Hybrid Life/Long Term Care Insurance
On the other hand, a hybrid insurance policy will pay out some portion of unused proceeds to beneficiaries upon the death of the policyowner. A hybrid policy is basically a life insurance policy with an LTCi rider or an accelerated benefit clause, which, either way, means it will cost more.
First and foremost, it works just like life insurance – once the owner passes away, the beneficiary receives a payout. However, if the owner needs money to pay for long-term care while he is still alive, he can tap the rider or life insurance payout to pay for the care. Then, when he passes away, his heirs receive any amount of the unused proceeds. With this type of policy, the owner doesn’t pay for LTCi coverage he does not need, but it’s available if he does need it.
Premiums for a hybrid policy, like any life insurance, depend on the age, gender, health, and amount of insurance proceeds desired, as well as any additional charge for the LTCi rider. Some policies include LTC benefits as a standard feature.
Employer-Sponsored Benefit
If your employer offers long-term care insurance as a voluntary benefit, it’s worth considering because group rates are generally cheaper than on the individual market. However, while employer-sponsored LTCi policies are usually portable – meaning you can keep paying for it after you leave your employer – your premiums may increase when no longer part of the group policy.
As always, reach out to a professional when it comes to planning for you and your family’s future care.