As you prepare for a long and full life, planning for a time when you may not be able to fully care for yourself should be part of that big picture.
Long-term care insurance can help ensure your loved ones have choices about how and where you receive care, should the need arise. How does long-term care insurance work? Here's a look at this important planning tool for you and your family.
What is long-term care insurance?
Long-term care insurance can help cover your needs if you become disabled or severely ill. This might happen through the natural aging process or due to a medical condition or unexpected event that leaves you needing dedicated daily support.
When you're dealing with these changes, choice can feel like the greatest gift. Long-term care insurance can allow you to stay in charge of when and how you'd like to receive care, the level of independence you'd like to maintain and what role your family will play in your care—as long as they are prepared and willing to do so.
Depending on your preferences and needs, long-term care insurance can provide coverage in these settings:
- Home care
- Assisted living facilities
- Nursing homes
- Adult day care
- Hospice care
Offsetting long-term care expenses with insurance can serve as a critical financial safety net, considering that many government programs have
Even with long-term care insurance, you'll still need to rely on health insurance to cover your medical costs, such as doctor visits and prescription medications. Long-term care insurance also won't pay for charges that are eligible through Medicare or would be if you paid the deductible or co-pay.
How does long-term care insurance work?
As with other insurance products, you keep your coverage in force by paying the premiums. Depending on your contract, you may have the option to spread them throughout the rest of your lifetime—resulting in lower monthly payments—or pay a set amount for a specific number of years.
If you receive qualifying care in your home or at a facility, you'll pay costs out of pocket until you reach the elimination period, typically 30-90 days. After that, your long-term care plan will pay the remaining covered costs. Most policies only require you to reach the elimination period once during your lifetime.
Long-term care policies may have a daily or monthly cap on how much they'll cover and a lifetime limit on total payouts. Insurers often have separate limits based on whether you receive care in your home or in a facility.
Applying for long-term care coverage
Long-term care policies are sold privately through insurance companies. To
- Your age
- Your health history
- The amount of coverage limits, if applicable
- The length of the elimination period
- Whether the contract has benefits that increase with inflation
Age is one of the most important factors in creating a quote. Some policies are available to adults as young as 18 while some have older age limits. You'll typically get a lower premium the earlier you apply for coverage. You'll also get a better rate if you're in good health because there's a lower probability that you'll need significant levels of care in the first few years of owning the contract.
Besides personal factors, the level of coverage is another key determinant of your premium amount. The longer your elimination period and the lower your daily or monthly coverage caps, the lower your premium is likely to be—and vice versa.
Customizing your long-term care contract
Many long-term care policies can be tailored to fit your expected needs. Some may provide supplemental benefits, including equipment and home modifications that allow you to remain comfortably in your home. Your insurance also may offer coordination of care services, where a licensed professional develops a formal plan of care and regularly reviews your needs.
You often can pay to add additional benefits to further customize your long-term care plan. These optional contract features, known as riders, can help to further minimize your financial risk. The menu of available riders can vary from one carrier to another. Some of the more common add-ons include:
Cash benefit rider
This rider provides you with a separate cash benefit when you receive eligible care in your home or in a facility. You can use those proceeds to pay informal caregivers or for any other financial needs you may have.
Survivorship benefit rider
If you or your spouse die after your contract has been active for a certain length of time—typically 10 years— the surviving spouse no longer has to pay premiums to continue coverage. This feature is more common among younger applicants, who have a greater chance of going a decade or more before filing a claim.
Return of premium upon death rider
Should you pass away after a certain number of years after purchasing your contract, the insurer may pay a lump sum to your estate.
Shared care benefit rider
The shared care benefit rider enables couples with identical long-term care insurance policies to share their benefits. Should one insured individual reach their reimbursement limit, for example, they can access their spouse's remaining benefits.
When to buy long-term care insurance
Adults in their 30s or 40s may not be focused on buying long-term care insurance. Understandably, this age group may be prioritizing their financial strategy around caring for children or investing heavily in their retirement. But it's worth noting that you often receive the lowest premiums when you buy insurance earlier, in part because you'll potentially be paying premiums for a longer period of time than older applicants. The younger and healthier you are, the easier it usually is to qualify for insurance.
You may find that your early 50s to early 60s is the sweet spot for applying for long-term care insurance, when you're young enough to receive an affordable rate but may have room in your budget to make payments. That way, you're still putting coverage in place well before you're likely to need care.
If a full long-term care contract doesn't feel like the right fit yet, you can explore
Is long-term care insurance the right choice for you?
If extended care is needed, you'll want to have the important conversations squared away ahead of time. Considering the scope of a caregiver role, it's worth a discussion with your loved ones to determine if they'd be up for it. It's also wise to examine