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What to Know About Long-Term Care Insurance

Why you may want to consider a hybrid version in case you never need long-term care benefits

By Richard Eisenberg

Two things can be very expensive when it comes to long-term care: the cost of the care and the cost of a long-term care insurance policy.

A woman researching long-term care insurance. Next Avenue
Long-term care insurance may not be for everybody, but long-term care planning is  |  Credit: Getty

There's not much you can do about the cost of long-term care itself — from about $5,100 a month for a home health aide to roughly $8,000 a month, on average, for a semiprivate room in a nursing home, according to the Genworth Cost of Care Survey. That can mean an annual cost of up to almost $100,000.

But there are ways to save on buying a long-term care insurance policy or reducing the annual premiums for a policy you already own.

What Long-Term Care Insurance Pays For

A long-term-care insurance policy can come in handy in the future should you wind up needing assistance with daily living activities like bathing, feeding, dressing or toileting. It won't pay for things like trips to the doctor or grocery store, though.

A person turning 65 has nearly a 70% chance of needing long-term care one day, based on a U.S. Department of Health and Human Services estimate. One in five people requiring long-term care will have that assistance for more than five years, the government says.

"Long-term care insurance is not for everybody, but long-term care planning is for everybody."

Medicare generally doesn't cover long-term care. Medicaid does, but only for the poorest Americans. So, unless you'll qualify for Medicaid or have enough in savings to self-insure, a long-term care policy could be worth considering.

"Long-term care insurance is not for everybody, but long-term care planning is for everybody," Brian Gordon, president of Gordon Associates Long Term Care Planning in Bannockburn, Illinois, said on the new Friends Talk Money podcast episode about long-term care policies.

(Full disclosure: I co-host that podcast with personal finance writer Terry Savage and Pam Krueger, CEO of the financial advisor vetting firm Wealthramp.com.)

What Long-Term Care Insurance Costs

A standard long-term care policy with inflation protection often runs between $2,000 and $3,600 a year for $165,000 in benefits if you purchase one in your mid-50s (the typical age of a buyer). Premiums for women can be substantially more than for men since women live longer, in general.

The price of a long-term care insurance policy can be considerably higher if you buy it in your 60s or 70s than in your 50s.

"Not everybody is going to be a candidate to buy long-term care."

"I usually tell people a policy will cost anywhere from about 4% to 6% a year more if you wait to buy it," said Gordon.

But your application may get rejected due to your health if you try to buy a long-term care insurance policy in your 60s or 70s. "Not everybody is going to be a candidate to buy long-term care," Gordon noted.

Potential reasons for declined applications: obesity, hypertension, cancer, dementia and joint problems.

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How to Cut Long-Term Care Policy Cost

One way to reduce the cost of a long-term care insurance policy is buying one that will only pay benefits for two to five years or so, rather than lifetime benefits.

You might also avoid owing long-term care insurance premiums year after year by purchasing what's called a "10-pay" policy.

This means you'll pay the premiums over 10 years but then never again. But annual premiums for 10-pay policies can run 2½ times the initial premium for similar traditional policies.

A 10-pay policy may also help avoid the substantial premium increases policyholders often face, though. Some 10-pay policies lock in the cost of your premiums, so they won't rise during the 10-year period.

Policy-Shopping Advice

When shopping for a long-term care policy, be sure to find an insurer with strong financial health, since its benefits likely won't be paid out for years. You or your agent can review insurers' financial strength by looking at their ratings from companies like A.M. Best, Moody's and Standard & Poor's.

Married couples who can't afford the cost of buying a long-term care insurance policy for each of them should look at each partner's financial assets, Gordon advised. They might then choose to buy a policy just for the person with fewer financial assets.

If you're peeved at the possibility of paying for a long-term-care policy and not getting many, or any, benefits paid out, a hybrid version could be an option.

Pros and Cons of Hybrid Policies

This type of policy combines long-term care insurance with universal life or whole life insurance, so your loved one will be guaranteed a death benefit in exchange for the premiums you pay.

It costs two to four times more than a standard long-term care policy, however, according to the American Association for Long-Term Care Insurance.

A hybrid policy also requires a substantial upfront lump sum, which might be $125,000.

"We always design them [for customers] where we have a very minimal death benefit, because usually people in their mid-50s or 60s really don't need life insurance anymore," said Gordon. "I have one that I'm doing right now for a woman in her 50s where it ends up being about a $145,000 death benefit."

Get the Most Bang for Your Buck

If that woman used $100,000 of long-term care benefits and then died, $45,000 would get passed down to her heirs.

Gordon often recommends hybrid policies with roughly six years of long-term care benefits. "Usually, when we get clients a six-year benefit period, they get the most bang for their buck," he said.

Photograph of Richard Eisenberg
Richard Eisenberg is the former Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and former Managing Editor for the site. He is the author of "How to Avoid a Mid-Life Financial Crisis" and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch. Read More
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