Long-Term Care v. Medical Insurance or Both?

Most people buy life insurance and health insurance policies, but one critical insurance coverage that often gets overlooked is long-term care insurance.

An estimated 70% of people will need some form of long-term care in their lifetime – and it’s not exclusive to just the elderly. 40% of those who are currently receiving long-term care are between the ages of 18 and 64.

Even if you think you’re too young to think about long-term care or already have medical insurance, read on to find out why getting long-term care insurance warrants serious considerations in planning for your future.


What Is Long-Term Care Insurance?

Long-term care insurance helps you prepare for financial costs associated with aging, such as nursing home care, assisted living, or in-home care. Yet long-term care insurance policies vary widely in terms of the amount of coverage and how long the protection lasts.


  1. Long-Term Care Can Be Expensive

Most people don’t realize how expensive long-term care can be. According to the 2021 Genworth cost of long-term care survey, the national median for the monthly costs of long-term care services are as follows:

  • Nursing home care = $9,034 (private room); $7,908 (semi-private room)
  • Adult day health care = $1,690
  • Assisted living = $4,500
  • Homemaker services = $4,957
  • Home health assistance = $5,148

In the DFW area, assisted living facilities can cost between $4,700 and $6,700 per month on average. For most Americans, this kind of expense is not sustainable for an extended period of time, which is why planning for long-term care is critical.


  1. Many Long-Term Care Services Are Not Covered By Medicare And Most Medical Insurance

Most private insurance, as well as Medicare, do not cover the costs of long-term care services. It’s a good idea to double check your benefits with your provider.


  • A Majority Of The Elderly Will Need Long-Term Care

The Department of Health and Human Services states that most people need long-term care by age 65. The majority of people need care for two years, but 20 percent require care for longer than five years. Most people should obtain at least two years of coverage and contemplate purchasing additional coverage.


  1. Long-Term Care Insurance Can Be A Prelude To Medicaid

As you plan for your future, consider purchasing long-term care insurance that protects you for five years if you intend to apply for Medicaid. Since the Medicaid lookback period is five years, you may transfer your assets to your family using an irrevocable trust and begin to spend down your assets left out of the trust so that you can qualify for Medicaid after your five-year coverage ends. After five years on private insurance, you may be able to transition to Medicaid.


Important Questions To Ask About Long-Term Care Insurance

Evaluating which services you expect to need will play a crucial role in assessing the pros and cons of getting long-term care insurance. Although many individuals need nursing home care, others can avoid nursing home costs by combining assisted living services with in-home care or day health services. Some important questions to ask are:


  1. Do you have a health condition that you know will require care in a skilled nursing facility?

Determining the type/s of care you could require can help you estimate the costs for the long-term care coverage you need.


  1. How prepared are you to handle unexpected medical events?  

It’s important to consider the possibility of accidents and illnesses, which can happen to anyone at anytime – and often without warning.


How Much Long-Term Care Insurance Do You Need?

Most policies provide between $2,000 and $10,000 of funds per month. To estimate how much long-term care insurance you will need:

  1. Review how much you can expect to spend on long-term care.
  2. Subtract the cost of services from the amount of money you can budget toward your long-term care expenses; the remainder is the amount you need long-term care insurance to cover.



Suppose you have a monthly income of $2,500 and plan to move into an assisted living facility that costs $4,500 per month. In that case, you will need a minimum of $2,000 per month in long-term care insurance to cover the cost of assisted living.

In addition to determining how much coverage you need each month, think about how long you want your plan to last. Long-term care insurance that lasts longer can be relatively more expensive, yet it provides increased protection.

The amount of long-term care insurance you buy should fit your unique circumstances. 


Learn more about planning for your long-term care. Consult a trusted Elder Law and Estate Planning attorney in the DFW Metroplex today.

Call The Law Office of Antoinette Bone now to schedule your appointment.  

To comply with the U.S. Treasury regulations, we must inform you that (i) any U.S. federal tax advice contained in this newsletter was not intended or written to be used, and cannot be used, by any person for the purpose of avoiding U.S. federal tax penalties that may be imposed on such person and (ii) each taxpayer should seek advice from their tax advisor based on the taxpayer’s particular circumstances.

Nothing in this message is intended to provide legal advice.  This message is for educational purposes only.

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