As retirement grows closer the decision on how you will cover potential long term care expenses becomes a serious concern. Unfortunately, with the high cost of long term care (LTC) and the high cost of long term care insurance there is no easy solution. LTC refers to services or support to help you with medical or non-medical personal care needs. LTC can provide assistance with cognitive impairment and activities of daily living such as eating, bathing, dressing, using the toilet and assistance with incontinence. About 80% of all LTC is provided in the home.
LTC expenses can be paid with a combination of personal or family savings, LTC Insurance and government assistance. Generally Medicare does not cover long term care. Medicare will provide 100 days of skilled nursing care following a 3 day stay in the hospital. Medicaid will pay for LTC after most of your assets have been depleted but Medicaid is usually limited to skilled nursing home care.
The decision to purchase LTC insurance is straight forward for the affluent who can self-insure and for those with little or no assets who must rely on Medicaid for their LTC expenses. The decision is more complicated for those who can’t afford to self-insure but want to protect their assets to provide a livelihood to a surviving spouse, an inheritance to children or want to avoid being a burden to family.
Individuals who are at the greatest risk for needing LTC are those with a history of a chronic condition such as high blood pressure or diabetes, or have family members with a history of a chronic condition. You may also have a higher risk if you are in poor health or have poor diet and exercise habits. Women are at greater risk than men because on average, they live 5 years longer.
According to a study using a microsimulation model performed by Kemper, Komisar and Alecxih, on average people currently turning 65 will need LTC for three years. They found that 3 out of 10 people will rely on family for their care for more than 2 of these years. They also found that 2 out of 10 people will need care for over 5 years. Overall, their analysis indicated that 50% will have no out of pocket expenditures for LTC, 25% will spend less than $10,000 and 6% will spend over $100,000.
Additionally, based on information from leading insurance actuaries, the Association for Long Term Care Insurance reported that someone who buys a LTC insurance policy, with a 90 day elimination period, at age 60 has a 35% chance of using it before they die. They also reported that the average stay in a nursing home is 2.3 years for men and 2.6 years for women. Most care is provided at home but statistics on this are limited.
My next column will address the cost of LTC and LTC insurance and the pros and cons of purchasing LTC insurance.