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what options are there when choosing long term care insurance

As we age, the possibility of needing long-term care (LTC) services becomes a growing concern. These services can include assistance with daily living activities like bathing, dressing, and medication management, either at home or in a facility. 

The cost of LTC can be significant, easily draining savings and impacting your family’s finances. Long-term care insurance can help alleviate this burden by providing financial protection for these future expenses.

Types of Long-Term Care Insurance

There are three main categories of LTC insurance, each with distinct features and benefits:

Traditional Long-Term Care Insurance: 

This is the most common type of LTC insurance. It functions as a standalone policy, solely dedicated to covering LTC expenses. Benefits typically kick in after you meet a specific eligibility criteria, such as needing assistance with a certain number of daily living activities. 

Traditional policies offer flexibility in the daily benefit amount, coverage duration, and choice of care setting (home care, assisted living, nursing home).

Hybrid Long-Term Care Insurance: 

Hybrid policies combine LTC coverage with another insurance product, most commonly life insurance or an annuity. This offers a death benefit for your loved ones if you don’t utilize the LTC benefits. There are two main types of hybrid policies:

Linked-Benefit Policies: 

These policies typically combine LTC coverage with a universal life insurance policy. You pay a single premium, and a portion is allocated towards LTC benefits. If you don’t use the LTC benefits, the remaining amount accumulates and pays out as a death benefit.

Life Insurance with a Long-Term Care Rider: 

This allows you to add LTC coverage as an optional rider to an existing or new life insurance policy. The rider typically lets you access a portion of your death benefit to pay for LTC costs. This is a flexible option, but the LTC benefits might be limited compared to traditional or hybrid policies.

Factors to Consider When Choosing Long-Term Care Insurance

Choosing the right LTC insurance involves careful consideration of your individual needs and circumstances. Here are some key factors to weigh:

Age and Health: 

As we age, our bodies naturally experience changes that can impact our overall health. These changes can sometimes lead to the development of chronic health conditions. This is why age is often a factor considered by insurance companies when determining premiums. 

Typically, younger individuals are considered to be a lower health risk, and therefore qualify for lower insurance premiums. On the other hand, pre-existing health conditions can significantly impact your eligibility for certain insurance plans or even increase the overall cost of your coverage. 

This is because pre-existing conditions suggest a higher likelihood of needing medical care in the future, which translates to a greater financial burden for the insurance company.

Desired Coverage Level:

When choosing long-term care insurance, it’s crucial to consider both the daily financial burden you anticipate facing and the total length of time you might require assistance. This desired coverage level can be broken down into two key factors: daily benefit amount and coverage duration. 

The daily benefit amount refers to the amount of money the insurance policy would pay towards your daily expenses if you needed long-term care services. 

This should be enough to cover the cost of care in your preferred setting, such as a nursing home, assisted living facility, or even in-home care. To determine this amount, research average costs in your area for the type of care you envision needing. The coverage duration, on the other hand, specifies the total period for which the policy would provide benefits. 

Common options include coverage for a set number of years (2, 5, etc.) or lifetime coverage, which would continue to pay out for as long as you require care. Ultimately, the ideal coverage level depends on your personal circumstances, health status, and risk tolerance. 

By carefully considering both the daily benefit amount and coverage duration, you can ensure your long-term care insurance policy offers the financial protection you’ll need when you need it most.

Care Setting Preferences: 

Choosing the right care setting is an important decision that can significantly impact your comfort and well-being. While there are various options available, each with its own advantages and limitations, considering your personal preferences and healthcare needs is key. In-home care allows you to remain independent in your familiar surroundings, with caregivers providing assistance with daily activities as needed. 

Assisted living facilities offer a more structured environment with social interaction opportunities and help with daily living tasks, but may have some restrictions on independence. Nursing homes provide the most comprehensive level of care, with medical professionals readily available 24/7 to address complex medical needs, but often involve a significant transition away from a familiar living space.

Understanding your priorities, whether it’s maximizing independence at home, enjoying social interaction in a supportive environment, or receiving around-the-clock medical care, will guide you towards the setting that best aligns with your wishes. It’s also important to consider that insurance policies may have different coverage levels for each care setting, so researching your plan’s specifics can be a helpful step in the decision-making process.


Consider how long-term care insurance fits into your overall financial picture. Look at your current budget and determine how much you can comfortably afford to spend on premiums each month. Remember, long-term care insurance is a long-term commitment, so factor in potential future cost increases. This way, you can ensure the premiums won’t become a financial burden down the road.

Inflation Protection: 

When shopping for long-term care insurance (LTC), a crucial feature to consider is inflation protection. This safeguard automatically increases your policy’s benefit amount over time to account for the rising cost of care. LTC services are a significant financial burden, and inflation can erode the purchasing power of a fixed benefit amount decades down the road.

With inflation protection, your LTC benefits adjust to match the increasing costs, ensuring you receive adequate coverage when you need it most. This feature is particularly important for those planning to use LTC services in the distant future, as it helps guarantee their benefits retain their value and won’t be significantly outpaced by inflation.

Financial Strength of the Insurance Company: 

When selecting an insurance company, prioritizing a financially strong provider is crucial. This ensures the company’s stability and ability to fulfill its commitments to you down the road.

Reputable insurance companies will have a well-established history of financial responsibility, demonstrated by their ability to consistently meet policyholder obligations and manage risk effectively. By choosing a financially secure insurer, you gain peace of mind knowing you’re protected by a company with the resources to handle potential claims, even in the face of unforeseen circumstances.

Additional Considerations

Beyond the core factors mentioned above, here are some additional considerations to keep in mind:

Tax Advantages: 

Premiums paid for LTC insurance may be partially tax-deductible depending on your income and tax bracket. It’s wise to consult with a tax advisor to understand the specific tax implications for your situation.

Partnership Programs: 

Some states offer Medicaid partnership programs that protect assets for individuals who exhaust their LTC insurance benefits. These programs can be a valuable safety net, but eligibility requirements and benefits can vary by state. Researching your state’s specific program can help you determine if it aligns with your needs.

Alternatives to LTC Insurance: 

While LTC insurance is a valuable tool, it’s not the only option for LTC planning. Consider self-insuring (saving aggressively), relying on family support, or exploring government assistance programs like Medicaid (needs-based). However, self-insuring requires significant discipline and financial resources, and relying solely on family support may not be a viable option for everyone. Medicaid eligibility has strict requirements, and qualifying often involves spending down assets.

Getting Help with Long-Term Care Insurance

Choosing LTC insurance can be a complex process. Consider consulting with a qualified insurance professional who can assess your needs, explain different policy options, and help you find a plan that fits your budget and goals. A good insurance professional will take the time to understand your personal situation, risk tolerance, and long-term care preferences. They can also help you navigate the often-complicated world of LTC insurance policies and answer any questions you may have.

Getting Help with Long-Term Care Insurance

By carefully evaluating your options and seeking professional guidance, you can make an informed decision about long-term care insurance and ensure you have a plan in place to address your future LTC needs. Here are some additional resources that can be helpful in your research:

National Association of Insurance Commissioners (NAIC): 

The National Association of Insurance Commissioners (NAIC) acts as a central hub for insurance regulation in the United States. Established and governed by chief insurance regulators from each state, the District of Columbia, and five U.S. territories, the NAIC works to create uniformity and best practices across the insurance industry.

This includes providing consumers with valuable resources and information on various insurance products, such as long-term care (LTC) insurance. One such resource is a shopper’s guide specifically designed to help consumers navigate the process of choosing an LTC insurance plan that meets their individual needs and financial situation. By offering these resources, the NAIC empowers consumers to make informed decisions when it comes to their insurance coverage.

State Health Insurance Assistance Programs (SHIPs): 

If you’re approaching eligibility for Medicare or are already a beneficiary, navigating the complexities of health insurance options and long-term care (LTC) planning can feel overwhelming. Thankfully, there’s a nationwide network of State Health Insurance Assistance Programs (SHIPs) designed to empower you with objective guidance and support. Each state administers its own SHIP program, staffed by trained counselors who provide free, one-on-one assistance.

Whether you have questions about enrolling in Medicare for the first time, understanding the different parts of Medicare (Parts A, B, D, and Advantage plans), or exploring LTC insurance options to safeguard your future care needs, SHIP counselors can be a valuable resource. They can explain the benefits and drawbacks of various plans, help you compare costs and coverage options, and ensure you make informed decisions about your healthcare.

AARP Long-Term Care Resource Center: 

AARP serves as a valuable resource for individuals and families seeking guidance on Long-Term Care (LTC) planning. Their website offers a comprehensive collection of informative materials that address various LTC considerations. This includes in-depth exploration of LTC insurance options, empowering users to make informed decisions about securing their future healthcare needs.

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Proactive planning for long-term care is essential, as unforeseen circumstances like aging or chronic illness can necessitate assistance with daily activities. Long-term care insurance offers a safety net, protecting your assets from potential depletion due to custodial care costs and ensuring you receive the high-quality care you deserve. 

By familiarizing yourself with the various LTC options available, thoughtfully evaluating your individual needs and preferences, and seeking guidance from a qualified professional, you’ll be well-equipped to make an informed decision about LTC insurance. This empowers you to craft a long-term care plan that brings peace of mind, knowing you’ve prepared for the future. Remember, LTC planning is a continuous journey. 

As your life unfolds and your circumstances change, it’s crucial to regularly assess your LTC needs and revisit your insurance coverage. By ensuring your plan adapts to your evolving requirements, you can guarantee it remains an effective safeguard for your well-being throughout your life.

Frequently asked Question

Do I need long-term care insurance?

This depends on your age, health, assets, and family situation. Long-term care can be expensive, and insurance can help protect your savings. Consider your risk tolerance and ability to self-insure for potential future costs.

What types of long-term care are covered?

Policies typically cover nursing home stays, assisted living facilities, and home care services. Some may also cover adult daycare or respite care.

How much coverage do I need?

Consider the average daily cost of care in your area and the desired length of coverage. Look for a plan that fits your budget and potential needs.

Should I choose a traditional or fixed-benefit policy?

Traditional policies offer daily benefit amounts that increase over time to keep pace with inflation. Fixed-benefit policies offer a set payout regardless of inflation, but the benefit may lose value over time.

What are the different riders (optional add-ons) available?

Riders can enhance your policy with features like waiver of premium if you become disabled, or a spousal benefit if your spouse also needs care.

Should I choose a level-premium or graded-premium policy?

Level premiums stay the same throughout the policy, while graded premiums may increase over time. Level premiums offer predictability, while graded premiums might be lower initially.

What is the elimination period?

This is the waiting time after qualifying for benefits before your policy starts paying. Choose an elimination period that balances affordability with your risk tolerance.

What are the financial strength ratings of the insurance companies I’m considering?

Look for companies with strong financial ratings to ensure they can meet future claims obligations.

Can I cancel my long-term care insurance policy?

Most policies allow cancellation, but you may receive a partial refund or no refund at all. Review the cancellation terms carefully.

How can I compare different long-term care insurance options?

Work with a qualified insurance agent or broker who can explain different plans and help you find one that meets your needs.

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