Long Term Care Insurance

Long-term care insurance can help pay for extended care without exhausting personal finances. As the general population gets older, long-term care (including nursing home and in-home care) has become a costly necessity for many families.

Without long-term care insurance, families can find their homes, savings, and other assets in jeopardy as they struggle to pay the costs. By planning and considering options to help pay for care, these situations can be avoided.

For any number of reasons – physical illness, an injury, or aging – some people find themselves needing help with eating, bathing, dressing, toileting or continence, and/or transferring out of a chair or bed. These six acts are called Activities of Daily Living also known as ADLs. In general, if you can't do two or more of these activities, or if you have a severe cognitive impairment, you'll need assistance - the cost of which could be covered by long-term care insurance.

Many people think that long-term care is provided exclusively in a nursing home. While it can be, it can also be provided in an adult day care environment, an assisted living facility, or at home.

Assistance with ADLs, called custodial care, may be provided in the same place as skilled care, which leads to the confusion regarding coverage. Skilled care means medical, nursing or rehabilitative services, including help taking medicine, undergoing testing (e.g. blood pressure), or other similar services. This distinction is important because Medicare and most private health insurance policies pay only for skilled care, not custodial care.

Do I need long-term care insurance?

If you need long-term care services, what financial resources could you call on? Do you have the necessary savings to pay for home health care for six months, a year or longer? What if you needed full-time care provided by an assisted living facility or a nursing home? Do you have resources to pay for that coverage?

If you're 65 or over, don't count on Medicare or private health insurance. Medicare doesn't pay for custodial care, and private health insurance rarely pays for long-term care. For those with very limited financial resources, you might qualify for Medicaid, a government program that pays the medical and long-term care expenses of people with limited income. If you expect to be in that situation, you probably shouldn't buy long-term care insurance, because your state's Medicaid program will pay your long-term care expenses.

If you are one of the lucky few with unlimited resources, than you don’t need to worry about how you will pay for your long-term care services.

However, if you fall between these two categories, owning long-term care insurance, like all other insurance coverage offers financial benefits.

It’s never too early to consider long-term care insurance because

  • The younger you are when you buy it, the less it costs, and
  • It’s available only when you’re healthy

So, unless you have so little money that you will qualify for Medicaid, or so much money that you can pay the bills out of your own pocket, long-term care insurance is worth considering.


Shane Quintana, LUTCF
Business and Estate Planning Specialist

Donna Quintana, RHU
Employee Benefits and Health Insurance Specialist



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