By Chris Gavrel, Licensed Agent 
Long-term care is one of the biggest unknowns in retirement planning. This is a general, educational look at what it is, where it happens, and the ways people plan for it.
What is long-term care?
Long-term care is help with everyday personal needs over an extended period. It’s not medical treatment to cure an illness. It’s support with daily living. People often need it because of aging, a chronic condition, an injury, or memory loss.
The need is often described in terms of activities of daily living:
- Bathing
- Dressing
- Eating
- Using the toilet
- Moving in and out of a bed or chair (transferring)
- Continence
Help with tasks like cooking, cleaning, managing medications, and getting to appointments is also part of the picture.
Where care happens
| Setting | What it generally looks like |
|---|---|
| At home | Family caregivers or paid home care aides; the most common place people receive care |
| Adult day programs | Daytime supervision and activities, while living at home |
| Assisted living | Housing with help for daily activities |
| Memory care | Specialized, secure settings for people with dementia |
| Nursing facility | Around-the-clock care and supervision |
Costs vary widely by setting, the amount of care, and where you live.
Why it’s worth planning for
A lot of people assume their regular insurance will pay for this kind of care, and they’re surprised to find it often doesn’t, especially for ongoing help with daily activities. Without a plan, care is usually paid from personal savings, or handled by family members who may cut back on work to help. The federal government’s long-term care planning site notes that people are often unsure what their insurance covers, so check yours (ACL: Long-Term Care Planning).
Ways people plan
| Approach | How it can help | Things to consider |
|---|---|---|
| Personal savings | Flexible and fully in your control | A long care need can use up savings meant for a spouse |
| Traditional long-term care insurance | Pays benefits for qualifying care, based on policy terms | Premiums may increase over time; if you never need care, there may be no payout |
| Life insurance with a long-term care or chronic illness rider | May let you use part of the death benefit for qualifying care; any remaining benefit goes to beneficiaries | Using the benefit reduces what’s left for your family; rider rules vary |
| Annuities with long-term care features | Some contracts offer increased income or waived surrender charges for qualifying care | Features and qualifications vary by contract |
| Family caregiving | Care from people who love you | Can be physically, emotionally, and financially demanding for caregivers |
Most policies and riders require you to meet certain conditions to get benefits, for example needing help with a certain number of daily activities, or having a cognitive impairment, as certified by a licensed health care practitioner. Waiting periods (often called elimination periods) may apply. Coverage and pricing vary by age, health, state, and carrier, and you generally need to qualify while you’re still healthy.
Questions to talk about as a family
- If I needed help someday, where would I want to receive care?
- Who in the family could help, and is that realistic?
- How would care be paid for without leaving my spouse short?
- Have I named someone to make decisions if I can’t, through proper legal documents?
- Where are my important papers and policies?
When to start thinking about it
Many people start looking at options in their 50s or early 60s, while they’re more likely to qualify for coverage. But it’s never too late to have the family conversation and get your documents in order.
A note on this article
This is general education, not advice about any specific policy or benefit program. Rules for public programs vary by state and change over time; a local Area Agency on Aging or an elder law attorney can help with those questions.
Supporting family caregivers
If you’re caring for a parent or spouse right now, take care of yourself too. Caregiving wears you out. Look into respite care, adult day programs, and support groups in your area, and let your church and community help. Keeping your own papers in order helps as well. Caregivers need a plan too.
Get your documents in order
Whatever you decide about paying for care, make sure the legal side is ready. An attorney can help with documents that name someone to handle your finances and make decisions if you can’t. Keep copies with your other important papers and tell your family where they are. Our free Important Documents Checklist can help.
If you’d like to know how life insurance or annuities with long-term care features work, I’m glad to explain your options plainly.
This article is for general educational purposes only and is not legal, tax, or financial advice. Coverage, pricing, and availability vary by age, health, state, and carrier.
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