It’s important to begin the process and make some crucial decisions now — before an unexpected health change could suddenly change your needs.2 And the chances of needing health care down the road are likely.
Americans turning 65 have almost a 70 percent chance of needing some form of long-term care in their lives. And about 8 percent of those between ages 40 and 50 have a disability that could require long-term care services.
Plus long-term health care can be expensive. The annual cost for a private, one-bedroom in an assisted-living facility is $43,536. The hourly rate for a home health aide is $20.50.
Questions to ask your financial professional
It’s always a good idea to consult a financial professional as you plan for the future. But whether or not you speak to a financial professional, here are five questions to consider as you think about your long-term care insurance options:
1. What are my insurance options for covering long-term care?
There are several kinds of long-term care (LTC) insurance policies, including traditional and hybrid options. And because Medicare doesn’t pay for LTC, it’s important to understand the pros and cons of each type so you can choose the policy that’s best for you.
Traditional LTC
This insurance can help pay for your future care — and in the event you go on claim, depending on the policy structure and benefits, may provide some of the most robust benefits to cover the costs for LTC. These policies stay in force as long as you keep paying the premiums, and although they may be affordable and less expensive than a hybrid policy initially, over time, the cumulative out-of-pocket costs can add up. Also, if you don’t need LTC, you generally won’t receive any benefits from your policy. Traditional LTC policies sold today do not offer guaranteed premiums or benefits so premiums may increase over time.
Hybrid LTC
Hybrid policies (typically a combination of life insurance or an annuity with long-term care insurance) guarantee premiums will never increase and benefits will never decrease. They also may offer a return of premium option so you can get your money back if you decide to give up your policy. They offer an income tax free death benefit and inflation protection options to help your LTC benefit keep up with rising health care costs.
Some hybrid policies are available with a single-pay (up front) or multi-pay (various payment periods may be available). Due to the shorter premium durations, Hybrids may be more expensive in the short-term compared to traditional policies.
Hybrid LTC policies are becoming increasingly popular — some 404,000 policies were sold in the United States in 2018.
2. What does LTC insurance generally cover?
Long-term care insurance may cover expenses related to assisting chronically ill people with their personal care needs, such as bathing, dressing, and moving between a bed or chair. It can also involve helping them accomplish everyday tasks, such as housework, managing money, preparing meals, shopping, and caring for pets.
Policies may also help pay for home- and community-based services, such as adult day care, caregiver training, home health care options, and respite care. They generally cover facility-based services, like assisted living, hospice, and nursing home care.
3. How will I receive benefits?
Your benefits will typically begin when you8 are certified as being chronically ill by a licensed health care practitioner and have satisfied your elimination period. This means you can’t perform at least two daily living activities due to a loss of function, or you need supervised protection due to severe cognitive impairment.
You can receive your benefits in one of two ways, either as a reimbursement for expenses incurred, or through a set monthly benefit amount often referred to as cash indemnity. With a reimbursement policy, you must first pay for qualifying medical expenses out-of-pocket, and then submit a receipt to the carrier to be reimbursed. On the other hand, a cash indemnity policy automatically sends you a monthly cash benefit that you can use to cover any of your care expenses, such as informal care, medical equipment, prescriptions, and even housekeeping and home maintenance needs.
4. What happens if I buy a policy but don’t need long-term care?
Traditional LTC insurance is generally “use it or lose it”, which means you typically won’t get any benefits from your policy if you don’t need LTC. Some traditional LTC insurance may allow you to get your money back if you decide you no longer want the policy, but this feature tends to be very expensive.
Hybrid LTC insurance will typically pay a death benefit if the policy is not used for long-term care costs. Also, many hybrid LTC policies offer a “return of premium” feature, which means if you give up your policy you can get back some or all of the money you have paid in.
5. Are there tax benefits to long-term care insurance?
For traditional LTC insurance, all or a portion of the premium may be tax-deductible based on some IRS limitations and qualifications. However, other than a handful of hybrid policies, the premiums associated with these plans are generally not tax deductible.
When it comes to how your LTC benefit may be taxed, LTC benefit payments are not taxable so long as:
- Your benefit is equal to the actual expenses incurred, or
- Your benefit is less than the IRS per diem ($370 in 2019)9
A rewarding life is really about being present in the here and now. Planning for your future health care can help you and your family do that. So you can enjoy the everyday moments — and confidently look forward to the major milestones, like retirement.