Long-Term Care Insurance

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As the number of Americans entering retirement increases sharply over the next 20 years, many are buying long-term care insurance. Long-term care insurance provides financial support if you become unable to perform basic activities of daily living (ADLs).

Features to look for in a long-term care policy include:

  • Maximum periodic benefits. Maximum periodic benefits are the total amount of benefits the insurer pays during a prescribed period.
  • Maximum lifetime benefits. Maximum lifetime benefits are the total amount of benefits the insurer pays over the lifetime of the policyholder.
  • Applicable services. Check what level of care is provided in the policy. Some policies will pay for skilled care, while other policies may also pay benefits for personal care.
  • Applicable points of service. Some policies will pay for care provided only in a licensed facility, while others may also pay for home-based care.
  • Inflation protection. A long-term care policy with inflation-protected features may help to shield you from health care costs that tend to rise at a faster rate than the general rate of inflation.
  • Cost of premiums. A long-term care insurance policy may cost thousands of dollars per year in premiums. You may only want to buy a minimum amount of coverage to prevent your premiums from spiraling out of control. According to the National Association of Insurance Commissioners (NAIC), long-term care insurance premiums cost about two times at age 65 as they do at 50. At 75, premiums cost about seven times as much as for a 50-year-old person.

    If you are living entirely off Social Security, you may be able to qualify for the Medicaid program for long-term care, provided you pass a means test.

Life insurance companies also sell individual long-term care policies. Some employers may offer a group policy for long-term care insurance. With a group policy, you're less likely to face as rigorous a health condition questionnaire as you will for an individual policy.

You may want to keep in mind the following additional pointers on long-term care:

  • Tax deductibility. The portion of your premiums that may be deductible is based on your age. You can add a portion of your premiums to your medical expenses and deduct that amount that exceeds 7.5% of your adjusted gross income (AGI) for 2018. In 2019, the threshold reverts to 10% for all taxpayers.
  • Medicare and health insurers don't pay. In general, Medicare, Medigap insurance, and private health-insurance plans don't pay for long-term care, the NAIC says.
  • Pre-existing conditions and exemptions. Some insurers will not issue you a policy if you have a pre-existing medical condition. You may also want to see whether coverage for Alzheimer's disease is covered in the policy. Some insurers exclude Alzheimer's disease.
  • Health questionnaires. Be honest when answering health condition questionnaires. If you misrepresent the facts about a pre-existing condition, an insurer generally has the right to cancel the policy within a period of time.
  • Insurer's credit ratings. Since long-term care policies are issued by life insurance companies, it pays to check the insurer's credit rating. You should aim to buy a policy from an insurer with a credit rating of single-A or higher.

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