We’ve previously discussed what long term care insurance is – it generally covers the cost of home health aides, skilled nursing, assisted living, and nursing homes. These are expenses not covered by medical insurance policies and Medicare, so you basically have four choices if you need long term care: 1) buy a long term care insurance policy; 2) save for long term care; 3) rely on family and/or friends; or 4) rely on government assistance.
The first question, of course, is whether you will actually need long term care – though common sense would seem to say that yes, unless you die a tragic and untimely death, you will at some point require assistance. As I get older, I see my grandparents’ generation requiring more and more assistance. In fact, my husband and I have four living grandparents between us, and all but one receive some form of long term care assistance. The one who doesn’t lives with an aunt, so there’s some assistance there, though not intensive when it comes to day to day life activities. There are all kinds of studies out there, and the lawyer in me tends to be skeptical of studies sponsored by insurance companies, but it’s not hard to believe statistics like at least 70 percent of people over age 65 will require some long-term care services at some point. It seems safe to assume that if we are able to grow old, we will eventually need assistance.
So assuming we’ll need long term care, let’s also assume that we don’t want to rely on government assistance or impose on family and friends. That leaves us with an insurance policy or personal savings.
The consensus seems to be that you’ll need to have at least one million dollars in assets (per person) to be able to afford retirement and long term care. If you think you’ll get there in retirement savings before you retire, then you may not need long term care insurance (but keep in mind that the younger you are now, the more you’ll need for retirement – more than one million if you’re quite young now).
For those of us who are not (yet) that wealthy, long term care insurance may make the most sense. Unfortunately, long term care insurance is like life insurance, in that the cost of the policy goes up as you get older. But unlike life insurance, which you are more likely to need when you are younger because of dependents, you are more likely to need long term care insurance when you’re older. Also, you’ll need to buy the policy while you’re still healthy – so someone who tends to be ill more might want to buy a policy at a younger age than someone who rarely gets sick.
The worst news is that long term care insurance costs are going up – a lot. Most states regulate the increase in insurance premiums so they likely won’t be allowed to skyrocket, but they can go up 15% per year or more. That means even if you can afford a policy right now, you’ll have to decide whether you can afford increased premiums in the years ahead.
Thus, whether and when you should buy long term care insurance seems like a really tricky, really personal question. But based on the way premiums increase as you get older, it makes sense to evaluate your health and financial situation and whether to buy a policy in your late 40’s.
If you are currently in the market for a policy, here are some tips for selecting a long term care insurance policy, as well as some strategies to consider if you can’t afford a full policy, such as choosing a catastrophic policy.
I’m grateful that I’m too young to worry too much about long term care right now, but I think I might have a chat with my parents about what’s going on with them.