Episode #1005
Planning Ahead for Long-Term Care with Nathan Sanow
Long-term care isn’t just a health issue. It can become a major financial and family decision. Most of us hope we’ll never need extended care, but wise stewardship means preparing for possibilities before they become a crisis. And while long-term care insurance may be part of that preparation, the first step isn’t necessarily buying a policy. It’s having a plan. Nathan Sanow, President of LTC Consumer and MasterCare LLC , has spent more than two decades helping individuals and families navigate long-term care planning. He says the most important place to begin is understanding what would happen if you or someone you love needed care for an extended period. Start With a Long-Term Care Plan People often hear “long-term care” and immediately think about insurance premiums. But insurance is simply one potential way to fund a larger plan. A good long-term care plan begins by asking several practical questions: Who would provide your care if you needed help? Would that person be physically and emotionally able to do it? Where would you prefer to receive care? How would your care affect your family? Most importantly, how would you pay for it? These conversations can be difficult, but they are much easier to have before a crisis occurs. Planning ahead also gives family members an opportunity to understand your wishes rather than making major decisions under pressure. What Medicare, Medicaid, and Health Insurance Actually Cover One of the most common misconceptions about long-term care is that Medicare or regular health insurance will cover the cost. In most cases, they will not. Medicare may pay for certain short-term rehabilitation services after a qualifying hospital stay. For example, someone recovering from a stroke or surgery may receive temporary rehabilitative care. But Medicare generally does not pay for ongoing custodial care—the type of help someone may need with everyday activities over an extended period. Traditional health insurance generally does not cover that kind of care either. Medicaid can pay for long-term care, but eligibility requires meeting strict financial requirements. That often means spending down assets significantly before qualifying for assistance. Another common source of confusion is long-term disability insurance. Long-term disability insurance replaces a portion of your income when you are unable to work. Long-term care coverage, by contrast, helps pay for the care you need when you can no longer adequately care for yourself. Where Long-Term Care Insurance Fits Long-term care insurance is essentially a risk-transfer tool. Instead of assuming the full financial risk of an unpredictable long-term care event, you pay a predictable premium and transfer some of that risk to an insurance company. Many policies allow considerable flexibility in how benefits are used. Depending on the policy, coverage may help pay for professional care at home, assisted living, or a long-term care facility. That flexibility matters because many people would prefer to remain at home as long as possible. Some policies also provide caregiver support services. When a long-term care event occurs, families are suddenly forced to navigate providers, facilities, benefits, and major financial decisions. Having professional guidance available during that process can be valuable in itself. How Much Does Long-Term Care Insurance Cost? The cost of coverage varies significantly depending on the type of policy, age, health, benefits selected, and length of coverage. Sanow says consumers can think of long-term care insurance much like buying a vehicle: there are inexpensive options, premium options, and many choices in between. Based on his company’s experience with thousands of consumers, hybrid life and long-term care policies may cost considerably more than traditional coverage, while shorter-term policies can cost less. The important point is that coverage can often be customized. Rather than asking, “How much does long-term care insurance cost?” a better question may be, “How much of this risk do I need to insure?” A household might choose insurance that covers only part of the potential cost while planning to pay the remainder from savings or other assets. The Financial Risk of Long-Term Care The potential cost of extended care is what makes planning so important. According to figures discussed by Sano, roughly half of Americans may eventually need professional long-term care services lasting 90 days or more. Women face an especially significant risk of needing care for an extended period. And the costs can add up quickly. In some areas of the country, facility-based care can cost well over $10,000 per month. Even one year of care could consume more than $100,000. For someone with substantial savings, that may simply represent an expense they have chosen to self-insure. But for many households, an extended care event could significantly alter a retirement plan, affect a surviving spouse, or reduce assets intended for other purposes. That is why every household should at least identify how those expenses would be paid. Should You Self-Insure? Not everyone needs long-term care insurance. Some households with significant assets may be comfortable paying for care themselves. Others with limited resources may ultimately depend on Medicaid. But many families fall somewhere in between. For those households, the question is whether they could comfortably absorb a long-term care expense without jeopardizing other financial priorities. If you decide to self-insure, the plan still needs to be specific. Which assets would you use? Are those funds liquid enough to access when needed? Would spending them affect the financial security of your spouse? Simply saying, “We’ll use our savings,” is not the same as having a plan. When Should You Consider Coverage? For many people, the early 50s through mid-60s can be an important window for considering long-term care insurance. Waiting too long can create challenges because premiums generally increase with age, and health problems may make coverage more difficult—or impossible—to obtain. At the same time, newer insurance products have created additional options for some older consumers who might not have qualified for traditional coverage in the past. That makes it important to evaluate your options while you are still healthy rather than assuming you can purchase coverage later. What About Premium Increases? Long-term care insurance has faced criticism over the years because some traditional policies experienced significant premium increases. Today, however, consumers may have additional choices. Some hybrid life and long-term care policies offer premiums that are contractually guaranteed not to increase. Sanow also notes that insurers now have decades of additional claims and interest-rate data that were not available when many older policies were originally priced. That information can help companies make more informed assumptions when designing newer products. Still, consumers should understand whether premiums are guaranteed or whether they could increase over time before purchasing any policy. Newer Long-Term Care Options Long-term care products have also become more flexible. One growing option is a cash-benefit policy. Once the policyholder qualifies for benefits, the insurance company provides a set cash amount that can potentially be used more freely—including paying certain family members or other caregivers, depending on the policy. Another development is the movement from daily benefit limits toward monthly benefits. That distinction can be especially helpful for people receiving home care only a few days each week. Instead of being limited to a specific amount per day, a monthly benefit provides more flexibility in how the available benefit is used throughout the month. As always, policy details vary, so understanding exactly how benefits are calculated and paid is essential. Have the Family Conversation First Long-term care planning ultimately begins with people, not policies. Before researching insurance, sit down with your spouse, children, or other family members and talk honestly about what you would want if you needed extended care. Ask: Who would provide care? Where would you want to receive it? What would that responsibility require from your family? And where would the money come from? Once you understand the answers, you can begin evaluating whether savings, investments, insurance, or some combination of those resources should fund the plan. If insurance may be appropriate, consider working with an independent professional who understands the underwriting requirements of multiple carriers. Health standards can vary significantly between insurers, and the right guidance may help you evaluate the options available to you. Long-term care insurance isn’t right for every household. But long-term care planning is something every family should consider. Preparing ahead can protect more than your finances. It can give your family clarity, preserve choices, and reduce the burden of making difficult decisions during an already stressful season. That, too, is part of wise stewardship. To learn more about long-term care planning and explore your options, visit LTCConsumer.com . On Today’s Program, Rob Answers Listener Questions: My family and I want to buy the home we’ve been renting, and our landlord is offering us a good price. We have about 25% saved for a down payment. Since we already know the property, who should we work with to handle the legal documents, closing, and other purchase details? I’m 39 and expect about $100,000 from an ESOP payout in 2027. My wife and I have roughly $60,000 in credit card and tax debt. Should we use the payout to eliminate the debt or roll it into my 401(k) for retirement? I’m updating my will and would like to leave part of my estate to my three children and a meaningful portion to three ministries I support. Is that a wise and God-honoring way to structure my estate? Resources Mentioned: Faithful Steward: FaithFi’s Quarterly Magazine (Become a FaithFi Partner) LTC Consumer | MasterCare Splitting Heirs: Giving Your Money and Things to Your Children Without Ruining Their Lives by Ron Blue with Jeremy White FaithFi Field Guide: How Much Money is Enough? Our Ultimate Treasure: A 21-Day Journey to Faithful Stewardship by Rob West Wisdom Over Wealth: 12 Lessons from Ecclesiastes on Money Look At The Sparrows: A 21-Day Devotional on Financial Fear and Anxiety Rich Toward God: A Study on the Parable of the Rich Fool Find a Certified Kingdom Advisor® (CKA) FaithFi App Remember, you can call in to ask your questions every weekday at (800) 525-7000. Faith & Finance is also available on Moody Radio Network and American Family Radio . You can also visit FaithFi.com to connect with our online community and partner with us as we help more people live as faithful stewards of God’s resources. Hosted by Simplecast, an AdsWizz company. 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