The Basics of Long-term Health Insurance

May 23, 2019

Recent news from the CDC paints an encouraging picture of American life expectancy, with more of us than ever living longer, healthier lives. And yet greater life expectancy can still carry a higher risk for chronic health problems like heart disease and diabetes that require sufficient monitoring and treatment, whether you enjoy the safety net of a senior living community or stay at home. The fact is that nearly 70% of us who make it to 65 will need long-term healthcare; for women, the statistics are even higher. Because they live on average five years longer  than men, women 65 and older needing long-term care will require it for an average of 3.7 years, while the male average is 2.2 years.


What is long-term healthcare?

Long-term care generally involves professional assistance with deficits in Activities of Daily Life (ADL) that result from a lengthy illness. This can include help with dressing and changing, incontinence, bathing, eating, and taking medications. Long-term care can be administered in the home, hospital, or in a senior living care community. While costs range widely and are based on a number of factors, they can end up being the most costly  aspect of retirement years, often running into the six figures.

And this is why long-term health insurance is so critical for seniors to consider. Many of us think we can rely on Medicare or Medicaid to pick up these expenses. But Medicare only covers a fraction of services; and in order to qualify you need to have essentially depleted your resources – not a good option. Long-term health insurance, whose yearly costs vary but average around $2000, can end up providing full coverage where Medicare leaves off. Timing is everything, though, in terms of qualifying for coverage. Over 50% of applicants 50-59 are able to get coverage; this number drops down to 24% at age 70.

Like any insurance coverage, not all long-term policies are the same. Make sure the policy you’re considering has an inflation rider to cover rising healthcare costs, and one that adjusts each year – some only offer riders that kick in every three years or so, which can fall short. Make sure, too, that your policy covers care both in-home and in-facility. And if you’re too young to qualify for a policy, your employer may be able to close the gap – ask your HR department.

When it comes to making a decision to purchase, it’s important to include any family members who would be involved or affected. Statistically, women are less comfortable raising the topic than their male counterparts. A recent study reports 31% of women feeling nervous or anxious talking about long-term care, while 40% of the men surveyed expressed no reservations about discussing it. This attitude needs to change, especially considering the fact that women are more likely to outlive male spouses.

We’ve only scratched the surface of this complex topic; for more helpful info, head to the US Department of Health and Human Services. Taking a look at our Stay or Go guide may also help you weigh up which living style would best support your future health care plans – simply click the download link below and begin your journey!


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