6 Things Many People Get Wrong About Long-Term Care

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Misunderstand long-term care, and you could contend with financial drain, mental strain and family pain as you scramble to meet the unexpected challenges of a life-changing terrain.

“Long-term care planning is complicated and emotional, and has a huge impact on financial well-being,” says Holly Snyder, Nationwide Life Insurance president, in a statement about a recent company survey revealing respondents’ fears and misconceptions about long-term care.

On behalf of Nationwide, The Harris Poll surveyed 1,334 adults age 28 and older with household incomes of at least $75,000 for its annual Nationwide Retirement Institute Long-Term Care survey. Many people expect to make financial sacrifices caring for ailing family members, researchers found.

Here’s what many people get wrong about long-term care and how you can rightly plan for your own needs and those of a loved one.

Wrong: You won’t need long-term care

Senior man in long-term care insurance facility
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The Nationwide survey found 29% of people age 59 and older would like to tell their younger selves it’s a mistake to assume you won’t need long-term care.

If you turn 65 today, you have almost a 70% chance of needing some type of long-term care services at least once in your life, the federal Administration for Community Living (ACL) says. You might even be among the 1 in 5 who will need long-term care for more than five years. On average, women need long term care for 3.7 years compared with 2.2 years for men.

You need long-term care when you can no longer carry out “activities of daily living” such as bathing, walking, dressing and toileting. You might think of nursing homes and adult daycare, but most care is actually provided at home, the government agency says.

Wrong: Medicare will cover the costs

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Nearly half the Nationwide respondents say they will rely on government programs such as Medicare and Medicaid to cover long-term care costs.

However, Medicare covers only up to 100 days of skilled nursing home care after a hospitalization, and even then you might face deductibles and copays. The average Medicare-covered nursing home stay is only 22 days, and Medicare does not pay for non-skilled assistance with “activities of daily living.”

As we reported about the top 10 medical fears of older Americans, the vast majority of people say they would have difficulty paying an estimated $100,000 a year for nursing home care or an estimated $60,000 for a paid nurse or aide at home.

If you use up your own money or have limited assets, you might be eligible for long-term care coverage through your state’s Medicaid program. Find your state here to get started. Medicaid may pay for nursing homes as well as in-home services such as housecleaning, meal preparation, laundry, grocery shopping, bowel and bladder care, bathing, grooming and accompaniment to medical appointments.

Besides tapping your retirement accounts and other savings, financing options include long-term care insurance, reverse mortgages and annuities.

Wrong: Insurance is too expensive

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Nearly half the Nationwide survey respondents say long-term care insurance is too expensive to prioritize. However, most overestimate its cost.

When shown a typical policy for a 50-year-old man which comes with six years of coverage that is available immediately at $2,000 a month and can increase annually until reaching $5,600 a month at age 85, more than half of respondents expect monthly premiums to run $150 or more — 20% guessed $500 and up.

After learning the actual average cost for such a policy was locked in at $130 a month, 40% of respondents say they are more willing to consider purchasing similar long-term care insurance for themselves.

When shopping for long-term care insurance, consider the services you’ll need, where you’ll need them, how much the policy will pay, how long it will pay and if it has a lifetime cap. You can explore other options such as hybrid LTC-life insurance policies which will pay a benefit to heirs if you die without using long-term care benefits.

As Money Talks News founder Stacy Johnson says in this article, read, compare costs and benefits, and decide if this insurance makes sense and is affordable for you.

Wrong: You should wait until near retirement to buy insurance

Older man with a beard and no hair holding up his hands to say "no thanks" as if pushing an offer away with a scrunched up face of disgust
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The longer you wait, the more you can expect to pay for long-term care insurance because you’ll be that much closer to needing care and receiving benefits from your policy. On the other hand, buy too soon and you could divert money better invested in your retirement account, your children’s tuition, or other financial priorities, warns KFF Health News.

The “sweet spot,” many advisors recommend, is in your 50s, which is what 1 in 4 Nationwide survey respondents expect. However, nearly half believe the best time to buy is between ages 60 and 90.

“Your money pays for long-term care insurance — but your health buys it,” according to the American Association for Long-Term Care Insurance, which tracks rates.

You’re more likely healthier in your 50s rather than your 60s, 70s or 80s so premiums are likely to be lower than if you wait — if you could even still qualify for a policy.

Wrong: It’s never too late to buy insurance

older woman shocked by bill
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About 7 in 10 Nationwide survey respondents feel it is never too late to buy long-term care insurance, but, as the National Association of Insurance Commissioners and others caution, not everyone can get it.

“If you already have health problems that could lead to long-term care (for example, Alzheimer’s disease or Parkinson’s disease), you probably won’t be able to buy a policy,” the association warns.

You could also be denied if you already use long-term care services, already need help with “activities of daily living,” have AIDS, had a stroke in the past year or two, or have metastatic cancer (cancer that has spread beyond its original site), the ACL says.

Wrong: Family can always take care of you

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Unpaid family and friends are the backbone of our nation’s long-term care system, the ACL says, but that can be a costly burden for caregivers.

About 80% of home care is provided by unpaid caregivers who spend an average of 20 hours a week giving care. Most are women, and 14% are already age 65 and up.

Surveyed caregivers say they pay an average $338 a month out of their own pockets for loved ones’ food, co-pays, prescriptions, transportation and other items. Four in 10 agree with the statement, “I’m afraid that caregiving expenses will keep me from ever retiring.”

In similar numbers, respondents fear they have to stop caregiving to keep their jobs or quit their jobs to continue caregiving. They also worry that caregiving could harm their relationships with their spouse, children, extended family or friends.

Worries about becoming financial, physical or emotional burdens for their loved ones are why many respondents tell Nationwide they would consider buying long-term care insurance.

Long-term care insurance policies and some state Medicaid programs could pay your caregiving family members.

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