Every approach solves the same problem differently - in what it costs, how hard it is to qualify, and what happens if care never comes.
A quick read on all four, then the details below.
Keep the risk yourself and pay for care out of your own savings and income.
Best when: You have substantial assets and/or income. 02A stand-alone policy with one job: paying for care.
Best when: Maximum care protection per dollar. 03One pool of money, two outcomes: care while living, or a benefit at death.
Best when: You want care covered and something left behind either way. 04Reposition an asset you already have and attach care protection to it.
Best when: You have savings sitting idle and want easier qualification.3 in 10 Americans will not need long-term care.1
According to US Government research, 3 in 10 people age 65 today will not need long-term care services.1 Retain the risk yourself, and maybe you will never need care on an extended basis. Be prepared to self-fund.
Advantages include no insurance policies to pay for and retaining all your assets. Disadvantages include having to pay for care on an extended basis with savings, investments, Social Security, pension income, etc.
If you have substantial financial assets and/or income, self-insuring may make sense.
No need to qualify for a long-term care policy. No out-of-pocket expense for one-time, or annual premiums.
Being forced to sell assets, pay taxes on gains, liquidate assets or even business interests that were intended as legacy assets to your loved ones.
“From my personal experience as a (now retired) 40 year financial advisor, when clients have a need to sell assets for an unexpected reason, it is never at the right time. Non-planned asset sales happen when the markets are down, not up. This just worsens the situation at hand.”Les Goldstein
A stand-alone policy with one job: paying for care.
Coverage reimburses covered care up to a daily or monthly limit you choose - at home, in assisted living, or in a facility.
Every premium dollar goes toward care instead of also funding a death benefit. Full health underwriting is required.
A basic policy returns nothing if care is never needed. Return-of-premium riders can change that.
Rates can rise later. Limited-pay designs end that exposure after the payment period.
Qualifying policies can shield a portion of your assets after benefits run out.
Usually the inability to perform two activities of daily living, or a qualifying cognitive impairment.
One pool of money, two outcomes: care while living, or a benefit at death.
A life policy with long-term care built in. If care is needed, it pays for care. If it is not, a death benefit goes to your family.
That solves the use-it-or-lose-it problem. The tradeoff is that your premium is funding two things at once.
Asset-based life premiums are typically locked in, so future rate hikes are not the worry.
Still underwritten, but generally lighter than traditional LTC. Carrier rules vary.
An LTC rider is more comprehensive. Chronic illness riders may require a permanent condition.
Money used for care comes out of what beneficiaries would receive.
Reposition an asset you already have and attach care protection to it.
The annuity value pays for qualifying care up to a set monthly amount. An extension-of-benefits pool can keep paying after that value is spent.
If care never exhausts the annuity, whatever is left stays yours and passes to your beneficiaries.
Underwriting is generally less stringent than traditional LTC or life-based coverage.
Qualified LTC payments can be income-tax-free under the Pension Protection Act.
Some riders only recognize nursing-home confinement; others include qualifying home care.
The cost of coverage can consume some or all of the interest the annuity earns.
| Question | Traditional LTC | LTC + Life | LTC + Annuity |
|---|---|---|---|
| Primary purpose | Dedicated care protection | Life insurance with care protection | Annuity with care protection |
| If care is never needed | Generally use it or lose it; riders can change this | A death benefit goes to your family | Remaining value stays yours |
| Underwriting | Full health underwriting | Simplified health underwriting | Often least stringent |
| Premiums | Not guaranteed; can increase | Usually guaranteed | Extension-of-benefit premiums typically guaranteed |
| Best fit | Maximum care coverage per dollar | Care plus a legacy | Repositioning an existing asset |
General characteristics only. Actual provisions, availability, underwriting, tax treatment and pricing vary by carrier, state and individual circumstances.
Run your numbers first, then talk it through with Les - no pressure, no pitch.
1. U.S. Department of Health and Human Services, LongTermCare.gov - "How Much Care Will You Need?" "What If You Need Long-Term Care?" 2024 educational brochure, Advisors Excel. NGL EssentialLTC Long Term Care Sales Guide (agent/broker material). Pension Protection Act of 2006 tax treatment of qualified long-term care payments from asset-based annuity contracts. Product features and availability vary by carrier and state. This page is educational only and is not a policy illustration, tax or legal advice, or a guarantee of benefits, premiums or eligibility.