The Long-Term Care Mistake Most Couples Regret—Don’t Be One of Them!

Recently, I received an email from Peter in Tulsa, Oklahoma, and I think his story will resonate with many of you. After being denied a traditional long-term care plan, Peter has grown concerned about the rising costs of long-term care and what options are available for him and his wife, Bonnie. Here’s what he shared with me:

“Morning, Toni,

I am retiring in June when I turn 70 and my wife, Bonnie, will be 68. Our Medicare issue is that recently we applied for a long-term care plan and were both denied due to our simple health issues. I had my prostate removed due to cancer about 5 years ago with no current issues and Bonnie has A-FIB, which is under control. The agent who helped us search for the insurance plan said that people over 60 find it difficult to be accepted by a long-term care insurance plan.

Our concern is that my brothers and I are paying about $9,000 a month to an Alzheimer’s facility for our father’s care. Can you please explain other long-term care options that Bonnie and I can explore because my father’s rate of $9,000 per month, this will drain our retirement? We do not have a plan in place should we need extra financial help since we were not approved for a long-term care policy?

Thanks,
Peter from Tulsa, OK”

Peter, thank you for your email. I completely understand your concerns. Many retirees fear the financial strain of long-term care, so it’s great that you’re being proactive about planning. Based on current data, the average cost of long-term care in the US is approximately $104,000 per year for a semi-private room in a nursing home, with a private room costing considerably more at around $116,800 annually. The good news is that there are options to help you and Bonnie protect your retirement savings—even if you’ve been denied a traditional long-term care insurance policy.

Before I get into your options, it’s important to clarify what Medicare does and doesn’t cover when it comes to long-term care. This is where so many people get caught off guard and end up paying far more than they expected.

What Medicare Covers (and Doesn’t Cover)

Medicare only pays for medically necessary skilled nursing care or home health care if certain conditions are met. For example, skilled nursing coverage only lasts for up to 100 days per benefit period. The first 20 days have a $0 copay, but starting on day 21, there’s a copay per day, and after 100 days, you’re responsible for 100% of the costs.

Medicare Coverage

• Part A: Inpatient hospital care, nursing facility care, nursing home care, hospice care, and home healthcare.
• Part B: Covers medically necessary services, like flu shots and cancer screenings.
• Part C: Also called Medicare Advantage, this may offer coverage for vision, hearing, dental, and wellness services.
• Part D: Extra coverage for people with Medicare can choose to help lower costs of prescription drugs.

Here’s the kicker, though—Medicare does NOT cover non-medical long-term care, which includes assistance with daily activities like bathing, dressing, or eating. These types of services can drain your savings quickly, which is why you need a plan for long-term care.

Since you and Bonnie were denied coverage under a traditional long-term care plan, don’t worry—here are some other options you can explore!

1. Short-Term Care Insurance Plans

A short-term care insurance plan might be a great solution for you. These plans typically have a simplified health questionnaire with simple yes/no questions, making it easier to qualify than traditional long-term care insurance.

Short-term plans can provide coverage for nursing homes, assisted living facilities, and even personal care at home. They have benefit periods ranging from 1 to 2 years, with daily benefit amounts between $50 and $400 depending on the plan. While short-term plans don’t offer the same extended coverage as traditional long-term care policies, they can act as a critical safety net to protect your savings if you face an illness or accident recovery. This type of coverage is much better than having no plan at all!

2. Life Insurance or Annuity Policies with Long-Term Care Riders

Some life insurance and annuity policies now offer built-in long-term care benefits. Here’s how it works—if your life insurance policy includes this feature, you may be able to access a portion of your death benefit to pay for long-term care.

However, just like traditional long-term care insurance, health questionnaires may still be part of the application process. If you and Bonnie already have existing life or annuity policies, check with your provider to see if this option is available through your current coverage.

3. VA Aid and Attendance Benefits

Peter, since you mentioned your father’s care expenses, I want to highlight a program for Veterans that often gets overlooked. The VA Aid and Attendance benefit is available to eligible Veterans and their spouses who require long-term care. The annual funding for this program exceeds $20 billion, yet many people don’t realize they qualify.

If you or Bonnie have a long-term care need and are Veterans or spouses of Veterans, this program could be worth exploring. It provides financial resources for care in a range of settings, such as assisted living or at home.

4. Traditional Long-Term Care Insurance (Plan Ahead if You’re Under 60!)

Finally, I need to stress this for anyone reading who is under age 60—if you’re in good health now, this is the best time to explore traditional long-term care insurance. The younger and healthier you are, the easier it will be to qualify and secure lower premiums. These policies are designed to cover extended care, whether it’s in a nursing facility or at home, and they provide real financial peace of mind when you need it most.

Why Planning Is Essential

Peter, the situation with your father highlights why planning is so important. As you have learned with your father, $9,000 a month for care can quickly deplete retirement savings. Far too many families face this financial burden without a plan in place. However, considering options like short-term care coverage, VA benefits, or combination life/long-term care policies can help build a safety net for your and Bonnie’s future!

Ignoring the Long-Term Care Crisis is a Mistake You Can’t Afford to Make

To Everyone Reading This

Here’s the truth—Americans are more concerned than ever that a chronic illness not covered by Medicare will become their biggest retirement expense. And they should be! But knowledge is power, and it’s what you don’t know about Medicare and long-term care that can hurt you the most.

If you have any questions about long-term care options or Medicare, don’t hesitate to reach out to me and my team. You can call us at 832-519-8664 or email us at [email protected].

Peter, thank you again for allowing me to share your story. I hope this information gives you and Bonnie clearer steps on how to move forward. For everyone else reading, take this as a reminder to plan now—you’ll thank yourself later!

More Medicare Resources

Get weekly tips on housing, retirement living, senior care, and more sent right to your inbox.