In the world of insurance products, long-term care insurance is a relative newcomer. It was introduced in the late 1970s, but in recent years, it has become a much more important element of retirement planning thanks to twin rises in health care costs and longevity. (Life expectancy in 1930 was just 59.7; in 2010 life expectancy for Americans was 78.7.)
Many people associate long-term care insurance with nursing homes, but it also pays for in-home care and assisted living facilities. According to the American Association for Long-Term Care Insurance, 50 percent of long-term care insurance benefits in 2011 went to pay for in-home care, 31 percent for nursing home care, and 19 percent for an assisted living facility.
How Long-Term Care Insurance Works
Each long-term care insurance policy is slightly different, but most benefits kick in based on a similar definition of "disability": either you have severe cognitive impairment or you need help with at least two daily living activities. These activities include bathing, dressing, eating or using the bathroom.
In other words, you don't just automatically receive the benefits when you think you could use some help or when you move into a retirement community. Policies are typically purchased with fixed daily benefits for a fixed period of time such as three years or five years.
Can You Cover These Costs Without It?
On an hourly, daily and monthly basis, the cost of the kinds of services covered by long-term care insurance really add up.
A 2012 MetLife Survey of Long-term Care Costs found:
The national average monthly base rate in an assisted living community cost $3,550 in 2012.
The national average daily rate for a private room in a nursing home cost $248; a semi-private room ran $222 per day.
The national average daily rate for adult day services was $70.
The national average for hourly rates for home health aides was $21.
While many people recognize the value of having insurance coverage to help pay for their care when they age, not everyone purchases it.
A 2012 Generational Research project by Financial Finesse showed that just 10 percent of people age 45 to 54 have purchased long-term care insurance, and only 16 percent of people age 55 to 64 have it.
Why are people forgoing coverage? It comes down to cost, according to the AARP.
How Much Does Coverage Cost?
Long-term care insurance can vary widely depending on your age at the time of purchase, the length and amount of coverage, and policy characteristics including whether your benefits are adjusted for inflation and the length of any waiting period before benefits are paid, among other things.
According to the American Association for Long-Term Care Insurance, the average annual premium for long-term care insurance in 2012 for a policy for a 50-year old with a daily benefit of $200 for three years of coverage and a 3 percent automatic compound inflation coverage was $2,235. Your policy can't be cancelled (except for non-payment) and premiums for long-term care insurance cannot be increased on an individual basis for your age or health reasons. Still, insurance companies can raise the premiums for an entire class of policyholders (such as everyone age 75 and older).
Obviously, the older you are when you purchase long-term care insurance, the more expensive the policy and the higher the likelihood that you will be turned down for the coverage. Underwriters look at your health records as well as mortality risk to determine your eligibility for coverage.
Some companies give you a discount if you're married because they assume spouses are likely to take care of each other longer before resorting to a nursing home.
Four Reasons You Need Long-Term Care Insurance
So how do you know if you need this kind of insurance? If you have more limited retirement savings, long-term care insurance should probably be part of your financial plan. And even if you have $2 million or $3 million in the bank for your retirement and future health care needs, don't dismiss these policies before you examine the benefits more closely. Consider, for example:
How much longer we're living these days. The longer you live, the higher your chances of needing some type of long-term care, either in your home, in a nursing home or in an assisted living facility.
Rising health care costs. AARP says that health care costs have historically outpaced the overall rate of inflation. If you need to live in a nursing home for more than a year or two, you could need $250,000 or more to pay for it.
How far your retirement investments will really take you. Your 401(k) may look good when you retire at 65, but if you need to pay for assisted living or even a home health aide the income generated by your retirement investments could get eaten away very quickly. If one spouse needs to live in a nursing home but the other can stay at home, you'll need enough savings to cover two separate living expenses.
Your family's emotional and financial health. Even wealthy families often choose to purchase long-term care insurance because the policy can make decisions about how to care for loved ones easier by giving them more options. Instead of draining their inheritance, your family members can use insurance benefits to pay for home health care or to cover some of the expense of a more costly nursing home.
Financial experts suggest purchasing long-term care insurance between age 55 and 64, but remember that the younger you are when you buy it, the lower your premiums will be. If you or your parents are 50 or 55, it's time to discuss your options with an insurance agent.
Photo Credit: Alamy
Your Insurance Doesn't Cover That: Hidden Dangers in the Fine Print
Long-Term Care Insurance Should Be Part of Your Financial Plan
When buying homeowners insurance, be sure that you're buying enough coverage to rebuild your home, if necessary. Don't look at market prices for homes, but rather at the replacement cost for your home, which would include removing what's left of your home, buying new building materials, and labor. "Guaranteed replacement" policies should cover the whole cost, while "replacement cost" coverage often covers less than the full amount. Check your policy to see what kind you have, and be sure that your home's value isn't being understated.
Also, know that in standard homeowners policies, many kinds of damage are typically excluded, such as that from earthquakes, floods, nuclear attacks. These days, mold damage is often excluded, too. If you're worried about any excluded risks, talk to your insurer. You can probably expand your coverage, for a price. You may also get it elsewhere, such as from the FEMA-administered National Flood Insurance Program, or the California Earthquake Authority.
You may know that dental or vision-related expenses are not covered by your health care insurance, but that's probably not all. Pre-existing conditions have long been excluded by many insurers, though President Obama's health care reform act is addressing that. A nose job or other cosmetic surgery, for example, is most likely excluded, too, no matter how much of an emergency you think your double chin is.
Your policy may also not cover ambulance services, maternity care, prosthetics, kidney dialysis, organ transplants, diabetes management, emergency-room visits, mental-health care, and care you receive outside the United States -- or any of a number of other expenses. Don't be overly alarmed -- policies vary widely, and you may be covered for many of the above costs, at least to some degree. Just be sure to find out what is and isn't covered, and when shopping for a policy, seek out the one that fits your needs and pocketbook best.
The main reason to get renters insurance is because many possible losses renters face are excluded from their landlords' insurance policies. If a roof leak destroys much of your collection of first-edition books, your landlord's insurance will likely fix the roof and any damage to your apartment's floor, but your book loss will probably be excluded. Thus, it's smart to get renters insurance, which is often rather inexpensive, as well.
When shopping for such policies, be sure you know whether losses will be insured for their replacement cost or their current, depreciated value. (The former is, of course, preferable.) Renters policies can include or exclude coverage if a guest is injured on your premises. If you'd like that coverage, ask for it. Know that in many renters policies, damage due to natural disasters or structural damage to the building may not be covered, too. If you're worried about those issues, including burst pipes, ask about it. You may need to add a rider to your policy.
There are coverage holes with car insurance, too. At a basic level, while most drivers carry liability coverage, many don't carry collision coverage, which will address damage to your car. Omitting it can make sense if you're driving a clunker that you'd just replace after an accident, but crunch some numbers before passing it up.
There are some tricky little car-insurance details, too. For example, a stolen car may not be covered if you left it running with the doors unlocked. Damage due to hitting an animal such as a deer, or damage from a lightning strike, tornado, or flood, may also be excluded or limited. Medical bills may also be off-limits unless you have medical coverage, and valuables stolen out of your car are also often excluded. (They may be covered via your homeowners policy, though.)
A key thing to understand about life insurance is that not everyone needs it. If no one is depending on your income, then sad though your demise will be, you need not protect against anyone's financial loss from it. But many people do have dependents, in the form of children, spouses, and even parents or others. So know that with life insurance, you may not be covered if the death is a suicide, if it happens as part of war-time combat or during the commission of a felony, or if it's due to a private-aircraft accident. (Deaths tied to commercial flights are typically covered.)
Also, if you regularly engage in dangerous activities such as car-racing, hang-gliding, or extreme mountain-climbing, a related death may not be covered -- unless you pay a premium for a rider to your policy. Lying on your insurance paperwork can also lead to a denied claim.
If you're an investor and you've got much of your retirement security resting on an account at a brokerage, you can take comfort that you're probably protected by the Securities Investor Protection Corporation. It's a bit like the Federal Deposit Insurance Corporation, which covers bank accounts, but it may not provide all the protection you expect it to. The SIPC protects the cash and securities such as stocks and bonds that you may have in your brokerage account -- in the event that the brokerage runs into deep trouble or fails, or if a broker steals your assets. It does not cover losses that occur if your stock or bond loses money or a company in which you're invested goes out of business.
Even FDIC protection has limits. It typically covers assets in bank accounts up to $250,000 for each person's accounts at each bank in each account ownership category. So if you have $350,000 in savings accounts at one bank, you may not be fully covered and you might want to divide the sum between two banks.
You're smart to look into insurance for all kinds of needs -- and smarter still to read the big and small print to be sure you understand what is and isn't covered. In many cases, you can add the extra protections you seek. That might come at a cost, but it might be worth it, too.