Can’t qualify for long-term care due to health issues…What do I do?
Morning, Toni:
Recently, you wrote a Medicare column about various life policies available after 65 and I have a retirement insurance question.
In January, I’m retiring when I turn 70 and my wife, Anna, will be 68. Our retirement insurance issue is that recently we applied for a long-term care plan and were both denied due to our health issues. I had my prostate removed due to cancer about 5 years with no current issues and Bonnie has AFIB which is under control. The agent writing the long-term care plan said that those past 60 years old find it difficult being accepted by an LTC plan due to health issues like we have.
My brothers and I are paying an Alzheimer’s assisted living facility over $12,000 a month for our father’s care. Are there long-term care options available for Anna and me with our health issues because paying $12,000 a month will drain our retirement.
Thanks, Paul from Tulsa, Okla.
Hi Paul:
I’m glad that my article about life insurance plans past 65 caught your attention and you took the time to email me about your long-term care situation. New short-term care plans that have extended care benefits have been developed assisting Baby Boomers when there is a need for extra help with unexpected health or accident issues.
The 2026 Medicare & You handbook, under “Paying for long-term care,” discusses how important it is to plan properly to maintain your independence and receive the proper care in the facility you desire. Medicare only pays for medically necessary skilled nursing facility care or for home health care if you meet certain conditions. Skilled nursing has 100 days of benefit with days 1-20 having a $0 copay per day and days 21-100 with a specified copay per day. If you cannot qualify or do not meet Medicare’s qualification for skilled nursing, you will pay 100% of the cost out of your pocket. Medicare doesn’t cover non-medical long-term care. This is why purchasing a policy to help with a long-term need becomes essential.
Let’s discuss options that can help to protect your finances from excessive long-term care costs. Especially for those who have health issues that can keep one from being accepted by a long-term care plan.
- Short-term care insurance plans have a simple health questionnaire with yes/no questions, making it easy to qualify. These policies will assist paying for nursing home, assisted living and personal care home as facility care with benefits for care in your house. Providing various options ranging from $50-$400 per day with benefit periods ranging from 1 or 2 years depending on plans. Allowing one to not drain their retirement dollars due to a serious illness recovery.
- Life and Annuity Policies are insurance policies that have a provision if you need long-term care; you can receive a certain amount of long-term care with your life/annuity policy’s face (Health questions may keep one from qualifying.)
- Aid and Attendance benefits is a VA benefit that can help Veterans with long-term care issues. There is over $20 Billion dollars available for long term care pension money just waiting for America’s Veterans to apply for their Aid and Attendance benefits. The must be a long-term care issue to qualify.
Important note: If you are under 60 and in good health, please take your time to apply for a traditional long-term care policy. It is easier to qualify and receive a lower premium whether annual or monthly. Most Americans retiring are concerned about a chronic illness being their biggest retirement expense if not planned for properly.
If you have long-term care or Medicare questions, please feel free to reach out to the Toni Says Medicare team at 832/519-8664 or send an email to info@tonisays.com. Sign up for the Toni Says newsletter at www.tonisays.com to download Toni’s new Medicare 2026 First Steps guide