Options for a long-term care plan when there are health issues.

Morning, Toni:

I am retiring in January when I turn 70, and my wife, Sharon, will be 66. I have heart issues with AFib and Sharon is a diabetic. Last month, we applied for a long-term care policy and were both denied due to our health. 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 two younger 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 we can explore because my father’s rate of $9,000 per month 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, Toni

Jeff from Dallas, TX

Hi Jeff:           

I’m glad you took the time to email me about your situation, because I have good news for you and Sharon. In the past few years, new plans with extended health care benefits have been developed, assisting America with unexpected health or accident issues.

In the 2025 Medicare & You handbook, on page 56 under “Paying for long-term care,” discusses how important it is to plan now and in good health to maintain your independence. You will want to receive proper care in the setting you desire whether at home or in a medical facility such as assisted living, nursing home or a private personal care home.

America needs to be aware that Medicare only pays for medically necessary skilled nursing facility care or for home health care if you meet certain conditions. 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 assist with ways to protect your finances from excessive long-term care costs, especially for those with health issues that can keep one from being accepted for a long-term care plan.

• Short-term care insurance plans: These policies have a simple health questionnaire with yes/no questions, making it easy to qualify. They will assist paying for nursing home, assisted living and personal care home as “facility care” with additional benefits for care at home. Providing various facility care options ranging from $50-$400 per day with benefit periods ranging from 1 or 2 years, depending on the plan. A Short-term care plan can help America from draining their savings or 401k for an illness or accident whether recovering in a facility or at home.
• Life or Annuity Policies with long-term care benefits: Many life or annuity insurance policies have a provision for long-term care; one can receive a certain amount of long-term care with your life or annuity policy’s face Health questions may keep one from qualifying.
• Traditional long-term care: If you are under 60 and in good health when you purchase a long-term care policy, it may be easier to qualify with lower premiums. A long-term care plan can help to protect your savings or 401k. One has to answer health questions to be approved.

Remember, even Christopher Reeves (Superman) didn’t think he would fall off a horse, which changed his life forever. Always be prepared by planning properly for a long-term care issue. No one knows what the future holds for your medical care.

Toni King is an author and columnist on Medicare, Social Security and Long-Term Care issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. Sign up for the Toni Says newsletter at www.tonisays.com to keep up to date on Medicare changes.