Someone turning 65 has almost a 70 percent chance of needing some long-term care, and about 20 percent will need it for more than five years, according to the U.S. Administration for Community Living. CareScout's 2025 Cost of Care Survey puts the national median at $129,575 a year for a private nursing home room, $74,400 for assisted living, and $80,080 for a non-medical caregiver working 44 hours a week. Those are the numbers a self-funding assumption has to survive; the care plan below turns them into a household-specific figure.
Make the care plan specific
Long-term care includes help with daily activities or supervision for cognitive impairment. A family member may coordinate that care even when professionals provide it. Ask what that role would involve before assuming someone can take it on.
- Where would the client prefer to receive care, and is that setting practical?
- Who would arrange care and make decisions if the client could not?
- Which assets would fund care first, and how accessible are they?
- How would a longer or more expensive care period affect the other spouse?
- Which legacy goals could change if the family funds care itself?
Use local provider costs and several duration assumptions. A national median can provide context, but it is not a quote for the care this family would choose. CareScout's cost survey offers a starting point for regional comparisons.
Use our free long-term care cost calculator and funding planner to explore care costs, savings, income, and insurance benefits in an editable scenario.
Traditional long-term care insurance
Traditional coverage pays eligible benefits under a contract focused on long-term care. Compare the daily or monthly limit, total benefit pool, covered settings, inflation protection, and waiting period. Premium increases may be possible on a class of policies, subject to the contract and applicable approval requirements.
Benefits may go unused if care is never needed. Some designs offer additional features, so avoid assuming all traditional policies have identical premium or residual-value terms.
Hybrid life or annuity policies
Hybrid designs combine long-term care benefits with life insurance or an annuity. Compare how care payments affect remaining cash value and death benefits, whether any minimum death benefit remains, and what premiums are guaranteed. A life policy's chronic-illness rider is not automatically equivalent to dedicated LTC coverage.
Compare actual illustrations using consistent assumptions. Neither traditional nor hybrid coverage always provides the most LTC benefit per dollar; age, funding pattern, guarantees, inflation features, and benefit structure affect the result.
Aligned Path can compare fixed, fixed indexed, and immediate income annuities on request. Some designs may support long-term care funding; availability, benefits, and tradeoffs depend on the product. Variable annuities are not offered.
Self-funding some or all of the cost
A self-funding plan identifies the accounts that would pay for care and tests the effect on spending, taxes, liquidity, and the other spouse's resources. A client may also insure part of the exposure and retain the rest. Review the funding decision with the financial and tax professionals who manage those parts of the plan.
Compare coverage for both spouses
For a married couple, test one spouse needing care and both needing care at the same time. Compare separate benefits with any shared-care option: how much can either spouse use, and what remains for the other? Shared-care designs differ; some draw from a common pool, while others add a separate shared pool. Ask what happens after one spouse exhausts benefits or dies, and if only one spouse qualifies for coverage.
Use the LTC comparison worksheet to record each spouse's benefits and the shared-care rules.
If an LTC application is declined
Before applying again, obtain the carrier's stated reason and check whether the health information it reviewed is accurate and current. Underwriting standards vary; another product is not a guaranteed route to approval. Ask whether further carrier review is worthwhile, and plan for care using existing coverage, income and assets if new insurance is unavailable.
Put the proposals on a common basis
Compare each proposal's funding commitment, whether it calls for ongoing premiums, a single payment, or payments over a fixed number of years. Compare the full payment schedule and the liquidity left after funding, alongside the care benefits each contract could provide.
- Care benefits: compare the monthly limit and total pool at the same future age, including each policy's inflation protection terms and covered care settings.
- Payment terms: identify required premiums, which terms are guaranteed, and any possibility of premium changes.
- Remaining value: check surrender terms, death benefits, and how using care benefits changes what remains. Distinguish guaranteed values from illustrated values.
Aligned Path can compare available traditional and hybrid options or review an existing LTC policy for advisors' clients and individuals. Request long-term care quotes with the state, ages, health overview, and benefit or funding target. Include existing proposals or policy documents when available. For an in-force contract, request a policy review before deciding to change coverage. Expect an initial response within two business days; carrier responses, documents, and underwriting affect completed work. Availability varies by product, state, and case.
Read the benefit triggers
Check how the policy defines a qualifying need, including assistance with daily activities or cognitive impairment. Review certification requirements, eligible providers, the elimination period, and whether the policy reimburses expenses or pays a cash benefit. Having a policy does not mean every care expense qualifies.
Medicare does not cover custodial care when it is the only care needed. Short-term skilled-nursing coverage has separate conditions. Medicaid eligibility and benefits are state-specific and require their own review.
Further reading: NAIC shopper's guide, including shared care and medical underwriting, the Administration for Community Living on how much care people need, Medicare nursing-home coverage, and CareScout regional care costs.
For coverage already in force, use the existing-policy review tool to identify what to check in the contract and current notices.
