Determining Long Term Care Needs and Options for Covering the Costs

Chances are you will need some form of long term care as you age. Most of us will. Here’s what you need to consider to determine your long term care needs so you can plan ahead for this potentially expensive situation.

by June Duncan
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We’d all like to live a long, happy, and independent life in the comfort of our own homes, but the truth is it’s estimated that 70 percent of people age 65 and older will need some form of long term care. That means needing help with daily activities like walking, bathing and eating.

Given the statistical likelihood of requiring long term care, it’s a wise precaution to begin preparing early rather than later. The last thing you want is to wait until it’s too late and have to find some means of getting help. It can be a difficult process to get your arms around.

Planning – Think Through Your Health Care Needs

According to the National Institute on Aging, about 25 percent of older Americans aren’t capable of making important decisions about medical treatment later in life. That’s where advanced care planning can help, which is a process that involves those who know you and your health situation best – your doctors and loved ones – and generally leads to the development of an advanced care directive.

It also establishes a medical treatment plan based on your wishes if you become incapacitated and designates an individual who will have medical power of attorney. As you plan, think through how your lifestyle might impact your long term health and how you might improve it (stop smoking, start exercising, etc). Take into consideration any history of family illness that might affect your long-term health.

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Paying – Know Your Options

It’s important to know about any insurance programs, policies, or plans that can help you finance long term care. Your contribution level should be determined by your age and how many more years you anticipate working.


There’s often many questions about Medicare/Medicaid and what these services will cover, such as deductibles, the cost of a brief stay in a nursing facility for hospice care, and home health care under certain conditions. However, it doesn’t cover custodial care for assistance with daily activities. You’re likely to pay more for medical costs as you age, which means supplemental plans may be necessary since Medicare won’t cover everything for you and your spouse. Medicaid is a health insurance program for low-income individuals. If you do not qualify, you may require long term care insurance.

Long Term Care Insurance

Financial planners typically recommend beginning long term care insurance in one’s 50s since the annual premium will be lower than starting in your 60s. However, if you wait until your 60s, you’ll pay less premiums overall until you reach 80 years old.


Unfortunately, the cost of a long term care policy is out of reach for many people. There are a number of alternative options that could prove helpful, like adding a rider to a life insurance policy, which allows you to use part of your death benefits to pay for long term care. Consider starting a health savings account (HSA), for which you may be eligible if you’re an employee with a high-deductible health insurance plan. An HSA allows you to make tax-deductible contributions. Many people are able to use their savings to pay for long term care. The amount of savings needed would be indicated by your anticipated level of care needs.

When it comes to preparing for long term care, starting early is key if your intent is to take out a long term care policy. But be sure to consider all possible alternatives first to find the long-term care option that suits you best.

Reviewed April 2024

About the Author

June is the co-creator of Rise Up for Caregivers, which offers support for family members and friends who have taken on the responsibility of caring for their loved ones. She is author of the book The Complete Guide to Caregiving: A Daily Companion for New Senior Caregivers.

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