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May 15, 2012 by |

Weighing the Risks of Long-Term-Care Insurance

On behalf of The Evans Law Firm on Tuesday, May 15, 2012.


Should You Purchase Long-Term-Care Insurance?

Costs of long-term care are rising, and more seniors are finding themselves in positions where such care appears necessary or desirable. But is Long-Term-Care Insurance a reasonable and viable way of dealing with this problem? A recent article in the Wall Street Journal weighs the pros and cons of purchasing long-term care insurance. The article pits the arguments of George Mason University professor Mark Meiners against those of California Advocates for Nursing Home Reform senior staff attorney Prescott Cole.

While the two consider similar evidence to arrive at diverging opinions, they agree on certain important facts about long-term-care insurance. For one, both Meiners and Cole agree that the decision about whether to purchase long-term care insurance is most pressing to individuals with “mid-wealth” or mid-level savings – people who may identify with the middle-class income bracket. With more than $2000 of savings, these individuals do not qualify for Medicaid, but at the same time are not capable of financing their own long-term care using savings.

The two experts also agree that regardless of whether or not someone purchases long-term-care insurance, he or she should have additional savings set aside for the purpose of long-term care. This is because few, if any, long-term care policies offer 100% coverage of daily care in nursing homes. Even if you are covered under a long-term-care insurance policy, you will most likely have to pay a portion of the nursing home bills. This is especially significant given the “90-day rule” or policy that most insurance packages offer. Given that many long-term-care insurance policies do not kick in until after the insured has spent 90 days in a nursing home facility, individuals wind up bearing the financial responsibility for any stay under 90 days.

Prescott Cole points out that this 90-day rule, paired with the statistic that 67% to 70% of seniors who enter nursing homes leave before 90 days, means that regardless of whether or not a senior has long-term-care insurance, they will probably have to pay out-of-pocket for their stay at a nursing home. Cole applies this instance to a more general argument against long-term-care insurance: the cost (typically $3,500 per year) is extremely high, while the benefits are low. In addition, Cole argues that the risk associated with long-term-care is low; today, only 3.7% of seniors are currently living in nursing homes. As an alternative to long-term insurance, Cole suggests that a person might begin early on to set aside the amount he or she would otherwise pay for long-term insurance into savings specifically for that purpose. That way, the individual would have a sizeable fund on which to draw should the need for long-term care arise.

Meiners counters that this proposed method could be risky if the cost of long-term-care eventually exceeds the amount of savings. Yet, Meiner also acknowledges that even with long-term insurance coverage, an individual may outlive or outspend that coverage, thereby acknowledging that not even a long-term insurance plan is an entirely safe bet.

An added consideration – especially to seniors considering long-term care insurance – is that of insurance scams and fraud. If you suspect that you or a loved one has been the victim of long-term care insurance fraud in California, contact the Evans Law Firm for a free and confidential consultation at 415-441-8669 or 1-888-50EVANS (3-8264). Or contact the Evans Law Firm by email at

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