Most families don’t think about long-term care until a phone call forces the conversation. A parent falls. A spouse gets a diagnosis. Suddenly, questions about cost, coverage, and who will help come up, with very little time to sort them out. The simplest answer to “when should we plan for this?” is before care is needed, while health, time, and options are still on your side.
October is Long-Term Care Planning Month, a yearly reminder to have that conversation early. For benefits brokers and HR teams, the timing is useful too. It lands in the middle of enrollment season, when employees are already paying attention to their benefits.
What Is Long-Term Care?
Long-term care is help with everyday tasks when someone can’t manage them on their own because of an illness, injury, disability, or cognitive decline. These tasks, often called activities of daily living (ADLs), include bathing, dressing, eating, and moving from a bed to a chair.
Most long-term care is non-medical, which is why it’s so often misunderstood. It can happen at home, in an assisted living community, or in a nursing home. In fact, more people receive long-term care at home, and for longer, than in facilities.
How Likely Is It That You’ll Need Long-Term Care?
Almost 70%. Someone turning 65 today has almost a 70% chance of needing some type of long-term care services and supports in their remaining years.
How long care lasts varies. Women need care for an average of 3.7 years and men for 2.2 years, and 20% of people will need care for more than five years.
It isn’t only a retirement-age issue, either. Long-term care insurance claims data show claimants ranging from age 31 to 101. An accident or illness can change things at any stage of life.
What Does Long-Term Care Cost Today?
$80,080 a year. That’s the 2025 national median cost of in-home non-medical caregiver services, based on 44 hours of care per week. Other care settings are just as significant:
- Assisted living: $6,200 per month, or $74,400 a year
- Nursing home, semi-private room: $114,975 a year
- Nursing home, private room: $129,575 a year
Costs vary widely by state and by the level of care needed, and state-by-state data can give a clearer picture for your area. Either way, a few years of care can quickly use up savings that took decades to build.
Won’t Medicare Pay for Long-Term Care?
This is one of the most common misconceptions in long-term care planning. 58% of Americans believe Medicare will cover their long-term care costs.
Here’s the reality: Medicare doesn’t pay for long-term care, and neither does most health insurance, including Medicare Supplement (Medigap) plans. Medicare may cover a short-term stay in a skilled nursing facility for up to 100 days after a hospitalization. That’s rehab and recovery care, not ongoing help with daily living.
Medicaid does pay for long-term care, but only for people who meet their state’s eligibility rules, which include income and asset limits. Families who don’t qualify generally pay out of pocket.
Another common belief is “I probably won’t need it.” 41% of Americans doubt they’ll live long enough to use long-term care insurance, even though the odds of needing care are high.
Why Does Planning Before Care Is Needed Make Such a Difference?
Your health is what qualifies you. Individual long-term care coverage usually involves health questions or medical underwriting, and insurers decline nearly half of applicants after age 70. Once a health condition develops, or care is already needed, options narrow quickly.
Coverage needs time to do its job. People typically buy coverage long before they use it. Claims data shows an average of 14.8 years between buying a policy and becoming eligible for benefits.
Planning keeps decisions in your hands. An early plan lets you think through where you’d want to receive care, who might help, and how it will be paid for. Without one, those decisions tend to happen in a crisis, and they often fall to family members.
Where Does Life with LTC Fit Into Long-Term Care Planning?
Life Insurance with Long-Term Care combines two protections in one policy. If the insured person needs qualifying long-term care, they can access benefits to help pay for it. If they never need care, the policy pays a death benefit to their beneficiaries.
Offered as a voluntary benefit at work, it gives employees a practical way to plan early:
- Offered as a voluntary benefit at work, it gives employees a practical way to plan early:
- Enroll while healthy and working, often with guaranteed issue
- Pay through convenient payroll deduction
- Keep value in the policy even if care is never needed
What is guaranteed issue? It means eligible employees can enroll up to a set amount of coverage without answering health questions, typically during a defined enrollment window. For employees who might not qualify for individual coverage, that can make all the difference.
The Role of Benefits Brokers
For many employees, a broker is the reason long-term care planning comes up at all. Long-Term Care Planning Month offers a natural, timely way to bring it to employer clients before year-end enrollments wrap up. Features worth highlighting:
- Dual-purpose coverage: One policy addresses both life insurance and long-term care needs.
- Guaranteed issue enrollment: Eligible employees can get coverage without medical underwriting, which matters most for people who might not qualify on their own.
- No reduction to death benefit: Some plan designs preserve the death benefit even after LTC benefits are used, so families don’t have to choose between care and legacy.
- Level premiums: Premiums are based on age at enrollment and designed to stay level, which makes budgeting easier.
Why Does Long-Term Care Planning Matter for Retention?
Employees who understand and are satisfied with their benefits are 1.4 times more likely to feel engaged and 1.2 times more likely to be productive at work.
Loyalty is also more fragile than it looks. 77% of employees intend to stay with their current employer, but only 18% plan to stay because they truly want to. Benefits that meet real-life needs and are explained clearly help close that gap. Long-term care planning is one of those needs, and it affects employees of every age.
Frequently Asked Questions
When should someone start long-term care planning?
Earlier is generally better, since age and health both affect eligibility and cost. For traditional individual coverage, ages 55 to 65 are often cited as the ideal window, but workplace coverage can make it possible to start sooner.
Does Medicare cover long-term care?
No. Medicare doesn’t cover ongoing help with daily living. It may cover short-term skilled nursing care for up to 100 days after a hospitalization, under specific conditions.
What happens to Life with LTC coverage if care is never needed?
The policy pays a death benefit to the insured person’s beneficiaries, so the coverage still provides value.
Is long-term care planning only for people near retirement?
No. An accident or illness can create a need for care at any age, and enrolling while younger and healthier generally makes coverage easier to get.
Looking Ahead
Long-term care planning works best when it happens on your schedule, not in response to a crisis. The odds of needing care are high, the costs are significant, and the window to qualify for coverage doesn’t stay open forever. Starting early keeps more options available for employees and for the families who count on them.
This Long-Term Care Planning Month is a good time to start that conversation. If you’re a broker or HR leader exploring how Life with LTC could fit into your benefits lineup, The VB Shop team is here to help.
This article is for general educational purposes and is not legal, tax, or financial advice. Coverage features, eligibility, guaranteed issue limits, and availability vary by carrier, plan design, and state. Please review plan materials or speak with a licensed professional for details.