Start with two numbers. Roughly seven in ten people turning 65 will need some form of long-term care during their lives. And the national median cost of a private room in a nursing facility now runs well north of $100,000 a year — with home care aides not far behind at full-time hours.
The coverage gap
Medicare pays for short rehabilitative stays after a hospitalization — not for extended custodial care, which is most of what long-term care actually is. Medicaid pays only after assets are largely spent down. The gap between those two programs is precisely where retirement savings, and the healthy spouse's future, sit exposed.
Three ways to cover it
Traditional long-term care insurance. The most coverage per premium dollar, but premiums can rise and the benefit is use-it-or-lose-it.
Hybrid life insurance with care riders. A life policy whose death benefit can be accelerated to pay for care. Costs more, but the money goes to someone either way — care for you or a benefit to your family.
Annuities with chronic-illness benefits. Some contracts double the income payout during qualifying care needs. Underwriting is lighter, which matters if health history closes the other doors.
When to act
Pricing and insurability are both functions of age and health. The plan you can build at 55 is meaningfully cheaper and broader than the one available at 68 — and after a diagnosis, options narrow fast. This is the definition of a decision to make early.
