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Will you be prepared to cover the costs of long-term care?

Medicare often falls short when it comes to covering certain expenses. Here are some ways to plan ahead.


CONSIDER THESE FACTS: People turning 65 today have almost a 70% chance of needing some type of long-term care.1 And Medicare generally doesn’t cover the cost of that care.


Under the Chronic Care Act approved by Congress in 2018, Medicare Advantage plans purchased at extra cost may now pay for certain home care services. But Medicare itself offers very limited coverage for nursing home and home health services, and that coverage is subject to strict rules.

So what are your options as you begin to think ahead to how you’ll pay for the care you or your family might need? “Hoping that you’ll stay healthy isn’t enough,” says Robert Murray, director, insurance relationship manager, Retirement and Personal Wealth Solutions at Bank of America. He recommends putting together a plan for covering future medical costs using a combination of the suggestions below.


“Relying on self-funding as the exclusive means of covering the costs of long-term care has its risks.”

— Robert Murray, director, insurance relationship manager, Retirement and Personal Wealth Solutions, Bank of America

Save and invest for the care you’ll need

Creating a portfolio of conservative, liquid assets for the specific purpose of funding the needs of long-term-care is one choice to consider. Those assets could be placed in a revocable trust designated for your future care, says Murray. Or, if you are covered under a high deductible health plan, they could be invested in a health savings account (HSA) to pay for qualified medical expenses on a tax-free basis. But relying on self-funding as the exclusive means of covering the costs of long-term-care has its risks. “Your expenses may exceed the amount you’ve set aside and then deplete the assets you’ve designated for other goals or for heirs,” he says. “Then, again, if you set aside enough funds for a worst-case medical or disability scenario, you may be tying up assets that could otherwise be invested and growing.” Murray suggests bolstering that safety net with some sort of insurance.


Transfer some of the risk to an insurer

“You’ve got several approaches to consider here,” he says. Insurance policies for long-term care provide the most robust benefits, but insurers have had poor experience with these products, which has resulted in significant premium increases, even on existing policies. Generally premiums for long-term care insurance can, however, be treated as qualified medical expenses and paid for with money drawn from an HSA, which you can fund with pretax dollars, notes Murray. The premiums for long-term care insurance that you can treat as qualified medical expenses are subject to certain limits.


But what if you purchase a policy for long-term care and end up not needing care? In that case, you’d forfeit the money you paid out in premiums. For that reason, you might consider hybrid life insurance with a benefits rider for long-term care. If you use only a portion or none of the long-term-care benefits, your beneficiaries will receive a death benefit without income tax from the balance of the policy. Or you might explore permanent life insurance with a benefits rider for long-term care or chronic illness. This option could be a good fit if your primary goal is to provide a death benefit for your beneficiaries, but you also want the option of tapping into the policy’s death benefit early if you need it to supplement your health care costs.


“Your financial advisor can help you decide how to put together a long-term-care funding strategy that’s right for you — one that’s based on your age, your family’s medical history and the resources you have available to you,” says Murray. “Whatever option you choose, you’ll feel better that you’ve done something to prepare.”


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1 Pew Research Center, 2015 “World’s centenarian population projected to grow eightfold by 2050.”

2 U.S. Census Bureau, 1980, “2010 Census Special Reports.”


This material should be regarded as general or educational information on Healthcare/Medicare considerations and is not intended to provide specific healthcare/Medicare advice. If you have questions regarding your particular situation, please contact your legal or tax advisor.


Merrill, its affiliates, and financial advisors do not provide legal, tax, or accounting advice. You should consult your legal and/or tax advisors before making any financial decisions.


Long-term-care insurance coverage contains benefits, exclusions, limitations, eligibility requirements and specific terms and conditions under which the insurance coverage may be continued in force or discontinued. Not all insurance policies and types of coverage may be available in your state.


All guarantees and benefits of the insurance policy are backed by the claims-paying ability of the issuing insurance company. They are not obligations of, nor backed by, Merrill or its affiliates, nor do Merrill or its affiliates make any representations or guarantees regarding the claims-paying ability of the issuing insurance company.


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