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Chances are you’ve come across a headline or two pointing out that retirement health care costs will likely run well into the six figures. What often gets lost in translation is that those scary estimated costs are spread out over a retirement that is expected to last 20 or more years.

As an analysis by T. Rowe Price calmly pointed out, when you break down the big scary number into a monthly or annualized basis throughout retirement, it becomes a much more manageable sum that can often be paid for out of regular retirement income, or by dipping into savings from time to time.

That’s the good news.

Now some not-so-good news: Those estimates don’t factor in the cost of needing long-term care.

It’s vitally important to understand that long-term care is not solely about nursing homes.

Long-term care is a catch-all phrase for all sorts of help older adults may need in their homes. That can include so-called activities of daily living such as help with bathing, dressing and eating. Help with household chores and errands is another common need.

The odds you might need long-term care help

HealthView Services is a data company that provides retirement health care estimates for financial advisers and consumers, drawing from government data, medical claims and actuarial data on life expectancy. It recently published a report on both the potential for needing long-term care help later in life and the potential cost of that care.

A healthy 65-year-old male has a 44% probability of needing some level of long-term care during his expected life span. For a woman, the odds are 56%. If those 65-year-olds are married there’s a 75% chance that at least one spouse will need long-term care assistance.

If a 65-year-old has heart disease, the odds of eventually needing long-term care rise to 61% for women and 45% for men.

In what may at first seem counterintuitive, certain health conditions lower the probability of needing long-term care. For instance a 65-year-old female smoker has a 35% probability of needing long-term care, and for male smokers the odds are 26%. That’s because smokers have much shorter average life expectancies: 84 years for women and 82 for men. By comparison, HealthView estimates a 65-year-old with no serious health conditions has a life expectancy of 89/87.

Those are just averages; if you have a serious medical condition, but end up living beyond your average life expectancy, your odds of needing care rise. For example, if a 65-year-old female smoker is still alive at 90, the odds of her needing long-term care assistance rise to 46%. (Side note: Life expectancy estimates are when 50% of a given cohort will be dead, and 50% will still be very much alive.)

On average, HealthView’s data suggests that someone will need care for no more than three years. Keep in mind, that’s per person. For a married couple the years of care can be higher if both need help at some point.

The cost of long-term care

Even before COVID-19, there was a desire among older people to stay at home rather than move to a nursing care or assisted living facility. HealthView crunched the numbers and for someone who receives 44 hours of at-home care a week today, the annual cost adds up to a national average of $50,000. If the need is for 12 hours of care (84 hours a week), the average cost today is more than $107,000. Double that for 24/7 care. Those are the costs for someone needing care today — in today’s dollars. The costs are obviously going to be a whole lot higher if you need long-term care 10, 15, 30 years from now.

Time for an important disclaimer: Those are just broad estimates. The actual cost will of course depend on where you live, and the specific level of care needed.

Even if your costs are half those sums, it is still a significant outlay.

The value of sitting down with a certified financial planner

Panic is not a healthy response to all that. Nor is sticking your head in the sand and deciding there is nothing you can do to plan for the potential need to pay for long-term care.

Take a deep breath. One of the smartest moves is to work with a financial planner. Not someone who sells long-term care insurance, or life insurance.

Both may be a smart solution if you want to plan for long-term care. But the first step is to get uncompromised clear-eyed advice from a financial pro who isn’t in the business of selling you a long-term care insurance or life insurance policy.

There are many possible ways to address planning for potential long-term care costs if you live a long life. You want someone who will look at all the options based on your financial situation today (and in retirement).

If the recommendation is long-term care insurance or life insurance, great. You can now shop for either with confidence, with advice from your planner on what features to focus on. Many fiduciary financial planners will work with clients on an hourly or project basis.

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