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Long-Term Care Insurance: The Retirement Expense Nobody Plans For

Adult child helping elderly parent at home - long term care planning
A Resource from MD Mortgage · Powered by MD Life Insurance

Long-Term Care Insurance:
The Retirement Expense
Nobody Plans For

7 out of 10 people turning 65 will need long-term care. The average nursing home costs over $114,000 a year. Most people have no plan to pay for it.

🏥 Medicare covers a maximum of 100 days of skilled nursing care. After that, you’re on your own — unless you planned ahead. Here’s what you need to know, and what your options actually are.

Traditional LTC Insurance
Hybrid Life + LTC Policies
Asset-Based LTC Strategies
Maryland Coverage Options
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A note from MD Mortgage: Long-term care is one of the biggest financial risks our clients face in retirement — yet almost no one talks about it at closing. We partnered with MD Life Insurance to bring you this complete guide. They specialize in LTC coverage and can get you a quote in minutes at mdlifeins.com/care.

Most Families Don’t Find Out They Have No Plan Until They Need One

By then, the cost is a crisis — not a planning item.

Picture this: You’ve done everything right. You paid your mortgage. You maxed your 401(k). You built a retirement nest egg that should carry you comfortably for the rest of your life. Then one day, a stroke. A fall. An Alzheimer’s diagnosis that comes on slowly, then all at once. And suddenly, everything you saved — your house, your IRA, your legacy — is being consumed by a care system that costs more per year than most people’s mortgages.

This is not a rare scenario. According to the Administration for Community Living (ACL), someone turning 65 today has nearly a 70% chance of needing some form of long-term care before they die. Not 7%. Not 17%. 70%. And the Federal Long Term Care Insurance Program (FLTCIP) reports that a nursing home currently costs over $112,000 per year — and projects that number will climb to nearly $186,000 annually within 20 years if inflation holds its recent pace.

Despite those numbers, most Americans have no plan. They assume Medicare will cover it. It won’t — not for long-term care. They assume their savings are enough. For most people, they’re not. They assume they’ll figure it out when the time comes. By then, the options are drastically fewer, the costs are dramatically higher, and the burden lands squarely on the people they love most.

70%
of people turning 65 will need long-term care
— ACL / HHS
$114,975
median annual nursing home cost (semi-private)
— CareScout 2025
3.1 yrs
average duration of long-term care need
— ASPE / HHS
100 days
maximum Medicare skilled nursing coverage — then it stops
— Medicare.gov
$138K
average total lifetime LTC cost per person
— HHS / ASPE 2022
1 in 5
Americans turning 65 will face over $200,000 in LTC costs
— ASPE 2025

The numbers don’t lie. And yet most people have no coverage in place. Long-term care insurance is the tool that keeps a health event from becoming a financial catastrophe — for you and for the family members who would otherwise have to step in.

What Medicare Covers — and the Cliff It Falls Off

The #1 myth in retirement planning is that Medicare covers long-term care. It doesn’t — at least not the way most people think. Here’s the reality according to Medicare.gov:

Medicare’s Skilled Nursing Facility Coverage — The Full Picture

Days 1–20

Medicare pays 100% — but only if you were admitted to a hospital for at least 3 days first and go directly to a skilled nursing facility (SNF).

Days 21–100

You pay a daily copay of $209.50 (2025 rate). Medicare covers the rest — but only if you continue to show medical improvement.

Day 101 and Beyond

Medicare pays nothing. You pay 100% — roughly $315/day or $9,500+/month for a semi-private room. With no end in sight.

And Medicaid? It only steps in after you’ve spent down nearly all of your assets. In Maryland, that typically means reducing countable assets to around $3,000. Your savings, your IRA, potentially even your home — all gone first.

This is why long-term care insurance exists. It is not a luxury. It is the mechanism that keeps you from having to choose between your legacy and your care. And as the team at MD Life Insurance describes it — the medical system is the coyote that circles your retirement savings, waiting for a moment of vulnerability. Long-term care insurance is the fence that keeps it out.

Your Three Main Options for Long-Term Care Coverage

Not all LTC coverage is the same. The right option depends on your age, health, existing assets, and what you want to protect. Here’s how the three main types stack up — and who each one is best for. The specialists at MD Life Insurance will walk you through all three options at no cost.

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Option 1: Traditional Long-Term Care Insurance

BEST PRICE-TO-BENEFIT

Traditional LTC insurance works like any other insurance policy — you pay a monthly or annual premium and the policy pays a daily or monthly benefit when you can no longer perform two or more Activities of Daily Living (ADLs) like bathing, dressing, eating, or toileting, or when you experience cognitive impairment.

Benefits typically include a daily benefit amount (e.g., $150–$300/day), an elimination period (like a deductible — usually 30–90 days before benefits begin), a benefit period (how long benefits pay — 2, 3, 5 years, or lifetime), and optional inflation protection riders to keep pace with rising care costs.

✅ Pros

Lowest premium for the highest benefit. Tax deductible (partially) for self-employed. Large benefit pools available.

⚠️ Cons

Use-it-or-lose-it — no benefit if you never need care. Premiums can increase over time.

Best for: Ages 50–65 in good health who want maximum coverage per dollar and are comfortable with a “pure insurance” structure.

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Option 2: Hybrid Life + LTC Policy

MOST POPULAR — NO WASTED PREMIUM

A hybrid policy combines permanent life insurance with a long-term care benefit rider. If you need care, the LTC benefit pays your bills — tax-free. If you never need care, your heirs receive the life insurance death benefit. If you change your mind entirely, many policies offer a return-of-premium option. The money is never just gone.

Many hybrid policies are funded with a single lump-sum premium or a short 10-pay schedule. A $100,000 single premium might provide $250,000–$400,000 in LTC benefits plus a $100,000+ death benefit. The leverage is significant.

✅ Pros

Money doesn’t disappear if unused. No premium increases. Death benefit preserves legacy. Often easier to qualify for.

⚠️ Cons

Higher upfront cost than traditional. LTC benefit pool may be smaller per dollar than pure LTC insurance.

Best for: Ages 55–70 who want the security of knowing their money is never wasted — whether they need care or not. Especially popular with homeowners who have equity to reposition.

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Option 3: Annuity with Long-Term Care Rider

ASSET REPOSITIONING STRATEGY

Some annuities offer a long-term care doubler or tripler rider — meaning that if you trigger the LTC benefit, your monthly annuity income doubles or triples to help cover care costs. This is a particularly attractive option for people who have already planned to use an annuity for retirement income and want to add a layer of care protection without buying a separate policy.

✅ Pros

Two-for-one: retirement income plus LTC protection. No separate underwriting for LTC in some products. Efficient use of a single asset.

⚠️ Cons

LTC benefit tied to annuity income — may not be sufficient for high-cost care. Varies significantly by product and carrier.

Best for: People already planning to use an annuity for retirement income who want to add care protection efficiently. Works well as part of a layered strategy.

Not sure which option is right for your situation? The team at MD Life Insurance will walk you through all three options for free. They work with dozens of top carriers and can show you side-by-side comparisons in a single call. Get your free LTC quote →

🏠 A Note Specifically for MD Mortgage Clients

Your home is likely your largest single asset. And for many of our clients, it’s also the asset most at risk if long-term care costs spiral out of control. Here’s why: without a care plan, many families are forced to sell the family home to fund care — or to tap a reverse mortgage under distress rather than as a deliberate financial strategy.

A properly structured LTC policy protects your equity. It keeps the house in the family. It means you’re not scrambling to refinance or sell under pressure. And for homeowners who have built significant equity, a hybrid life/LTC policy funded with a lump sum can actually reposition assets you were already sitting on — converting a CD, a low-yield savings account, or a portion of your investment portfolio into a benefit pool that’s two to three times larger.

This is exactly why we recommend our clients speak with the specialists at MD Life Insurance as part of their overall financial picture — not just at retirement, but when they’re refinancing, buying, or tapping equity. The two conversations belong together.

When Should You Get LTC Coverage?

There is a window for long-term care insurance. It doesn’t stay open forever. Premiums are based primarily on age and health at the time of application. The older you are, the more expensive coverage becomes — and the more likely you are to encounter health conditions that make you uninsurable altogether.

50s

The Sweet Spot

Lowest premiums. Most carrier options. Best chance of qualifying. The decade when smart families lock in coverage.

60s

Still Good — Act Soon

Premiums are higher but hybrid products are especially compelling. Health underwriting still manageable for most. Don’t wait for 70.

70+

Options Narrow Fast

Traditional LTC may be unavailable or cost-prohibitive. Asset-based and annuity strategies may still work. Get a quote immediately — every month costs more.

According to the CareScout 2025 Cost of Care Survey, nursing home costs have risen an average of 2–5% every single year. The policy you can get today will be more expensive next year — and harder to qualify for. There is genuinely no reason to wait.

“I Had No Idea How Fast It Could Disappear”

Real families. Real costs. Real consequences — and real protection.

$500,000 Gone in 4 Years

Patricia’s family · Rockville, MD

“My dad had $500,000 saved when he was diagnosed with Parkinson’s. He needed full-time memory care within two years. At $12,500 a month in Maryland, it was gone in under four years. He had to sell the house we grew up in to cover the last year. There was nothing left for my mom. She was 74 and starting over.”

What LTC coverage would have done:

A hybrid policy with a $300,000 benefit pool at age 58 would have cost roughly $200–$280/month. It would have covered the entire care bill. The house stays. Mom’s retirement stays intact. Read: You Saved $500K. A Nursing Home Could Take It in 4 Years →

The Hybrid Policy That Protected Everything

Michael & Diane · Silver Spring, MD · Ages 62 & 60

“We had $120,000 sitting in a low-yield CD doing basically nothing. Our advisor at MD Life suggested repositioning it into a hybrid LTC policy. We now have a $380,000 long-term care benefit pool for each of us, plus a $120,000 death benefit if neither of us ever needs care. The CD money is still working — it’s just working much harder now.”

Their coverage details:

$120K single premium → $380K LTC benefit pool each. 3% compound inflation protection. Home care, assisted living, and nursing home all covered. See what your numbers look like →

No LTC Plan vs. Protected Retirement

Scenario No LTC Coverage With LTC Insurance
2-year nursing home stay $230,000+ out of pocket — IRA, savings drained Policy pays — savings protected
Family home May need to sell to fund care Equity stays in the family
Surviving spouse’s retirement Devastated — starting over at 75+ Intact — retirement income continues
Children’s burden Forced to quit jobs or drain own savings Professional care funded — kids’ lives undisturbed
Medicaid spend-down Lose nearly everything before qualifying Assets protected — Medicaid not required
Legacy for heirs Depleted or gone Preserved — passed on as intended

Long-Term Care Is a Retirement Income Problem — Not Just a Health Problem

A nursing home stay doesn’t just affect your health. It affects your spouse, your home, your legacy, and the financial security of everyone who depends on you. The right coverage protects all of it. Take the free quiz at MD Life →

Every year you wait raises your premium and narrows your options. A 55-year-old pays roughly half what a 65-year-old pays for the same coverage.

Ready to Protect Your Retirement From Long-Term Care Costs?

🎁 FREE: Side-by-side comparison of all three LTC coverage types, personalized to your age, health, and assets — from our partner MD Life Insurance

No obligation. No pressure. Just real options from real specialists who do this every day.

LTC Specialists Since 2010
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Your Home Protected the Loan.
Now Protect What’s Inside It.

You worked with MD Mortgage to protect your home purchase. The next step is protecting everything else — your savings, your spouse’s retirement, and the legacy you’re building. Our partners at MD Life Insurance specialize in exactly that.

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LTC Coverage Quote

Traditional, hybrid, and annuity-based options. All three compared side-by-side for your age and health — free at mdlifeins.com/care.

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Retirement Income Quiz

See how your retirement savings stack up — and where the gaps are — in 2 minutes at mdlifeins.com/quiz.

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Talk to a Specialist

Call MD Life Insurance directly: 301-569-2224. Mon–Fri 9AM–6PM. Real people, real answers.

This post is provided by MD Mortgage in partnership with MD Life Insurance · Brookeville, MD · 301-569-2224 · mdlifeins.com · LTC insurance is not offered by MD Mortgage. Coverage provided through MD Life Insurance, licensed in MD, VA & DC. Statistics sourced from ACL/HHS, CareScout, ASPE, and FLTCIP. Not medical, legal, or financial advice. Consult a qualified advisor for your specific situation.