Published on January 17, 2020. Last Updated on December 23, 2025.
Long-term care insurance is one of the most misunderstood topics in estate planning and elder law. Many people believe it’ss only relevant if they expect to enter a nursing home, or that it becomes unnecessary once Medicaid planning is an option. As an elder law attorney, I regularly see how these assumptions prevent families from fully understanding their planning options.
I am not licensed to sell long-term care insurance, and I do not receive compensation for recommending it. I raise this topic because long-term care insurance often plays a critical role in helping individuals maintain control, independence, and dignity as they age. Unfortunately, misinformation and confusion cause many people to dismiss it before they truly understand what it can provide.
This article is not about selling a specific policy or product. Instead, it’s about reframing how long-term care insurance fits into a comprehensive long-term care and estate planning strategy.
An Elder Law Attorney’s Perspective on Long-Term Care Insurance
Much of my practice focuses on asset protection, asset preservation, and Medicaid planning. In many situations, my firm is able to help families protect assets even after a loved one has entered a nursing home and requires skilled-level care. Because of this, some people assume I am opposed to long-term care insurance.
That assumption could not be further from the truth.
Medicaid planning is an essential tool, but it is not designed to maximize choice. It is designed to provide coverage once resources are limited and eligibility rules are met. Long-term care insurance, by contrast, is about preserving options long before a crisis occurs.
Both tools can be valuable. They simply serve different purposes.
What Clients Really Want as They Age
In all my years of practice, I have never had a client tell me they want to move into a nursing home.
What I hear repeatedly is this:
- “I want to stay in my home as long as I can.”
- “If I can’t stay at home, I want to choose where I live.”
- “I don’t want my family making decisions for me because of money.”
These goals are universal. People want familiarity, independence, and control. They want to age in a setting that feels like home, not one dictated solely by financial necessity.
For many individuals, remaining at home with in-home care is the ideal scenario. For others, a personal care home becomes the preferred option once living at home is no longer safe.
Understanding Personal Care Homes and Why They Matter
Personal care homes are often misunderstood or overlooked in long-term care planning. These facilities typically assist with daily activities such as:
- Bathing and dressing
- Medication management
- Meals and housekeeping
- Supervision and support
Personal care homes are usually one step above independent living and do not provide skilled nursing care. Many of these facilities are attractive, comfortable, and designed to feel like a true residence rather than an institution.
Importantly, personal care homes are often private pay. While some limited assistance programs may exist, Medicaid generally does not cover long-term stays in personal care homes the way it covers nursing home care.
This creates a significant gap between what people want and what public benefits are designed to provide.
Long-Term Care Insurance Is About Choice, Not Institutions
One of the most important points I try to convey to clients is this:
Long-term care insurance is not primarily about nursing homes.
At its core, long-term care insurance is about funding care where you want to receive it. That may include:
- Care provided in your own home
- Assisted living or personal care homes
- Adult day care services
- Skilled nursing care, if and when it becomes necessary
Regardless of the type of policy—traditional, partnership, or hybrid—the most valuable benefit long-term care insurance provides is flexibility. It allows people to make care decisions based on preference and safety, rather than cost alone.
Different Types of Long-Term Care Insurance Policies
There are several categories of long-term care insurance, each with its own structure and benefits. While a detailed comparison is beyond the scope of this article, it is helpful to understand the broad categories.
- Traditional long-term care insurance policies provide a pool of benefits that can be used for qualifying long-term care services.
- Partnership policies offer additional asset protection features under certain state programs.
- Hybrid policies combine life insurance with long-term care benefits, providing a death benefit if care is never needed.
The specific policy type matters less than the planning purpose behind it. The key question is not, “Will this pay for a nursing home?” but rather, “Will this help me stay where I want to be for as long as possible?”
Why Cost Is Often Viewed Incorrectly
Another common concern is the cost of long-term care insurance. Many people see premiums as an unnecessary expense, particularly if they believe Medicaid will eventually cover their care.
In my experience, this perspective often comes from individuals who have never seen a family member forced to leave their home or personal care setting because they could no longer afford it. Once someone has lived through that experience, the value of long-term care insurance becomes much clearer.
In virtually every case where a person has watched a loved one move prematurely due to financial constraints, the conversation changes. Instead of asking whether long-term care insurance is worth the cost, they ask whether it could help them avoid the same situation.
The Emotional and Financial Cost of Limited Options
When long-term care decisions are driven solely by finances, families often face difficult and emotional choices. Care decisions become reactive rather than proactive. Loved ones may feel guilt, stress, and conflict over what could have been done differently.
Long-term care insurance does not eliminate all challenges, but it can significantly reduce pressure by:
- Extending the time someone can safely remain at home
- Allowing transitions to occur gradually rather than abruptly
- Reducing reliance on family caregivers
- Preserving dignity and autonomy
These benefits are difficult to measure in dollars, but they are deeply felt by families who experience them.
Long-Term Care Insurance and Medicaid Planning Can Work Together
One of the most persistent myths is that long-term care insurance and Medicaid planning are mutually exclusive. In reality, they often complement each other.
Medicaid planning focuses on eligibility rules, income limits, and asset protection once care needs become significant. Long-term care insurance focuses on delaying or avoiding the point at which Medicaid becomes necessary.
Even when Medicaid ultimately becomes part of the plan, long-term care insurance can:
- Cover care that Medicaid does not
- Provide more desirable living options
- Reduce the urgency of eligibility decisions
Used together, these strategies can create a more balanced and humane long-term care plan.
Planning Early Creates Better Outcomes
The best time to evaluate long-term care insurance is before a health crisis occurs. Early planning allows individuals to:
- Consider multiple policy options
- Secure coverage at more favorable rates
- Make decisions without pressure
- Integrate insurance into a broader estate plan
Waiting until care is imminent often eliminates options entirely. By that point, planning becomes limited and reactive.
This Is Not a One-Size-Fits-All Decision
Long-term care insurance is not appropriate for everyone. Health, finances, family support, and personal goals all matter. What is essential, however, is understanding the role it can play before dismissing it outright.
Taking time to speak with a licensed insurance agent or financial professional does not commit you to purchasing a policy. It simply gives you information—information that allows you to make an informed decision rather than one based on assumptions or fear.
Start Planning for Where You Want to Live
Long-term care planning is ultimately about maintaining control over your future. While nursing homes provide critical and necessary services, most people hope to delay or avoid institutional care if possible. Long-term care insurance can be a powerful tool in making that goal achievable.
Don’t let misinformation or confusion prevent you from exploring options that could allow you to remain in your home or choose a personal care setting that aligns with your values. Planning ahead creates flexibility, reduces stress, and protects quality of life.
If you have questions about long-term care insurance, Medicaid planning, asset protection, or estate planning, contact Bellomo & Associates or consider attending one of our free educational workshops. We’re committed to helping families understand their options so they can plan with confidence and protect what matters most.
