Question 1

What does Medicare cover for long-term care?

Accepted Answer

Medicare covers $0 for custodial long-term care — the help with daily activities (bathing, dressing, eating) that most people associate with nursing home or home health aide care. Medicare does cover short-term skilled nursing care after a hospital stay of at least 3 days, but only up to 100 days, and only while you're improving. After that, you're on your own. This is one of the most common planning blind spots: retirees assume Medicare will cover extended care costs, but it won't. Without a plan, long-term care expenses come directly out of retirement savings.

Question 2

What is a hybrid long-term care policy?

Accepted Answer

A hybrid (or asset-based) long-term care policy combines life insurance or an annuity with a long-term care benefit. If you need care, the policy pays for it — often a multiple of your original premium. If you never need care, your heirs receive a death benefit. This solves the "use-it-or-lose-it" problem of traditional LTC insurance. Hybrid policies typically require a lump-sum or limited-pay premium and often don't require medical underwriting for the base policy. They've become increasingly popular as traditional LTC premiums have risen and some carriers have exited the market.

Question 3

How much does long-term care cost in Florida?

Accepted Answer

In Florida, the median annual cost of a private nursing home room exceeds $108,000 (Genworth 2023 Cost of Care Survey). Assisted living facilities average around $45,000–$54,000 per year. Home health aide services run $55,000–$65,000 annually for full-time care. The average person who needs long-term care uses it for 3 years — which means a potential exposure of $150,000–$325,000 or more, per person. For a couple, the risk doubles. These costs can quickly deplete a retirement portfolio that took decades to build.

Question 4

Should I self-insure for long-term care?

Accepted Answer

Self-insuring means setting aside assets to cover potential long-term care costs rather than purchasing insurance. This can work if your net worth is substantial enough to absorb $300,000–$500,000+ without significantly impairing your retirement income or your spouse's financial security. For most retirees with $500K–$2M in savings, self-insurance carries real risk — especially if both spouses need care, or if care is needed early in retirement when the portfolio hasn't had time to grow. The analysis depends on your total assets, income sources, spouse's needs, and Medicaid planning goals.

Question 5

What is the Florida Long-Term Care Partnership Program?

Accepted Answer

Florida's Partnership Program allows you to protect your assets from Medicaid spend-down requirements in proportion to the benefits paid by a qualifying long-term care insurance policy. For example, if a partnership-approved policy pays $200,000 in benefits, you can keep $200,000 in assets and still qualify for Medicaid — rather than spending down nearly everything first. This "asset protection" feature makes partnership-qualified policies a powerful tool for middle-income retirees who want to preserve assets for a spouse or heirs while still having access to Medicaid as a backstop.

Income Risk Is Really About Loss of Flexibility

The Cost of Not Planning

Three Approaches We Evaluate

Traditional LTC Insurance

Hybrid / Asset-Based

Self-Insurance

Long-Term Care Fits Into Your Bigger Plan

Medicare Planning

Investment Management

Estate Planning

Long-Term Care Questions

Know Your Options Before You Need Them