Can you afford long-term care insurance?

Will you have enough money to cover your health care costs when you’re older?

Are you worried that you may not have family or friends who can properly take care of you as you age? Do you wonder if your nest egg will cover your long-term care costs?

Many Canadians expect that the government will cover health care costs when they get older. Yet the reality is very different.

When it comes to government-subsidized home care or long-term care, only some basic care is covered by a patchwork of provincial services, leaving a good portion of long-term care costs to be paid by you. And these costs are on the rise, as the list of approved health care expenses gets shorter every year.

You may want to follow the lead of Mary and Sonil. This couple wants to live in their three-story Toronto house until they can’t handle the upkeep, or a decline in their health means they can’t deal with stairs and need help with personal care.

They don’t have kids to care for them in their old age, and they are concerned about the health problems running in both of their families that may manifest themselves later. So when they were 65 and still in decent health, Mary and Sonil gave themselves peace of mind by buying long-term care insurance. Their financial advisor explained that it’s better to buy this insurance before it’s needed, since it can be hard to get once health problems start occurring.

Their insurance will start to pay benefits if they need help with any two of these five everyday personal care activities:

  • bathing
  • dressing
  • eating
  • toileting (due to incontinence or mobility problems)
  • getting out of bed; transferring from bed/toilet to wheelchair

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When Mary and Sonil turned 75 they both were in fairly good health, but they didn’t have as much strength or energy as they once had. They were tired of shoveling snow, and gardening had become a literal pain in the neck. Their 80-year-old house needed more and more repairs, which was also cutting into their savings.

Some of their friends had moved into an attractive local retirement home and were loving it, so they decided to explore this option for themselves.

It would cost them $7,000 a month ($3,500 each) for a nice room, 3 meals a day served in a dining room, having access an on-site nurse, and a wide variety of daily activities and day trips to keep them active and engaged. Their costs would be about $84,000 a year, not including their telephone bill, and other purchases including clothing.

They shopped around and discovered that some retirement homes charged as little as $1,500 per person per month, but those had fewer activities and the food was more institutional. And they were shocked to learn that there are homes that cost upwards of $6,000 per person a month!

They researched the cost of hiring home care, and learned that charges range from $15 to $75 an hour. They knew that if they started needing more help, that would add up fast and negotiating the stairs would still be a problem.

They quickly realized that their government pensions and dwindling after-tax savings wouldn’t cover their costs. However, the sale of their home would free up about $600,000, which would certainly help.

Their advisor presented them with some options. If they invested all their money in safe investments like Guaranteed Investment Certificates (GICs), they’d only earn about 2% a year. The money from the sale of their home would run out in about 7-1/2 years if they moved into a retirement home. This would get them into their early eighties but then what? They may live into their nineties, or even top 100!

Placing savings in riskier investments such as mutual funds could bring higher rates of return, but could also potentially lose value from year to year, leading to an even swifter evaporation of their funds.

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Putting this risk into perspective, their advisor pointed out that if their savings drop by 25% in one year, they would need to earn 33% on their money the next year to make up the difference. If their investments dropped by 50%, they’d need to make 100% to make up the difference! Their savings would shrink even faster, because they would have to keep drawing up on the remaining funds to cover their expenses. Mary and Sonil agreed that this type of investment strategy was too risky.

Instead, they decided to purchase of a joint annuity with some of the proceeds from the sale of their house. It started providing them with an income that was contractually guaranteed and almost tax-free, which they would receive for the rest of their lives, even if they outlived the funds originally invested in the annuity. This provided them with a lot of comfort. Their second safety net was their long-term care insurance.

Mary and Sonil confidently moved into their first choice of retirement residence, and surrounded by friends, good food and a wide variety of activities, they knew that they had made a good choice, and could sleep well, knowing they could cover their costs and live in dignity.

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Is long-term care insurance right for you?

Long-term care insurance is often for people who prefer to know that their financial health care costs will be covered for life. It can also be for people who are passionate about leaving behind money to support friends, family and their favourite charities after they die because the thought of spending down their entire estate during their lifetime makes them uncomfortable.

Because the benefits paid from long-term care insurance can be indexed to inflation, everyone can find comfort in this insurance product.

Knowing that long-term health costs are taken care of also allows people to explore advanced tax-smart and creative ways to redirect some estate assets away from the taxman, but that’s a story for another blog, or a conversation you could have with your financial advisor.

What does long-term care insurance cost?

The cost of long-term care insurance varies with such things as your age (the younger you are, the lower the cost); health; what size of monthly payment you choose; and if you choose extras like inflation protection or lifetime coverage vs. payments over a fixed number of years.

In addition, insurance costs can vary depending on your health; family medical history; and your desire to leave a legacy for the people and causes you are passionate about, or simply your desire not spend down all your assets during your life just in case you need funds for a special reason.

To give you an idea of cost, Mary and Sonil, a healthy 65-year-old couple, paid this for their shared long-term care insurance plan:

Annual insurance premium:  $4,594.56/year ($382.88/month)

The benefits they’ll receive with this plan will be: $1,500/month ($18,000/year) indexed to inflation.

At age 80, Sonil had a serious fall. He now needs a wheelchair to get around, and requires much more intensive daily care. Sonil and Mary made the hard decision to move Sonil into a long-term care home. They were no longer required to pay premiums eligible on their long-term care policy, and started collecting benefits, which had risen to $2,019/month ($24,228/year).

In total, over the 15 years of contributing to their policy, they have paid $68,919.

If they had put this money into safe investments like GICs, the 2% a year in earnings would have resulted in a total savings of about $86,385 by age 80.

Although that might sound like a lot, Sonil’s payments on his private room are $2,439/month ($29,268/year). If Sonil was using these savings alone to pay his long-term care costs, he would run out of money in less than three years. As it is, between the money he receives from his pensions, his long-term care insurance, and a top-up from their annuity payments, Sonil and Mary don’t have to worry about covering Sonil’s health care costs or other living expenses.

Keep in mind that at age 80, the probability is quite high that the average person could benefit from long-term care insurance for five years or more. It’s clear that In the case of Mary and Sonil, their policy would more than pay for itself.

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Are you worried that long-term care costs may be out of reach when you need the care?

Here are a few solutions to covering long-term care costs:

  1. Buy long-term care insurance.
  2. If it makes sense, delay a move to a retirement home.
  3. If you need help taking care of your home, you can hire people to clean, shovel snow, do your gardening and cut your grass.
  4. If you need health care support, contact your local Community Care Access Centre. You may be eligible for a few hours of government-supported care a week.
  5. Because interest rates are currently very low, it may be advantageous to put some of your savings into a life annuity or similar guaranteed solutions for some or all of these reasons:
    i) Annuity income will be much higher than most other sources of guaranteed income today.
    ii) Life annuities generate a guaranteed income for life, even if you outlive your initial investment.
    iii) Increasing your income in this way can help pay for affordable individual or shared long-term care insurance and take away any worries you have of being able to pay for care you may need later in life.

Everyone’s situation is different but it’s certainly worth a look to see whether a long-term care insurance plan makes sense for you.

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