LTC Archives - Page 7 of 7

Asking the Tough Questions on a Long-Term Care Application

September 25, 2026January 28, 2021 by Tim Fuller

Adult daughter and her aging mother sharing a warm moment while discussing long-term care planning

Long-term care applications ask personal questions: every medication, every diagnosis, and exactly how much the client weighs. Asking them well is part of getting the best possible offer.

Key takeaways

Explain up front why you’re asking, so clients understand the questions protect their offer.
Complete, honest answers lead to better recommendations and fewer surprises.
Know which common medications signal conditions that are usually uninsurable for LTC.

“You don’t have to be in perfect health for long-term care insurance, but you do need to be in relatively good health. It’s my job to get that picture right.”

Set the stage

Tell clients why you’re asking before you start. For example: “You don’t have to be in perfect health to get long-term care insurance, but you do need to be in relatively good health. It’s my job to gather that information, so I need to ask about your health and any medications.”

Get an accurate health picture

Just as a doctor needs complete information to diagnose, you need it to recommend the right carrier and product. Encourage clients to be thorough. Missing details surface in medical records anyway and can derail the case.

Learn the story behind the medication

Medications often tell the story. Become familiar with drugs associated with conditions that are typically uninsurable for LTC. Examples include:

Prednisone: often prescribed for COPD or rheumatoid arthritis
Requip (ropinirole): used for Parkinson’s disease (and restless legs syndrome)
Aricept (donepezil): used for dementia
Avonex: used for multiple sclerosis

More medication clues in six things to uncover before you submit.

Don’t guess the weight

Ask for current height and weight and check the carrier’s build chart. Estimates cause surprises.

Add a cover letter

Share context the application doesn’t ask for, such as healthy habits, lifestyle, and how conditions are being managed. The more the underwriter knows, the better the chance of a good outcome. See what to include in an underwriting cover letter.

Frequently asked questions

What health questions are on a long-term care application?

Medications, diagnoses, treatments, doctor visits, height and weight, and questions about daily functioning and cognition.

Which medications can lead to an LTC decline?

Drugs associated with conditions like dementia, Parkinson’s disease, or multiple sclerosis often signal an uninsurable condition. Ask about the diagnosis behind every medication.

Should I include a cover letter with an LTC application?

Yes, when there’s helpful context about lifestyle or how conditions are managed that the application doesn’t capture.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

Trust-Owned Life Policies With LTC or Chronic Illness Riders: Tax Traps to Avoid

September 25, 2026January 26, 2021 by Tim Fuller

Clients often want the death benefit out of their taxable estate and access to long-term care benefits if they need them. Putting a policy with an LTC or chronic illness rider in an irrevocable trust can seem to do both, but the structure can create estate and income tax problems if it isn’t handled carefully.

Key takeaways

Indemnity-style riders are generally better suited to trust ownership than reimbursement-style riders.
Reimbursement riders that pay the insured’s care providers could be treated as an incident of ownership or retained interest, pulling the death benefit back into the estate.
Under IRC 101(g), tax-free treatment of chronic illness benefits may depend on the payee incurring the care costs, which is uncertain when a trust owns the policy.

When a trust owns a policy with an LTC rider, there’s no specific IRS guidance on the tax result. The client must get tax advice first.

The planning goal

An irrevocable life insurance trust (ILIT) keeps the death benefit out of the insured’s taxable estate. The insured also wants access to rider benefits if they need care. A common approach uses an indemnity-type rider: the insured pays care costs personally (reducing their estate), and if they need cash, the trust can lend to them.

Why reimbursement riders are a problem

With a reimbursement rider, benefits are paid for the insured’s care expenses, so the trustee is effectively bound to pay the insured’s creditors. That could be treated as an incident of ownership or a retained interest, either of which could pull the death benefit back into the taxable estate.

The income tax question

IRC section 101(g) treats accelerated benefits paid for a chronically ill insured as paid “by reason of death,” and therefore generally income-tax-free. But for chronically ill insureds, section 101(g)(3)(A) conditions that treatment on the payment being for costs incurred by the payee for qualified long-term care services. When the payee is a trust that didn’t incur the costs, tax-free treatment is uncertain. Carrier materials commonly note there’s no specific IRS guidance on third-party ownership and that adverse income, estate, or gift tax results are possible.

The advisor’s responsibility

When a client wants third-party ownership of a policy with an LTC or chronic illness rider, make sure they get advice from a qualified tax advisor before implementing. For background on rider types, see the nuances of LTC and chronic illness riders.

Frequently asked questions

Can an ILIT own a life policy with an LTC rider?

It can, but it raises estate and income tax questions. Indemnity-style riders are generally better suited, and tax advice is essential.

Why are reimbursement riders a problem in a trust?

Paying the insured’s care expenses could be treated as an incident of ownership or retained interest, bringing the death benefit back into the estate.

Are LTC rider benefits tax-free if a trust owns the policy?

It’s uncertain. IRC 101(g) ties tax-free treatment of chronic illness benefits to the payee incurring care costs, and the IRS hasn’t issued specific guidance.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

Connect on LinkedIn →

Medicare, Medicaid, or Private Insurance: Who Really Pays for Long-Term Care?

September 25, 2026January 21, 2021 by Tim Fuller

Many people approaching retirement assume Medicare or Medicaid will cover their long-term care. Both programs have major limits, and clients who rely on them often discover that too late.

Key takeaways

Medicare covers limited skilled nursing care after a qualifying hospital stay, not ongoing custodial care.
Medicaid pays for long-term care, but generally only after assets are spent down, and choices of care setting can be limited.
Private long-term care coverage pays for care in a range of settings, including at home.

Medicare doesn’t pay for custodial care — the help with bathing, dressing, and daily living that people may need for years.

What Medicare covers

Medicare is designed for acute illness. It can pay for up to 100 days in a skilled nursing facility per benefit period, but only after a qualifying hospital stay of at least three days, only for skilled care, and with significant daily coinsurance after day 20. It doesn’t cover custodial care, which is what most long-term care needs involve.

What Medicaid covers

Medicaid, a joint federal and state program, pays a large share of the nation’s long-term care costs. But eligibility generally requires spending down assets to low limits, subject to look-back rules on transfers, and the care settings and providers available can be restricted. Program rules vary by state and can change.

Why private coverage matters

Private long-term care insurance, including hybrid products, pays for care in a variety of settings, including home, and preserves choice and assets. Clients who plan ahead keep control of how and where they receive care. See what modern LTC policies cover.

Position yourself as the educator

Explaining these differences is one of the most valuable services you can offer clients nearing retirement, and a natural way to start the LTC conversation.

Frequently asked questions

Does Medicare pay for long-term care?

Only limited skilled nursing facility care after a qualifying hospital stay. It doesn’t pay for ongoing custodial care.

Does Medicaid pay for long-term care?

Yes, but generally only after the person has spent down most of their assets, and care options may be limited.

What does private long-term care insurance cover that Medicare doesn’t?

Custodial care at home, in assisted living, in adult day care, and in nursing homes, depending on the policy.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

Connect on LinkedIn →

Long-Term Care Statistics Advisors Should Know (2026)

September 28, 2026January 14, 2021 by Tim Fuller

Long-term care is the unsolved problem in many middle- and upper-middle-income retirement plans. These are the numbers that matter most in client conversations, from reliable, current sources.

Key takeaways

Someone turning 65 today has almost a 70% chance of needing some type of long-term care, and 20% will need it for more than five years.
In 2025, national median costs were $35 an hour for in-home care, $6,200 a month for assisted living, and $10,798 a month for a private nursing home room.
Medicaid paid 61% of the $459 billion spent on long-term care in 2023, and 63 million Americans now provide unpaid family care.

Almost 70% of people turning 65 will need long-term care, and 1 in 5 will need it for more than five years.

How likely is it, and how long does it last?

Someone turning 65 today has almost a 70% chance of needing some type of long-term care services and supports.
Women need care longer on average (3.7 years) than men (2.2 years).
About one-third of today’s 65-year-olds may never need long-term care, but 20% will need it for more than five years.

Source: U.S. Administration for Community Living. Averages hide the real risk: the long, expensive claims. See why the average claim misleads clients.

What care costs (2025 national medians)

In-home care: $35 an hour (about $80,080 a year at 44 hours a week)
Assisted living: $6,200 a month ($74,400 a year)
Nursing home, private room: $10,798 a month (about $129,600 a year)
Private duty nursing: $90 an hour
Cost growth slowed in 2025, with most settings rising 1–5% year over year

Source: CareScout 2025 Cost of Care Survey. At 3% inflation, a three-year private nursing stay costing about $389,000 today would cost more than $800,000 in 25 years. More in our cost of care summary.

Who pays for long-term care

Medicaid paid 61% of the $459 billion spent on long-term care in the U.S. in 2023.
Long-term care accounts for roughly 36–37% of all Medicaid spending.
Medicare doesn’t pay for most extended custodial care; it covers limited skilled care after a qualifying hospital stay.

Source: KFF. Medicaid generally requires spending down assets first; see what Medicare and Medicaid actually cover.

The toll on family caregivers

63 million Americans, nearly 1 in 4 adults, provided ongoing care to an adult or a child with a complex medical condition or disability in the past year.
That’s an increase of 20 million caregivers from 2015 to 2025.

Source: AARP and National Alliance for Caregiving, Caregiving in the US 2025. See why family shouldn’t be the long-term care plan.

Planning options for the middle

High-net-worth clients may be able to self-fund, and many lower-income households rely on Medicaid. Clients in between face the hardest choices: traditional LTC insurance (with the possibility of rate increases), hybrid life or annuity products with guaranteed premiums, or self-funding. Compare approaches in traditional, hybrid, and rider options.

Frequently asked questions

What percentage of people need long-term care?

According to the U.S. Administration for Community Living, someone turning 65 today has almost a 70% chance of needing some type of long-term care.

How much does long-term care cost in 2025?

CareScout’s 2025 national medians: $35 an hour for in-home care, $6,200 a month for assisted living, and $10,798 a month for a private nursing home room.

Who pays for most long-term care in the U.S.?

Medicaid, which paid 61% of long-term care spending in 2023, according to KFF.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-28

Tim Fuller

President, SRS Inc.

Connect on LinkedIn →

How the Long-Term Care Market Has Changed: Traditional, Hybrid, and Rider Options

September 25, 2026January 7, 2021 by Tim Fuller

Long-term care used to mean one product: a traditional stand-alone policy. Today clients can choose among traditional coverage, hybrid life or annuity products, and riders on life insurance. Knowing how they compare is the key to reaching more clients.

Key takeaways

Traditional LTC policies typically offer the most care benefit per premium dollar, but premiums aren’t guaranteed.
Hybrid life and annuity products provide care benefits plus a death benefit, often with guaranteed premiums.
LTC and chronic illness riders add care benefits to life insurance, sometimes with little extra underwriting.

There’s no single right LTC product anymore. The right choice depends on the client’s age, health, budget, and how they feel about “use it or lose it.”

Traditional long-term care insurance

Stand-alone policies pay for qualified care with flexible design choices: benefit amount, benefit period, elimination period, and inflation protection. They usually offer the most benefit per dollar, but premiums can increase if a carrier raises rates for a class. See how to design traditional LTC for a budget.

Hybrid (asset-based) products

Life insurance or annuities with LTC benefits pay for care if needed and a death benefit if not. Many offer guaranteed premiums and single- or limited-pay options, and annuity-based versions often have easier underwriting for older clients. See four client profiles for asset-based LTC.

Riders on life insurance

LTC riders and chronic illness riders let the insured accelerate the death benefit for care. They’re often the most budget-friendly entry point and can reach clients who don’t qualify for stand-alone coverage. See life insurance with an LTC rider.

Adapting your approach

Clients are more aware of long-term care than ever and open to planning. Start the conversation by age 50, present more than one approach, and let the client’s priorities decide. Our LTC team can run side-by-side comparisons.

Frequently asked questions

What’s the difference between traditional and hybrid long-term care insurance?

Traditional policies pay only for care and usually have non-guaranteed premiums. Hybrids combine care benefits with a death benefit, often with guaranteed premiums.

Which is cheaper, an LTC rider or a stand-alone policy?

Riders can be less expensive as an add-on to needed life insurance, but stand-alone policies typically provide more care benefit per premium dollar.

When should clients start long-term care planning?

Ideally by age 50, when more options are available and premiums are lower.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

Connect on LinkedIn →

Generating Long-Term Care Leads From Your Existing Client Reviews

September 25, 2026December 23, 2020 by Tim Fuller

Seminars and direct mail can generate long-term care leads, but they’re costly and slow. Your best leads may already be in your database: clients who said “not now” because of price.

Key takeaways

Past prospects who stalled on price are warm leads when you can show a more affordable design.
A short follow-up meeting to revisit needs and budget often restarts the conversation.
Tailored, needs-based materials shorten the sales cycle.

The client who said “too expensive” two years ago may say yes to a plan designed around their budget today.

Step 1: Find price-sensitive prospects

Search your client and prospect records for people who were interested but didn’t buy because of cost. New designs, including hybrids, riders, shorter benefit periods, and couples discounts, may now fit. See couples discounts and asymmetrical designs.

Step 2: Schedule a short meeting

Reach out to each and schedule a brief review of what they need and what they can spend. Use the annual review questions in LTC fact-finding at the annual review.

Step 3: Use tailored materials

Needs-based, personalized proposals and marketing support shorten the sales cycle. Contact our LTC team for materials and side-by-side designs.

Frequently asked questions

Where can I find long-term care insurance leads?

Start with existing clients and past prospects, especially those who hesitated over price, then add referrals and community events.

How do I re-engage a prospect who said LTC was too expensive?

Offer a short meeting to review needs and budget, and present lower-cost designs such as shorter benefit periods or hybrid options.

Are seminars good for LTC lead generation?

They can work but are costly and slow. Mining your existing book is often faster and cheaper.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

Connect on LinkedIn →

Honoring a Last Wish to Die at Home: Why a Long-Term Care Plan Matters

September 25, 2026December 23, 2020 by Tim Fuller

“What’s your plan?” It’s the question we encourage advisors to ask every client about long-term care, because when there isn’t one, the consequences can be heartbreaking.

Key takeaways

Most people want to receive care, and spend their final days, at home.
Without private coverage, the rules of Medicare and Medicaid can make extended in-home care very hard to arrange.
A comprehensive long-term care plan preserves the choice of where and how care is received.

A long-term care plan isn’t just about money. It’s about being able to choose where you spend the end of your life.

A story that shows the stakes

A New York Times article, “Fighting to Honor a Father’s Last Wish: To Die at Home,” followed one family’s struggle to keep their father at home. It showed how the requirements of Medicare and Medicaid can make it nearly impossible to arrange enough in-home care, even when that’s what the patient and family want.

Why government programs fall short

Medicare covers only limited skilled care, not ongoing custodial help at home. Medicaid generally requires spending down assets and may limit home care hours and options. See what Medicare and Medicaid actually cover.

What a comprehensive plan provides

A comprehensive long-term care policy can cover home care, adult day care, hospice-related support, assisted living, and nursing home care. Most importantly, it gives the insured the dignity and independence to choose where they receive care. More on home care benefits.

Your role

Advisors have a real opportunity to protect clients’ dignity, not just their assets. Ask the question, and help them build a plan that fits their budget.

Frequently asked questions

Does long-term care insurance pay for care at home at the end of life?

Many comprehensive policies cover home care, and some include hospice-related support, allowing people to stay home.

Why is it hard to get extended home care through Medicare or Medicaid?

Medicare doesn’t cover ongoing custodial care, and Medicaid has asset limits and may restrict home care hours and options.

What question should advisors ask about long-term care?

Simply, “What’s your plan?” Most clients haven’t made one.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller

President, SRS Inc.

Connect on LinkedIn →

Asking the Tough Questions on a Long-Term Care Application

Set the stage

Get an accurate health picture

Learn the story behind the medication

Don’t guess the weight

Add a cover letter

Frequently asked questions

Tim Fuller

We’re Here to Help

The planning goal

Why reimbursement riders are a problem

The income tax question

The advisor’s responsibility

Frequently asked questions

Tim Fuller

We’re Here to Help

Tim Fuller

We’re Here to Help

Tim Fuller

Tim Fuller

Tim Fuller

Tim Fuller