Hybrid Long-Term Care and Short-Term Care Options

Read Time: 8:41
Published: Jan 31st, 2017
Hybrid Long-Term Care and Short-Term Care Options
Article Updated:January 15th, 2021

We see the consequences of long-term health care daily. The impact of changing our changing health due to aging or other factors adversely affects our families and finances. 

You see changes in your health, body, and even memory as you get older. For Generation X and Boomers, it is on your mind as you think about your future retirement. As the parents of these generations have aged, their adult children (age 40 to 60 primarily) have seen first-hand the costs and burdens long-term health care places on finances. The additional burden of caregiving or managing paid care services is mainly placed on the daughters and daughters-in-law. This stress creates issues within the family.

The role of the caregiver is physically and emotionally demanding. The cost of long-term health care is expensive and is getting even more expensive due to generational factors and as a result of COVID-19. 

In Washington, we have seen bi-partisan support of the idea of private Long-Term Care Insurance. In addition to federal and state tax incentives available for some people and businesses, Health Savings Accounts allow you to use pre-tax money toward paying your premium. 

Traditional Plans Still an Affordable Option

First, let's review Traditional Long-Term Care Insurance. Traditional Long-Term Care Insurance is still the primary way people address extended health care. Most states have partnership plans which provide additional dollar-for-dollar asset protection. These insurance policies are very affordable if purchased younger when your health is usually much better.

For example, a healthy married 50-year-old male could obtain a partnership certified policy in Colorado, featuring $4000 a month with an initial $150,000 growing by 3% compounded for life would run about $130 a month with a major company. 

The smaller the initial benefit you have in your policy, the lower the premium, the larger your benefit, the bigger the premium. Spousal discounts exist as well.

Premiums are intended to remain level. Some companies have had approved increases on older "legacy" policies priced decades ago prior to rate stabilization rules and record low-interest rates. Today, any increase must be approved by the state's insurance department and must impact a class of people, not an individual.

“Interest rates or investment return is vitally important.”

“Years ago, when interest rates were higher, an insurance company easily assumed a five percent interest rate when it priced policy for a 55-year-old.  If the actual interest rate was closer to say one percent and assuming every other actuarial assumption was correct, they would need a 50 percent or greater premium increase to pay out future claims.”

Jesse Slome, Executive Director for the American Association for Long-term Care Insurance (AALTCI) 

Rate Stabilization Rules Benefit Consumers 

Today Long-Term Care Insurance policies are priced for the low-interest-rate environment we have been experiencing. Also, experts say underwriting criteria is much more conservative than 20 years ago. For consumers today, this is good news. Many states have rate stabilization rules in place. This makes it much harder for an insurance company to raise the premium on these policies. You can find if your state has this rule in place by clicking here. You will also learn about partnership and tax incentives which may be available in your state.

Asset-Based or "Hybrid" Plans Provide Long-Term Care and Death Benefits

Today other options are available. One option getting the attention of the news media and advisors is an asset-based "hybrid" Long-Term Care policy. A hybrid policy is typically a life insurance policy or annuity with a rider for long-term care. While many insurance companies offer these types of policies, experts warn consumers to be careful of policy language.

These "linked-benefit" policies accelerate the death benefit (or cash value) and provide an extension of benefits for long-term health care once the death benefit has been used to pay for care. These policies follow the guidelines under federal law for Long-Term Care Insurance (U.S. Tax Code Section 7702B). 

The upside and benefits of these "hybrid" policies? You could get all your money back, and more, if you never require care. Most of these plans are single premium (or annual payment that can never go up). The single premium could be $75,000 or more, depending on your age and the amount of long-term care benefit you wish to have available. 

There are also life insurance policies with a Long-Term Care Acceleration rider. While these policies follow the same triggers as any Long-Term Care Insurance policies, they are less valuable as a solution for long-term care.

Once you qualify for benefits, the insurance company will accelerate the death benefit back to you on a 2% or 4% basis. The insurance company is just giving you the death benefit early. There is no "extension" of benefits and usually no inflation benefit. The total amount of the benefits is equal to the death benefit.  

Downside of Life/LTC Policies

The downside? Experts say the opportunity cost of the single premium may not be worth it for some people. You do not want to use money that should be set aside for retirement expenses. Traditional Long-Term Care Insurance is usually a better value for most people. If you have savings sitting in low return investments, a hybrid plan could be a solution. A specialist in Long-Term Care Planning can discuss the pros and cons of this type of policy.

Be careful. Sometimes life insurance gets marketed as a long-term care solution - but it is not! A life insurance policy with a "chronic illness" rider allows you to access the death benefit before you die, often only a limited portion of the death benefit – if the eligibility conditions are met. The definition of being "Chronically Ill." is not regulated by any government agency, so it varies depending on the insurance company. Traditional Tax-Qualified Long-Term Care Insurance and Hybrid (linked-benefit) policies use regulated triggers for benefits.

In some cases, these "chronic illness" rider policies require the policyholder to be "terminal," meaning you must have no chance of recovering, or your condition must lead to death. Most long-term care situations are not deemed "terminal." Some policies will not pay benefits over a certain age (making them a bit useless for long-term care). 

The best policies for long-term care planning use the regulated language triggers for Long-Term Care Insurance. If you are considering a combination product (combing life insurance or an annuity with long-term care benefits), only consider a true "hybrid" Long-Term Care policy that meets federal guidelines (U.S. Tax Code Section 7702B) for Long-Term Care Insurance.

Limited Duration / Short-Term Plans

The third option is what the industry describes as "Short-Term Care." These are limited benefit plans designed to be affordable and available to those with some existing health problems or older adults who may not qualify for traditional plans.

These short-term policies offer one to two years of benefits. Don't confuse this to mean your policy is only good for one or two years. Once you start receiving benefits, your benefits will exhaust in one or two years.

While this type of solution is not considered a complete solution for long-term health care - it will help your family when they most need it.

The vast majority of buyers (90 percent) of Short-Term Care insurance policies were age 60 or older; however, younger consumers with health issues that make them otherwise uninsurable or difficult to insure may find this an ideal and affordable solution. 

You need some plan to address the costs and burdens of aging. People require extended health care due to an illness, accident, or the impact of aging. 

If you have little or no assets, the Medicaid program is available. Otherwise, consider some plan to reduce the financial impact long-term care will have on your assets. Remember, long-term care planning is not all about money. Yes, long-term care expenses will create a cash flow issue, but it is also a family issue.

Prepare your family and finances for future long-term care before you retire, ideally in your 40s or 50s. Be sure to seek the assistance of a qualified Long-Term Care Insurance specialist who can guide you properly. 

“Some 45 percent were between ages 61 and 70 and around a third (36.5%) were between 71 and 80.”

“It’s a great option for people who waited too long to start the Long-Term Care planning process.”

Jesse Slome

Can You Self-Fund for Long-Term Care Expenses?

There is a fourth option: Roll the dice and do nothing. Self-funding future long-term health care expenses mean you become the insurance company. Usually, it means your family will become caregivers and decide how much of your money will be used for paid care. They control the quality and setting of your care. They may not make the same decisions as you would.

The risk of needing long-term care services and supports is high, especially as you get older. Since you can experience changes in your health at any time, it is best to obtain coverage when you still enjoy relatively good health.

“I'm a huge fan of this insurance. If you become ill, it ensures that your spouse will have enough money to eat and your kids won't be burdened with huge payments. Not having LTC insurance can be a $300,000 to $400,000 mistake.”

 Dave Ramsey, a nationally known author, and radio talk show host.

Tax Incentives for Qualified Long-Term Care Insurance Policies

Don’t forget to consider the tax benefits of these plans. In addition to being able to use pre-tax money from Health Savings Accounts, you can deduct premiums if you itemize under the medical expense section. Also, if you are self-employed or own an LLC, S Corporation or C Corporation the premiums can be a tax-deductible business expense. Seek the advice of a tax professional for details.

Also, many states offer tax incentives as well. Those states are:

Alabama Arizona Arkansas California
Colorado District of Columbia Hawaii Idaho
Indiana Iowa Kentucky Louisiana
Maine Maryland Minnesota Mississippi
Missouri Montana Nebraska New Jersey
New Mexico New York North Dakota Ohio
Oklahoma Oregon Virginia West Virginia
New Mexico New York North Dakota Ohio
Wisconsin      

The AALTCI says to work with a Long-Term Care specialist who represents all the top companies to help you learn your options and shop and design an affordable plan to make sure you have a successful retirement.

About the Author

An LTC News author focusing on long-term care and aging.

Editor's Note

No matter which type of plan you purchase, Long-Term Care Insurance is easy, affordable and rate stable income and asset protection. These policies are custom designed. Be careful, however, since premiums can vary over 100% between companies for the exact same coverage. This is why you should seek the help of a qualified Long-Term Care Insurance specialist. Find a specialist by clicking here.

Items to Discuss with a Long-Term Care Specialist:

  • Partnership – Most states offer special policies that provide dollar-for-dollar asset protection. The Long-Term Care Insurance Partnership Program might be one of the best-kept secrets in retirement planning. Make sure the specialist explains this program and how it might help you.
  • Tax incentives – There are federal tax incentives available for some people. If you own your own business be sure to ask.
  • Health Savings Accounts – If you have an HSA you can use the pre-tax money in your account to pay for the premium.
  • Asset-Based or Hybrid policies – These are life insurance or annuities with a rider for long-term care. Careful, only a handful are actually a long-term care benefit. However, one of these policies can provide you with the flexibility of both a long-term care benefit or a death benefit. They are expensive but can be paid with a single premium.
  • Health and Family History - Make sure the specialist asks you detailed questions about your health, family history, and retirement plans. Underwritingcriteria varies with each insurance company. If they are not asking you detailed questions then find another specialist.

Start Your Research By Using the LTC NEWS Cost of Care Calulator

Take a moment and find the current and future costs of long-term care in the area you live in. This will help you decide the amount of coverage is appropriate for you in your situation. For example, if you have a defined pension when you retire the amount of benefits you would need for long-term care would be less than an individual who will fund their future retirement with earnings off investments. In that case, protecting the principal is essential since that will produce your future income.

Find your state and use the LTC NEWS cost of care calculator by clicking here.

It is always best to start planning before you retire. Once you have your plan in place you will enjoy peace-of-mind and your family will thank you decades from now.

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LTC News Contributor James Kelly
James Kelly

Contributor Since
August 21st, 2017

LTC News author focusing on long-term care and aging.

About the Author

LTC News author focusing on long-term care and aging.

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