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Long-Term Care Annuities: Pros and Cons

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Requiring long-term care later in life can be pricey. According to SeniorLiving.org, in 2024, the median annual cost for nursing care in a semi-private room is $107,146. For most seniors, that amount could soon exhaust their assets. Buying long-term care insurance is one option for offsetting these costs, but rising premiums can make that expensive, too. A long-term care annuity may be a better choice for helping you plan for the future.

If you have questions about long-term care planning, consider speaking with a financial advisor who serves your area.

What Is a Long-Term Care Annuity?

An annuity is an insurance contract in which you pay a premium, either upfront or monthly, to receive payments back from the insurance company at a later date. An annuity can be immediate, meaning your annuity payments begin within a year of paying the initial premium. Or it may be deferred, with payments beginning at a specified date in the future, such as your 65th birthday.

A long-term care annuity is a deferred annuity that includes a long-term care rider. A rider is essentially an add-on you can include when purchasing an annuity that offers extra features or benefits.

Here’s how it works: You purchase an annuity with a long-term care rider. Then, when you eventually need long-term care, you can begin receiving payments to help with those expenses. Payments can be made to you monthly or as a lump sum. Your annuity company can either give you funds to use as needed, or reimburse you after the fact for long-term care expenses you’ve already paid for.

To activate the long-term care rider and begin receiving benefits, you’ll have to meet medical standards that necessitate long-term care. For example, that might mean being diagnosed with a chronic or terminal illness. Examples include Alzheimer’s disease or another degenerative disease that requires round-the-clock care, either in home or in a nursing facility.

Annuities grow with interest and a long-term care annuity can either be fixed or variable. With a fixed annuity, you’re earning a guaranteed rate of return. This type of annuity is generally considered a safe investment since your returns are predictable. A variable annuity tends to be riskier. But, if the underlying investments perform well, it offers the opportunity to earn higher returns.

What Are the Pros of a Long-Term Care Annuity?

A woman discussing long-term care with her healthcare professional.

Adding a long-term care rider to an annuity could be a good option to consider if you’re looking for long-term care coverage but don’t want a separate insurance policy. In a way, it provides the best of both worlds. It’s essentially a regular annuity payment you can rely on for retirement, with the long-term care rider to pay for care costs, if necessary.

There’s another advantage, too, especially if you have an existing health issue. You might find it easier to get approved for an annuity with a long-term care rider versus long-term care insurance. For example, you may run into fewer hassles with a long-term care annuity if you’ve had a hip replacement or similar surgery compared to long-term care insurance. However, conditions such as Parkinson’s disease may not be eligible for coverage either with a long-term care rider or a long-term care policy.

Cost-wise, a long-term care annuity could also be a more budget-friendly option. Long-term care insurance premiums are dependent on several factors. These include your home state, age, gender, whether you need coverage for yourself or a spouse as well, how long you want the policy to pay out, and the dollar amount of benefits you’d like the policy to pay. With a long-term care rider, your age and overall health can affect the cost, but you may pay less in premiums for coverage.

What Are the Cons of a Long-Term Care Annuity?

There are a few drawbacks to keep in mind when it comes to an annuity with a long-term care rider. For one thing, you may be expected to make a large upfront premium payment to get covered. And the more likely you are to need long-term care, based on the insurance company’s risk assessment, the higher that premium might be.

Paying it could also be challenging if you don’t have a lot of liquid cash reserves to tap into. You might have to sell off some of your investments. Or withdraw money from a 401(k) or IRA to cover the premium payment, which could trigger a tax penalty.

Speaking of taxes, it’s important to mention that annuity payments are taxable. The tax treatment depends on how you purchase them. Suppose you buy an annuity inside a qualified plan, such as a 401(k) or IRA. In that case, the entire annuity is taxable, including the money you used to purchase it and any earnings. If you buy an annuity using after-tax dollars, then only the earnings are taxed. Long-term care insurance benefits generally wouldn’t be taxable.

Long-Term Care Annuity vs. Long-Term Care Insurance

A long-term care annuity is different from long-term care insurance in a few ways. With long-term care insurance, you’re buying an insurance policy specifically for long-term care. You may pay an upfront premium or monthly premium. Once you need long-term care, the policy can pay out monthly or on a lump-sum basis to help with those costs.

Long-term care insurance doesn’t have the growth component that a long-term care annuity would. Another key difference is that if you don’t need long-term care, you don’t get the premiums you paid back unless you purchase a return premium rider.

With a long-term care annuity, you could still receive annuitized payments even if you don’t use the long-term care rider’s benefits. In other words, it’s a form of guaranteed income that you can use for long-term care if needed, or for other expenses in retirement.

Bottom Line

A group of seniors discussing long-term care.

A long-term care annuity could be right for you if you think you may need long-term care down the road. Medicare doesn’t pay for nursing care, and while Medicaid can, you might have to spend down your assets before you can get approval for benefits. An annuity with a long-term care rider can give you regular income, and at the same time prepare you for the worst-case scenario if long-term care is something you eventually end up needing. As with all financial goals, planning is key to long-term care.

Tips for Planning for Long-Term Care

  • Consider talking to a financial advisor about your options for preparing for long-term care costs. Finding a financial advisor doesn’t have to be hard. SmartAsset’s free tool matches you with up to three vetted financial advisors who serve your area, and you can have a free introductory call with your advisor matches to decide which one you feel is right for you. If you’re ready to find an advisor who can help you achieve your financial goals, get started now.
  • A related concern is how much regular life insurance you need. SmartAsset’s life insurance calculator will give you a good idea of how much life insurance you should have.

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