01
Assuming Medicare Covers Long-Term Care
Medicare is health insurance, not long-term care insurance. It covers skilled nursing facility care for a limited time, typically up to 100 days, but only under specific conditions following a hospital stay. It does not cover custodial care: the assistance with bathing, dressing, eating, and mobility that most long-term care actually involves.
Medicaid does cover custodial care, but requires spending down assets to qualify, which may not align with plans to pass wealth to a spouse or family members. The gap between what Medicare covers and what long-term care actually costs is substantial.
02
Waiting Until It’s Too Late to Qualify
Long-term care insurance involves health underwriting, meaning insurers assess your health before issuing a policy. Chronic illness, cognitive decline, multiple major health events, or certain diagnoses can disqualify an applicant entirely. By the time many people consider buying coverage, they may no longer be able to qualify for it.
Applying earlier, typically in your 50s or early 60s, generally means better health, lower premiums, and more coverage options. Waiting until the need feels immediate often means the door is already closed.
03
Not Discussing It With a Spouse
Long-term care is rarely just an individual financial issue. If one partner needs extended care, the financial and emotional impact falls heavily on the other, often at an age when that partner is also managing their own health and retirement income needs. Couples who haven't talked about this tend to face the decision under stress, with fewer options.
Planning together, understanding costs, preferences (in-home vs. facility), and what resources are available, creates a clearer picture of what each person would want and what the household can realistically afford.
04
Underestimating the Cost
Assisted living in the Las Vegas area averages over $4,000 per month. Memory care is higher, often $5,000 to $7,000 per month or more. Skilled nursing facilities can exceed $10,000 per month. A multi-year care need can cost hundreds of thousands of dollars, which is a meaningful draw on retirement assets even for well-prepared households.
Understanding what care actually costs in your state, Nevada, Texas, Florida, or Arizona, puts the planning question in concrete terms rather than abstract ones.
05
Treating Home Equity as a Backup Plan
Many people assume they can sell their home to fund care if it becomes necessary. That may be true in some situations, but it's worth examining the assumptions. Selling a home takes time, often months, and the process is emotionally difficult, especially when someone's health is declining. If care is needed immediately, the home sale proceeds may not be available when the bills arrive.
Home equity can be part of a broader long-term care funding strategy, but treating it as the primary or only plan creates timing risk that's easy to underestimate from a distance.