What Do Clinicians Caring for Aging Patients Need to Know About Private Long-Term Care Insurance?

Brian E. McGarry, PT, PhD; David C. Grabowski, PhD


J Am Geriatr Soc. 2019;67(10):2167-2173. 

In This Article

Abstract and Introduction


Preparing for future long-term care (LTC) needs is a critical component of successful aging. Clinicians with aging patient panels may be a valuable source of information about the importance of LTC planning and the mechanisms available to do so, including private LTC insurance (LTCi). This article provides an overview, from a clinician's perspective, of current LTC financing and the key questions patients should consider when assessing LTCi. Although actual purchasing decisions likely require support from impartial financial experts, clinicians may be well positioned to help initiate difficult conversations about LTC planning and point patients to unbiased resources concerning LTCi.


An important, and often overlooked, component of successful aging is preparing for future long-term care (LTC) needs. Unlike postretirement healthcare expenses and income, where public entitlement programs (ie, Medicare and Social Security) provide at least basic levels of security for most Americans, LTC financing is largely left to individuals. As a result, the potential costs of an extended need for services and supports to meet personal care needs represent one of the largest financial risks current retirees face.

Geriatricians, primary care physicians, and other clinicians with aging patient panels are likely caring for many individuals who are, or should be, grappling with the question of how best to ensure access to LTC services that are consistent with their preferences, the preferences of family members, and household budgets. Many clinicians have probably been solicited for advice on LTC planning, in particular the decision of whether to purchase private LTC insurance (LTCi). Although these questions are typically in the purview of financial advisors and estate planners, they have important implications for where individuals reside, their quality of life, and how they access and interact with the healthcare system as they age. A number of studies have demonstrated a direct link between high-quality LTC and better patient health.[1] As such, healthcare providers have a vested interest in ensuring that older adults and their families are able to access long-term services and supports at the right time and in the right setting.

This article aims to provide clinicians with the background knowledge necessary to counsel patients, from a healthcare provider's point of view, about the need for LTC planning and the mechanisms available to do so. Specifically, we aim to answer a number of key questions about the current state of LTC financing in the United States, private LTCi, and the various factors consumers should consider when deciding whether to purchase this product.