Many people know they should plan for it, but almost nobody does. Long-term care is an uncomfortable subject, but luckily, Kevin Engbers, CFP®, Senior Wealth Advisor, CEO, and Founder of Pinnacle Wealth, has spent years helping families navigate that conversation. Here’s what you need to know.
Why Do People Avoid This Conversation?
Planning for long-term care means picturing a version of yourself you’d rather not think about yet. As Kevin puts it: “Long-term care kind of sits right where [money and mortality] cross. So we tell ourselves, well, there’s time, we’ll get to it. But avoidance really isn’t a plan. It’s just a decision that’s made by default.”
What Long-Term Care Actually Costs
The numbers surprise most people. According to the 2024–2025 CareScout/Genworth Cost of Care Survey, national median rates include:
- Private Nursing Home Room: ($129,575/year)
- Semi-Private Nursing Home Room: ($115,000/year)
- Assisted Living: ($74,000/year)
These are national medians; actual costs vary by location, provider, and individual care needs. But even in historically more affordable states like South Dakota, Kevin notes: “The difference between zero and minus-10—it’s still cold, and it’s nasty.”
What Medicare Does (and Doesn’t) Cover
This is where many families get caught off guard. Medicare is health insurance. It’s built to help get you well, not to support you through a condition that won’t resolve.
It covers short-term skilled nursing after a hospital stay, typically up to 100 days. Even that comes with conditions and copays. What it does not cover is custodial care: the day-to-day help with bathing, dressing, eating, and moving safely from room to room.
Kevin states: “That’s precisely the kind of care that most people end up needing, often for years, not just weeks. The family assumes they’re covered, and then the bills start arriving.” About 7 in 10 Americans turning 65 will need some form of long-term care. Most don’t have a plan for it.
Three Ways to Help Fund Long-Term Care
Kevin outlines three main options; however, he starts with a disclaimer: “There’s no universally right answer. Only the one that fits your assets, your health, and your convictions.”
1. Self-Insuring
This means setting aside your own assets to cover the cost. This can work for families with significant net worth, but Kevin is direct: “It requires honest math, not just hope. A three- or four-year care can quietly consume a legacy that took a lifetime to build.”
2. Traditional Long-Term Care Insurance
This option means you pay premiums and transfer the risk to an insurance carrier. Premiums are lower the younger and healthier you are when you start. The drawback: it’s “use it or lose it”—if you never need care, your premiums don’t come back.
3. Hybrid Policies
There are life insurance or annuities with a long-term care rider (an add-on benefit that pays out for care costs). If you need care, the benefit is there. If you don’t, your family receives a death benefit instead. “The dollars don’t just vanish,” Kevin explains, and premiums tend to stay more level over time.
What Happens When There’s No Plan
Without a plan, care costs come out of shared assets first. The healthier spouse watches resources that were meant for both of them just drain away. The cost isn’t only financial, either. “All of a sudden, a daughter becomes a full-time caregiver, or siblings argue over decisions that no one ever wrote down. A spouse carries guilt, exhaustion, and money fear all at once.”
Kevin calls planning ahead “an act of love”—protecting the people you care for while you still can.
When Should You Start?
Kevin explains, “The sweet spot for exploring coverage is generally in the early 50s or mid-50s to early 60s. Old enough that it’s real, but young enough that you’re still insurable and premiums are at least reasonable.”
But the thinking should start the moment you have people who depend on you and assets worth protecting. As Kevin says: “The best time was a decade ago, and the second-best time is this week.”
Have the Conversation Before You Have To
The first meeting isn’t about policies or premiums. It starts with a simple question: If you ever needed care, what would you want it to look like? Kevin speaks from experience, saying: “The goal of the first sitting isn’t a signature—it’s relief. People walk out lighter because the fear of carrying it alone is finally out on the table where they can deal with it.”
Long-term care planning isn’t about fear. It’s about love—expressed early, while there’s still time to make a real choice. When you’re ready to start the conversation, the team at Pinnacle Wealth is ready to sit down with you to help. Schedule a conversation with an advisor today.
Costs referenced reflect the 2024–2025 CareScout/Genworth Cost of Care Survey and represent national and statewide medians. Actual costs vary by location, provider, and individual care needs. This material is for educational purposes only and is not individualized investment, tax, or insurance advice. Please consult a qualified professional regarding your specific situation.
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