When Clients Need Long-Term Care: Helping Them Know Where to Start

Mary Sizemore, CLTC, LTCCP
feet standing by chalk arrows

As an insurance professional or financial advisor, you’ve likely had clients call after a health event asking, “What do we do now?” Unfortunately, many families don’t begin thinking about long-term care until a crisis occurs.

Whether your client has planned ahead with long-term care insurance or is facing care needs without a plan, you have an opportunity to provide guidance and connect them with the right resources.

Read More: The Power of Planning: Turning Uncertainty into Control with Long-Term Care Strategies

Step 1: Help Clients Recognize the Need for Care

Long-term care isn’t limited to nursing homes. Most care begins at home and is needed because an individual can no longer safely perform everyday activities independently. Common indicators include:

  • Difficulty bathing, dressing, or transferring
  • Memory loss or cognitive decline
  • Medication management concerns
  • Frequent falls
  • Difficulty preparing meals or managing household tasks
  • Family caregiver burnout

Recognizing these signs early allows families more flexibility in choosing care options and preparing financially.

Step 2: Encourage Clients to Build Their Care Team

Many families simply don’t know where to begin. Encourage them to contact the appropriate professionals based on their situation. Recommended resources include:

  • Primary care physician
  • Home health or home care agency
  • Geriatric care manager or Aging Life Care Professional
  • Elder law attorney (when legal or Medicaid planning is needed)
  • Financial advisor or insurance professional to review available benefits

If your client owns long-term care insurance, encourage them to contact the carrier or their advisor before services begin. Starting the claims conversation early often leads to a smoother experience and helps families better understand available benefits.

Step 3: Prepare Clients for the Cost of Care

One of the biggest shocks a family experiences is the actual cost of extended care. Current national median annual costs include:

Type of CareApproximate Annual Cost
Home Care (44 hours/week)$80,080
Assisted Living$74,400
Nursing Home (Semi-Private Room)$114,975
Nursing Home (Private Room)$129,575

While costs vary by geographic location, they continue to increase each year. Helping clients understand these numbers often changes the conversation from “Do I need a plan?” to, “How should I prepare?”

Step 4: Clarify Medicare’s Role

One of the most common misconceptions you’ll encounter is that Medicare pays for long-term care. Help clients understand the difference.

Medicare generally pays for:

  • Physician services
  • Hospitalization
  • Short-term rehabilitation
  • Limited skilled nursing following a qualifying hospital stay
  • Physician-ordered skilled home health services

Medicare generally does NOT pay for:

  • Ongoing custodial or personal care
  • Assistance with Activities of Daily Living
  • Long-term home care
  • Assisted living expenses
  • Long-term nursing home care

Because most long-term care involves personal assistance rather than skilled medical treatment, families are often responsible for paying these costs unless they have planned ahead.

Read More: Medicare Isn’t a Long-Term Care Plan: Why Every Retirement Conversation Needs a Long-Term Care

Step 5: Discuss Funding Options

Depending on the client’s circumstances, care may be funded through:

  • Personal savings and investments
  • Traditional long-term care insurance
  • Hybrid life insurance with long-term care benefits
  • Short-Term Care insurance
  • Veterans’ benefits (if eligible)
  • Medicaid for those who qualify financially

This is where advisors can provide tremendous value by helping clients understand the advantages and limitations of each option before a crisis occurs.

Step 6: Encourage Family Conversations

Long-term care planning isn’t only about paying for care. It’s also about preserving independence and reducing stress for loved ones. Encourage clients to discuss:

  • Where they would prefer to receive care
  • Who they want making healthcare decisions
  • Whether their healthcare directives and powers of attorney are current
  • How care will be coordinated if family members live far away

Having these conversations before they’re needed often prevents confusion and conflict during a health event.

Position Yourself as a Resource

Clients don’t expect you to have every answer, but they do value having someone they trust to help guide them. Whether you’re introducing long-term care planning proactively or helping a family respond to an immediate need, you can become an invaluable resource by connecting them with the right professionals and helping them understand their funding options.

If you don’t specialize in long-term care insurance, partnering with an experienced team can provide additional expertise while allowing you to continue serving as your client’s trusted advisor.

Partner with Krause

Whether your client is planning ahead or facing an immediate care need, Krause is here to help. Our team specializes in extended care planning solutions, including traditional long-term care insurance, hybrid products, short-term care insurance, and crisis planning strategies.

You can write the case yourself with our underwriting, product, and case design support, or refer the opportunity to Krause. Our goal is simple: help your clients navigate one of retirement’s biggest financial risks while making you the trusted resource they rely on.

Book a call with us to get started!

Helpful Resources for Clients

Share these trusted resources with clients who are beginning the long-term care journey:

  • Medicare – Coverage information and benefit questions
    https://www.medicare.gov
  • Eldercare Locator – Local aging services, caregiver support, transportation, meals, and community resources
    https://eldercare.acl.gov
  • National Institute on Aging – Educational resources on aging, caregiving, dementia, and healthy aging
    https://www.nia.nih.gov
  • Alzheimer’s Association – Dementia education, care planning, support groups, and caregiver resources
    https://www.alz.org
  • Family Caregiver Alliance – Practical tools and support for family caregivers
    https://www.caregiver.org
  • BenefitsCheckUp® (National Council on Aging) – Helps older adults identify programs that may assist with healthcare, prescriptions, housing, and other expenses
    https://www.benefitscheckup.org
Mary Sizemore, CLTC, LTCCP
By Mary Sizemore, CLTC, LTCCP | Insurance Sales and Communications Coordinator

With over 25 years of experience, Mary leverages her industry knowledge to help agents and their clients navigate various insurance products. She stays current on the latest products and trends and develops creative content for both agents and consumers.