Tri-Valley Long Term CareCommunity Program
An older man and a younger man sit together on a sofa, going through paperwork and smiling.

Paying for the cost of care

A plan made in advance decides where care is received, how it is paid for, and which assets are protected.

Why planning matters

Someone turning age 65 has almost a 70% chance of needing some form of long-term care services and supports during the remainder of life. The duration and intensity vary widely, and about one in five will need care for more than five years.

Medicare generally does not pay for long-term custodial care. Most non-medical help with bathing, dressing, transferring, toileting, supervision, and other daily needs must be paid privately, covered by qualifying insurance, or funded through Medi-Cal after eligibility requirements are met.

What long-term care may cost

Costs vary by location, setting, hours of assistance, and the level of medical or cognitive support required. These are 2025 medians — a starting point for planning, not a quote. Note how far California runs above the national figures.

Annual medians from the CareScout 2025 Cost of Care Survey. Home care assumes 44 hours per week; part-time, overnight, and 24-hour needs produce very different totals.
Care setting2025 U.S. median2025 California median
Non-medical caregiver at home, 44 hrs/week$80,080$91,520
Adult day health care$24,700$24,440
Assisted living / residential care$74,400$82,800
Nursing home, semi-private room$114,975$146,000
Nursing home, private room$129,575$182,135

The five-step planning process

  1. Define care preferences

    Where would you prefer to receive care? Who is available to help? How important is remaining at home, protecting a spouse, or preserving an inheritance? Every later decision depends on these answers, and they are the ones families most often skip.

  2. Estimate the financial exposure

    Model part-time home care, full-time home care, assisted living, memory care, and nursing care. Include inflation, and include the possibility that one spouse needs care while the other still has normal living expenses.

  3. Inventory available resources

    Retirement income, Social Security, pensions, annuities, brokerage assets, retirement accounts, home equity, insurance, HSA balances, family support, and public benefits.

  4. Select a funding strategy

    Determine which costs will be paid from income, which risks will be insured, which assets will be reserved for care, and what financial floor must remain for the healthy spouse.

  5. Coordinate the plan

    Align beneficiary designations, powers of attorney, trusts, tax planning, insurance ownership, care instructions, and the family communication plan. A plan that is not coordinated is a collection of documents that contradict each other.

Funding options compared

These are presented neutrally. Most families will use a combination rather than a single solution.

No single approach is best. Most durable plans combine several.
ApproachHow it worksPotential strengthImportant limitation
Current income and self-fundingUse retirement income, cash, investments, or dedicated reserves.Maximum flexibility and no underwriting.Care may require selling assets during poor markets or creating large taxable withdrawals.
Traditional stand-alone LTC insurancePay ongoing premiums for a defined pool of care benefits.Can provide substantial coverage for each premium dollar.Premiums may rise, underwriting applies, and unused benefits may not create a legacy.
Life insurance with LTC benefitsA life policy allows qualifying care benefits to be accelerated or extended.Can provide care benefits, a death benefit, or both depending on use.Costs, guarantees, benefit triggers, loan treatment, and policy structure vary.
Annuity with LTC benefitsAn annuity value may be multiplied or enhanced for qualifying care expenses.May reposition an existing asset and provide value even if care is not needed.Liquidity, surrender charges, tax treatment, and benefit duration require review.
California Partnership policyA qualifying policy provides insurance benefits and Medi-Cal asset protection.Can protect assets equal to qualifying benefits paid, subject to program rules.Only specifically approved policies qualify; availability and suitability must be verified.
Medi-Cal or MedicaidPublic programs may pay for eligible long-term services and supports.A major source of long-term care funding for eligible individuals.Financial and functional eligibility rules apply, and care choices may be constrained.
Home equitySale proceeds, downsizing, a home-equity strategy, or a reverse mortgage when appropriate.May unlock a large household resource.Can affect housing security, heirs, interest costs, and spouse planning.
Family caregivingRelatives provide unpaid or partially paid support.May preserve familiar care and reduce cash cost.Creates time, income, health, and relationship costs for caregivers.

Illustrative case studies

Converting existing retirement assets into lifetime care protection

Situation

A married couple, approximately ages 62 and 64, wanted meaningful protection for both spouses. They were concerned about open-ended care costs and did not want an ongoing premium that might increase later.

Illustrative approach

An asset-based life/LTC illustration repositioned roughly $211,000 of IRA assets under the carrier’s permitted structure. The illustration included a benefit enhancement and showed maximum long-term care benefits of roughly $8,300 per month for each spouse — close to $100,000 per person per year — with a lifetime-benefit option.

Planning objective

Transform an existing asset into a larger pool of care benefits while preserving contract value or a death benefit if care is not fully used.

Why it may be useful

The structure can provide fixed premiums, benefits for both spouses, and protection against a very long claim. It may appeal to families comfortable repositioning assets who still want value if care is never needed.

What to review before acting

The carrier illustration itself, underwriting, benefit triggers, inflation option, claim method, IRA distribution and tax treatment, required minimum distributions, surrender provisions, death benefit, and whether the lifetime extension is guaranteed under the selected contract.

Traditional stand-alone coverage for a healthy couple

Situation

A California husband age 64 and wife age 62, both in standard health, wanted to insure a defined portion of future care costs while keeping most assets invested.

Illustrative approach

Compare traditional policies with a meaningful monthly benefit, a three-year benefit period, a 90-day elimination period, and 3% compound inflation protection. A preliminary planning estimate is roughly $7,500 to $10,000 per year combined, subject to carrier, health class, benefits, and underwriting.

Why it may be useful

Traditional coverage can provide substantial insurance leverage per premium dollar, and may suit people who prefer to keep investment and estate assets separate from insurance.

What to review before acting

Premium affordability across the full retirement period, carrier rate-increase history, shared-care options, inflation protection, home-care coverage, nonforfeiture benefits, and the possibility that no benefit is ever paid.

2025 price-index benchmarks for select-health couples with an initial $165,000 benefit pool per spouse, from the American Association for Long-Term Care Insurance. Benchmarks are based on Illinois pricing and vary by state and carrier — they are not quotes.
Illustrative traditional designCombined annual premiumInterpretation
Couple both age 60, level benefits$2,600Lower initial cost, but no automatic benefit growth
Couple both age 60, 3% compound growth$5,800Benefit pool grows annually
Couple both age 65, 3% compound growth$7,150Later purchase age materially increases cost
Age-65 couple, similar designs across three carriers$7,137 – $12,250Carrier selection can change cost substantially

Repositioning an existing annuity or conservative asset

Situation

A retiree had an existing annuity, certificate of deposit, or conservative reserve not needed for near-term spending, and wanted to pay for future care without buying life insurance.

Illustrative approach

Evaluate an annuity with long-term care benefits. The annuity value may remain available under contract terms and may provide an enhanced or extended pool for qualifying care expenses.

What to review before acting

Eligibility for a tax-free exchange, surrender charges, benefit multiplier, elimination period, reimbursement versus cash benefit, inflation protection, liquidity, beneficiary value, and tax treatment of withdrawals and care benefits.

A blended plan for a family that can partly self-fund

Situation

A financially secure couple could pay for several years of care but worried that a long claim might reduce the healthy spouse’s lifestyle or force the sale of investments during a poor market.

Illustrative approach

Create a dedicated care reserve for the first years of care, add insurance or an asset-based policy for catastrophic duration, and preserve a separate income and housing floor for the healthy spouse.

Why it may be useful

The family avoids over-insuring smaller costs while transferring the risk that could cause the most financial damage. It also coordinates investment liquidity, taxes, insurance, and spouse protection.

What to review before acting

Size and location of the reserve, market risk, taxable retirement-account withdrawals, home equity, inflation, expected family caregiving, estate goals, and the surviving spouse’s minimum income.

Questions to work through

Answer these before you compare any product. If several are unanswered, that is the work to do first.

Long-term care financial readiness

A short readiness check. Ticks stay in this browser; print the result and bring it to a conversation with an adviser, an attorney, or your family.

  • Could your retirement plan absorb $75,000 to $180,000 or more per year of care costs?
  • Would paying for care require large taxable IRA withdrawals, or selling investments during a market decline?
  • How would one spouse’s care costs affect the other spouse’s housing and lifestyle?
  • Do existing life, annuity, or long-term care policies provide benefits nobody has reviewed recently?
  • Are adult children expected to contribute money, time, or housing — and do they know it?

How this program can help

We provide education, planning tools, and referrals so families can make informed decisions and coordinate the financial plan with care needs and care-setting choices. We do not sell insurance, and we are not paid by anyone whose products are described on this page.

  • Estimating future care-cost exposure
  • Reviewing retirement income and available assets
  • Identifying risks to the healthy spouse
  • Explaining general funding strategies
  • Reviewing existing insurance and annuity documents
  • Helping families prepare questions for licensed professionals
  • Coordinating referrals to tax advisers, estate-planning attorneys, insurance professionals, and care managers

Want a second set of eyes on the numbers?

Tell us what you are trying to work out — whether you can self-fund, how to protect a spouse, or what an existing policy is actually worth — and we will help you find the right licensed professional.

Contact us