I don't have a spare $150,000, so long-term care insurance is absolutely worth the cost

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• With lifespans longer and families more spread out, it's essential that I think about long-term care.
• Long-term care insurance comes in many forms at many costs, including as part of a life insurance policy.
• I hope to have a long, comfortable life, but I'm preparing for whatever is ahead.

My father was one of 11 children, three male and eight female. All but two lived and worked within 50 miles of where they grew up. When his grandmother and mother grew ill, one of his sisters — divorced and with a young son — moved in to care for each of them until they died. That was the norm.

It is the norm no longer.

Women are having fewer children. According to the latest data from the World Population Review , the average household size in the United States is 2.6. At the same time, we are living longer than past generations. The average life expectancy for women is 79 years, and for men, 73 years.

Furthermore, extended family is more dispersed. The average American changes residences every five years, although that trajectory has shifted now that more work-from-home options have become available.

The days of an unmarried woman taking care of elderly relatives are a thing of the past, which is why long-term care insurance products — and long-term care riders on life insurance — are more popular.

Without insurance, I can't afford long-term care

Long-term care includes a wide range of services, from nursing homes and assisted living (out-of-home care) to licensed nurses and certified home health aides (in-home care).

In my home state of Massachusetts, the cost of out-of-home care in a private, Medicare-certified facility can be as high as $150,000 a year. For in-home care, at two hours per day, three days a week, the cost would be $8,000 a year. Medicare only covers a maximum of 100 days after a hospital stay.

Unless we win the lottery, my husband and I can't afford that.

"I begin discussing LTC with my clients when they're in their mid-50s," says Robert Kircher, a financial advisor with Northwestern Mutual Insurance . "It's at that stage when the kids are (mostly) out of the house and there's room to consider what's next. Given life expectancy projections, what's next could be another 25-30 years."

I have lots of options for long-term care insurance

That projected future could be an active lifestyle filled with good health, friends, travel, and volunteer work, followed by a quick and painless death. What's more likely is a slow decline in physical and cognitive health with professional home health aides and skilled nurses assisting with personal hygiene and other daily needs.

Long-term care insurance goes beyond the standard healthcare insurance policy. A long-term care insurance policy protects against the risk of having to pay out of pocket for in-home and/or out-of-home care services. As with other insurance products, the amount you pay in premiums varies according to the amount of your benefit.

Some life insurance plans include a long-term care benefit, a death benefit when you pass away, and a cash value if you stop the policy. The advantage to this type of plan is you know your benefactors get all or most of the money you spent on premiums returned if you pass with no claim, but the tradeoff is a lower benefit amount. Still other products offer a full death benefit of the entire amount, but those plans have substantially higher premiums.

I'm taking steps to make sure I live a good life

However long I may live, I want to be as healthy as I can during them. That means doing the work to stay healthy. I keep up with regular checkups with doctors and dentists, mammograms and colonoscopies.

I avoid fast food. Instead, I cook most meals, which include a wide variety of fresh vegetables, and snack on fruit rather than cookies, most of the time. I do yoga and take long walks. I have an active social life filled with good friends.

In the short term and the long run, the goal is to live long and healthy.

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This article was originally published in October 2023.