Eight hours of daily home care costs over $99,000 a year

A home health aide providing eight hours of care a day costs more than $99,000 a year, and Northwestern Mutual, citing 2025 figures, projects the annual bill could exceed $500,000 by the 2050s. Round-the-clock coverage means buying three shifts of that care.

MoneyGeek found that 45 states approved an average of 64% of long-term-care insurers' price-increase requests between 2021 and 2024, PLANADVISER reported. For a client already holding an in-force policy, that is the difference between a premium budgeted once and one that can be raised again.

For an adviser, the two figures set the reserve a client's plan needs, and the funding schedule decides whether that money can be reached without selling into a decline. Natovitz would start the conversation 10 to 15 years before retirement, early enough that a client may still qualify for insurance, and she puts care preferences and the decisionmaker ahead of any product.

Kim Natovitz, a long-term-care specialist and insurance adviser at Trivium Point Advisory LLC, says the conversation usually ends where it starts. "The conversation I have with so many people starts with, 'I want to stay in my home for as long as possible,'" she says. "They make that statement, and that is as much of the conversation as they have around planning."

Adviser movement around the carrier matters here because a reassigned household can arrive without any of that groundwork. Moves Wire recorded seven moves involving Northwestern Mutual in the past 12 months, with no arrivals listed. The latest, on Oct. 30, was Brandon Porter and Kyle Brooker taking a six-person team with $525 million in client assets to LPL Financial. LPL led advisor moves with $5.4 billion added, as Private Wealth Daily previously reported. An adviser inheriting that book needs to know whether a long-term-care plan exists and who funds it.

Natovitz, who has worked in long-term care planning for more than 25 years, says assuming that substantial assets solve the problem is a common mistake. "Just because you have assets doesn't mean that they can readily turn into [liquid assets] without there being consequences," she says. "What I see often is people creating a second problem trying to solve the first problem."

The gap between a balance sheet and available cash shows up fastest in a correction. Selling investments to fund care during a decline compounds the loss through the market move and through the tax due on the sale, which PLANADVISER notes can accelerate the damage.

Care needs rarely stay with one person. Natovitz says spouses often become caregivers until their own health deteriorates, and adult children may end up contributing time, money and other resources.

Her recommendation is to stress-test the retirement plan against realistic care scenarios, and to do that planning before a crisis removes the choices.