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Using Life Insurance to Pay for Long-Term Care: Tips for Seniors to Free Up Cash

15 minute readLast updated October 31, 2023
fact checkedon October 31, 2023
Written by Danny Szlauderbach
Reviewed by Erin Martinez, Ph.D.Dr. Erin Martinez is an associate professor of gerontology and director of the Center on Aging at Kansas State University, where she focuses on promoting optimal aging.
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Long-term care is expensive. For seniors who don’t have enough savings or long-term care insurance coverage, there are ways to use a life insurance policy to help pay for long-term care. These include selling a policy to create a long-term care benefit plan, setting up a living benefit program with the life insurance policy, surrendering the policy for cash value, and more. Read on for details, plus insights from industry insiders.

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4 types of life insurance policies that can help pay for long-term care

“If seniors don’t have a long-term care plan in place, the cash in [their] life insurance policy is a great place to start,” says Sam Price, an independent life insurance broker and owner of Assurance Financial Solutions.

But before figuring out whether a loved one’s life insurance can help cover their long-term care costs, you need to understand what kind of policy they own. Here’s a quick overview:

  • Hybrid life insurance has long-term care benefits packaged into the premium. Along with the life insurance death benefit, hybrid policies can also include long-term care coverage for illnesses not covered by traditional long-term care insurance.
  • Term life insurance accumulates no cash value. The policyholder has a choice to renew or end coverage when the term expires.
  • Whole life insurance has a death benefit but also contains a savings component. Part of the premiums go toward savings, so the policy can accumulate cash value.
  • Universal life insurance also builds cash value but offers a more flexible way to build savings. Premiums can fluctuate depending on the policyholder’s needs.

It’s important to note that nursing homes typically can’t take a life insurance policy payout away from named beneficiaries upon the insured’s death. Check with an elder law attorney to learn more.

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5 ways seniors can use life insurance to pay for long-term care

Below you’ll learn how to utilize a life insurance policy to pay for senior care, including assisted living, nursing home care, and more.

1. Sell a policy and create a long-term care benefit plan

With a life settlement, a policyholder sells their life insurance policy to a third party for market value and uses the proceeds to fund a long-term care benefit plan. Any type of life insurance — permanent with cash value, group insurance offered through an employer, even term life — can be used. However, most companies specializing in these transactions require a minimum death benefit of $50,000.

It’s best to delay a life settlement until one actually needs long-term care, says Nicole Gurley, owner of Gurley LTCI, a brokerage company specializing in long-term care funding solutions. “Generally, the shorter the life expectancy, the larger percentage of the death benefit will be paid to the insured,” Gurley explains.

For example, if someone with a $100,000 death benefit is 90 years old and needs long-term care, they could sell the policy and possibly receive as much as $60,000 of the death benefit. That amount is deposited in an FDIC-insured irrevocable bank account and professionally managed by a licensed benefit management company. The administrator then makes payments directly from the bank account to the home care agency, assisted living facility, or skilled nursing community on behalf of the person receiving long-term care.

2. Set up a living benefit program with a life insurance policy

A living benefit program is a lump sum payment that’s available to people who meet specific medical criteria. A living benefit program makes it possible to receive up to 50% of a life insurance policy’s death benefit while still reserving some death benefits for family. For example, if your loved one has $200,000 in coverage, it could be possible to secure up to a $100,000 living benefit. They don’t lose their entire life insurance and their beneficiaries remain. With the cash advance, your loved one can pay for their medical and senior living expenses.

To qualify for a living benefit program, one must have a life insurance policy with a death benefit of at least $100,000 in most cases. There is no other asset required, and credit history won’t be checked. Additionally, there are no out-of-pocket expenses involved. It is important to note a living benefit is essentially a loan against the policy. The entire loan, including any interest, must be repaid or it will be deducted from the death benefit of the policy. Following the death of the insured, the difference between the loan and the death benefit will go to the named beneficiaries.

A living benefit program works with all types of life insurance policies, including the following:

  • Term policies
  • Universal policies
  • Whole policies
  • Group policies

Keep in mind, loan proceeds are not taxable, and interest rates can vary depending on the state. Make sure to check with the loan provider for specific interest rates.

A copy of the insured’s medical records and a recent life insurance policy statement are required to approve the loan. Once approved, funds may be disbursed in as little as three weeks from the date of application. Going forward, life insurance premiums may be waived. Additionally, the policyholder cannot be held personally liable for the loan.

3. Surrender the life insurance policy for cash value

When a policy owner “surrenders” a life insurance policy to the insurance provider, they give up ownership and the death benefit. If the policy has accumulated cash, the insurance company writes a check for the full amount of cash value. In many cases, taxes must be paid on that amount — but not always.

“If the cumulative premium amount paid over the life of the policy is more than your current cash value, there are generally going to be no taxes,” says Price. “However, if you’ve had the policy for several years and the cash value has grown beyond the premiums paid into the policy, then you’re going to owe taxes on the gain.”

Many companies differentiate between “cash value” and “surrender value,” so those amounts may differ in the policy’s early years. Insurance companies may penalize a policyholder who surrenders a policy early on.

Also, if your loved one plans to use Medicaid to pay for long-term care, the cash portion of their life insurance policy — or the amount they’d receive when surrendering the policy — can be considered an asset and count against them for Medicaid eligibility.

“Generally, permanent policies with cash value can count toward Medicaid eligibility when the death benefit is more than $1,500,” says Price.

Term life insurance, which has no cash value, won’t count toward Medicaid eligibility.

4. Take a loan from cash accumulation

If your loved one takes a loan from their life insurance policy’s cash value, they won’t have to pay taxes on it. They can’t take it all, though, or the policy will lapse. However, a policy holder can usually take most of the cash value in a loan that they then pay back to themselves with interest.

“If your health care needs are more than the money you have in the policy, you’re going to surrender the policy because you need every dollar,” says Price. “However, if your needs are less than the amount of cash value, then a loan might make more sense. That way, you can keep some portion of the death benefit in place.”

5. Use the cash value to fund a new policy for life insurance with long-term care

If there’s time to plan, your loved one may be better off doing what’s known as a 1035 exchange. This exchange involves using one insurance policy’s cash value towards a new policy without first cashing out and risking tax exposure.

A tax-free 1035 exchange also allows a policyholder to use an existing life insurance policy’s cash value toward a new life insurance policy with long-term care insurance benefits. For example, your loved one could use the cash value to fund premiums on a hybrid policy, which includes life insurance, long-term care benefits, and even living benefits for costs related to strokes, cancer, or illnesses that long-term care insurance may not cover.

“Sometimes, that’s a convenient way for people to fund long-term care insurance because the premium is not coming out of household income,” says Gurley. “You just take the cash value in an old policy and move it to a new policy that offers long-term care benefits.”

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4 types of life insurance policies that can help pay for long-term care

5 ways seniors can use life insurance to pay for long-term careHow to find local senior living

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Meet the Author
Danny Szlauderbach

Danny Szlauderbach is a managing editor at A Place for Mom, where he's written or reviewed hundreds of articles covering a wide range of senior living topics, from veterans benefits and home health services to innovations in memory care. Since 2010, his editing work has spanned several industries, including education, technology, and financial services. He’s a member of ACES: The Society for Editing and earned a degree in journalism from the University of Kansas.

Reviewed by

Erin Martinez, Ph.D.

The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.

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