A Long-Term Care (LTC) component is essential to comprehensive financial planning because it addresses health and personal care needs—excluded by Medicare—that arise when a client becomes chronically ill or can no longer perform Activities of Daily Living (ADLs).

As the Silver Tsunami crests, 75 million Americans will be going into and through retirement, so many states have proposed or are considering state-level, taxpayer-funded programs to address the rising demand for LTC services.  Proponents argue these initiatives provide a necessary safety net—that doing something is better than doing nothing. 

However, advisors and their clients should view these programs for what they are and approach any government-controlled long-term care funding option with caution. None of the programs currently in place—or under serious consideration—meet even the minimum criteria required for sound personal financial planning.  Moreover, under any compliance regime—and regardless of where a client resides—Long-Term Care Planning that is driven by the client’s stated goals, preferences, and circumstances is the only appropriate and suitable path forward, for the following reasons:

Personalized Coverage...

One of the significant drawbacks of any state-proposed government-controlled LTC program is a cookie-cutter approach, where these plans are payroll-funded, first-dollar government benefits with catastrophic blind spots.  Options are limited, benefits are capped, and there is little control over desired or available LTC services.  In contrast, individual LTC planning allows you to help a client customize a plan to align with their retirement, estate, and financial planning and ensure the desired care is what they receive when the need arises. 

An existing plan, Washington state’s WA Cares Fund, illustrates why state-run LTC programs fail the personal financial planning test. The program provides a maximum lifetime benefit of $36,500 (indexed to inflation) for covered services.  According to the state’s own materials, that amount may fully cover long-term care costs for approximately one-third of participants. For the remaining majority, the benefit is explicitly described as “immediate relief” and “time to plan for future needs.”  In other words, the program is not designed to fund long-term care—it is designed to delay financial consequences and shift responsibility back to the individual once benefits are exhausted. 

Even when paired with private long-term care insurance, WA Cares merely helps offset a benefit waiting period; it does not materially reduce the overall care funding gap. The program offers no customization, no control over care delivery, no alignment with estate or tax planning, and no protection against extended or catastrophic care scenarios.  Similar frameworks have been proposed or discussed in states such as California and Massachusetts, following the same basic model—mandatory payroll taxes in exchange for a modest, capped benefit intended to address only a narrow slice of long-term care costs. These programs offer limited options, minimal consumer control, restricted portability, and catastrophic blind spots when extended or higher-level care is required.

By contrast, individualized Long-Term Care Planning allows advisors to help clients design a solution aligned with their personal goals, family dynamics, tax considerations, and desired care environment—helping ensure that the care they want is the care they receive when a need arises.

Maintain Control & Choice...

Taking personalization a step further, clients work with advisors precisely because they do not want to rely solely on government programs for critical aspects of their financial lives—retirement income (Social Security), healthcare coverage (ACA plans), or estate settlement (probate). In fact, most clients already accept a meaningful loss of choice once they enter Medicare.  When it comes to Medicare-excluded LTC, however, clients typically want—and reasonably expect—to retain control over critical decisions:  The type of care they receive, when and how that care is delivered, who provides it, and the setting in which it occurs.  

By contrast, the politicians and bureaucrats proposing or administering state-based, government-controlled LTC programs have no advisory relationship and no fiduciary duty to your clients. They bear no responsibility for whether these programs create a false sense of security—despite being insufficient to cover meaningful care needs—nor for the financial consequences that follow when benefits run out: continued out-of-pocket expenses, depleted savings, or increased burden on family and loved ones.

No state-based program is designed to preserve choice, customization, or client intent. Advisor-driven LTC planning removes the government from the equation and keeps control, dignity, and decision-making authority where it belongs—with the client.

Flexibility and Independence...

State-run, government-controlled long-term care programs are inherently rigid. Eligibility is rule-driven, benefits are capped, and portability is limited or nonexistent—meaning a client can pay into a program for years and still fail to qualify for meaningful benefits when care is actually needed. Even when benefits are available, they are often insufficient, narrowly defined, and disconnected from real-world care decisions.

Personal Long-Term Care Planning operates on the opposite principle: flexibility by design. A customized LTC plan allows clients to preserve independence by controlling when care begins, what type of care is received, who provides it, and where it is delivered. Planning dollars remain portable across state lines—and, when appropriate, internationally—rather than being trapped inside a single state’s political boundaries.

Most importantly, individualized LTC planning dramatically increases the likelihood that clients can age in place, which remains the overwhelming preference of aging Americans. Government programs respond after independence is lost. Proper LTC planning exists to preserve it for as long as possible.

Avoiding Waiting Lists and Limited Access...

History is clear: when benefits are government-funded, demand eventually exceeds funding. State-based, government-controlled long-term care programs are therefore vulnerable to eligibility bottlenecks, budget-driven restrictions, and administrative delays—often precisely when care is most urgently needed. Clients may discover that access to services is subject to waiting lists, phased eligibility, or delays that postpone care well beyond the point of functional decline.

Personal Long-Term Care Planning eliminates this uncertainty because a properly designed LTC plan provides defined, contractually guaranteed access to benefits, allowing care to begin promptly when ADL impairment occurs.  Some plans offer zero-day waiting periods, ensuring care can be initiated immediately—reducing medical risk, stabilizing family dynamics, and improving both care coordination and outcomes.

Protection Against Rising Costs...

Over time, the cost of long-term care services tends to rise due to inflation. Most state-based, government-controlled LTC programs face structural challenges in keeping benefits aligned with the actual, rising cost of care, which may result in coverage that falls short of client needs over time.

Advisor-driven, personal Long-Term Care Planning can address this risk directly. Many LTC planning strategies include guaranteed inflation protection features designed to help benefits keep pace with increasing care costs. In addition, when integrated into a comprehensive financial plan, these solutions may offer meaningful tax efficiencies and asset-protection benefits that extend well beyond the limited financial relief state-run programs are intended to provide.

Taken together, these planning advantages can give clients greater confidence that their LTC strategy will remain relevant in a changing economic environment. While state-based LTC programs may appear convenient at first glance, once the distinctions are explained clearly, most clients recognize that proactive, advisor-driven LTC planning is the more logical and durable path forward.

The question behind state programs is, “What is the maximum politically survivable benefit we can promise without blowing up payroll taxes?”  However, consumers and their advisors must answer a more important question: How do we guarantee adequate resources for an individual to meet their wants and needs when independence is lost?  One is politics, and one is planning.

For all of these reasons, personalized planning is the only way to address your CLIENTS' needs adequately.

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