The Long-Term Care Planning Question Advisors Should Ask Before Retirement: “Who Pays for Year Five?”

According to the U.S. Department of Health and Human Services, about 70% of Americans who reach age 65 will need some form of long-term care during their lifetime. While many people budget for a few months of assistance, the financial challenge often grows when care extends for several years.

Retirement planning often focuses on the exciting parts: travel plans, hobbies, a slower morning routine, and finally having time for projects around the house. Yet one question can change the entire conversation: “Who pays for year five?” Long-term care costs can stretch far beyond the first few months, and a solid retirement plan needs to look past the beginning of a care journey.

Many people prepare for the possibility of needing help someday, but they picture a short period of assistance rather than a multi-year expense. The tricky part is that long-term care rarely follows a neat calendar. A thoughtful plan considers what happens after savings cover the early years and life keeps moving forward.

The Fifth Year Often Reveals the Real Strength of a Retirement Plan

The first years of long-term care can create a false sense of security because families often focus on immediate needs rather than the years that follow. A retirement plan needs to answer what happens when care continues longer than expected. The fifth year matters because it tests whether a person’s financial strategy can handle a longer road.

A person may have enough savings to cover home care or assisted living for a while, but extended care can create pressure on investments and family finances. Advisors often help clients examine income sources, insurance options, and personal resources before retirement arrives. The goal involves creating a plan that does not rely on hope as the main strategy.

Long-term care planning also requires honest family conversations that many people delay because the topic feels uncomfortable. Talking about future care needs before a crisis gives families more choices and fewer rushed decisions. A simple question about year five can reveal gaps that a basic retirement calculation might miss.

“While costs remain high, they are only one part of the equation. Families are also weighing quality, access, timing, and how to pay for care over time,” said Samir Shah, CEO of CareScout.

What Long-Term Care Can Cost (2025 National Medians)

Care Type	Median Annual Cost
Home caregiver	$80,080
Assisted living	$74,400
Nursing home (semi-private)	$114,975
Nursing home (private)	$129,575

Source: CareScout 2025 Cost of Care Survey

Retirement Savings Need a Backup Plan Beyond the First Few Years

Many retirees build careful budgets for everyday expenses, but long-term care can introduce costs that look completely different from normal retirement spending. A monthly budget for groceries, utilities, and hobbies does not automatically account for professional caregiving support. Care planning deserves its own section in the retirement conversation.

Financial advisors can help people compare different ways to handle future care expenses, including long-term care insurance, personal savings, retirement income, and family support. Each option comes with trade-offs, and the right approach depends on personal goals and financial circumstances. A plan that works for one household may not fit another household at all.

One of the biggest retirement planning mistakes is assuming Medicare pays for long-term custodial care. Medicare generally covers short-term skilled nursing or rehabilitation following a qualifying hospital stay, but it typically does not pay for ongoing assistance with activities such as bathing, dressing, eating, or supervision over an extended period.

Families Need More Than a Financial Number on a Spreadsheet

Imagine a couple who retires with $1 million in savings. Paying approximately $75,000 a year for assisted living may seem manageable at first. But if care extends into a fifth year—or if both spouses eventually require care—that expense can easily exceed several hundred thousand dollars, fundamentally changing the family’s retirement picture.

Long-term care planning involves more than calculating dollars because care decisions affect relationships, routines, and living arrangements. A spreadsheet cannot fully show the emotional weight of asking a spouse, child, or relative to step into a caregiver role. Good planning considers both money and the people involved.

Real-life situations often look different from the simple examples found in retirement brochures. One spouse may need care while the other still wants to travel or maintain independence. Adult children may live far away, have demanding jobs, or face their own family responsibilities.

A strong plan creates a roadmap before a stressful moment arrives. It identifies possible care preferences, important documents, and financial resources that can support future choices. That preparation gives families more confidence when circumstances change.

How People Pay for Long-Term Care

Personal savings
Retirement income
Long-term care insurance
Hybrid life/LTC policies
Home equity
Medicaid (after meeting eligibility requirements)

A Simple Retirement Question Can Protect Future Choices

The question “Who pays for year five?” does not predict the future, but it encourages better preparation. It pushes retirement conversations beyond the first stage of care and toward the full picture. That shift can help people build plans with fewer weak spots.

Retirement planning works best when it includes realistic conversations about aging, health changes, and personal priorities. Advisors who ask detailed questions can help clients spot problems before those problems become emergencies. A complete plan considers the possibility of years of care, not just the first bill.

The strongest retirement strategies leave room for flexibility because life rarely follows a perfect script. People can review coverage, update documents, and adjust savings goals as circumstances change. A small planning conversation today can protect important choices tomorrow.

The Question That Keeps Retirement Plans Standing Strong

The phrase “Who pays for year five?” works like a flashlight in a dark corner of retirement planning. It shines attention on an issue many people prefer to postpone, while creating an opportunity to prepare with clarity. Long-term care planning does not need to feel overwhelming when people approach it step by step.

A retirement plan should support more than financial comfort during the early years. It should also provide a strategy for unexpected challenges that may appear later. Asking better questions before retirement can help families protect savings, preserve independence, and make decisions with less pressure.

The best time to discuss long-term care happens before a family faces a crisis. A thoughtful conversation with a financial advisor, loved ones, and trusted professionals can help create a stronger foundation. The year five question may seem simple, but it can uncover some of the most important retirement planning decisions.

If your retirement plan had to pay for five years of care starting tomorrow, would you know where the money would come from? It’s a question worth asking now—before you ever need the answer.