Q: Do I really need to think about long-term care insurance?

A: Headline: Last week, the Centers for Medicare and Medicaid Services reduced Medicare funding for nursing homes by an estimated $16 billion over the next 10 years. Twenty-four states already have reduced Medicaid funding this year. And $313 billion of additional cuts have been proposed by the administration to fund health care reform.

Message: Don't count on the government to take care of you in your old age! They're already running out of money -- long before the boomers begin to retire. Remember when boomers hit school age and were squashed into modular classrooms? As boomers age, you'll see crowded, modular nursing home rooms -- perhaps a final use for those old FEMA trailers! This is serious, a real warning.

Answer: Consider long-term care insurance now!

The cost of long-term custodial care is the most devastating thing that could happen to your retirement plans -- even worse than a bear market. Yet it is the thing we least want to think about. And boomers haven't been forced to confront this reality, because our parents are living longer, with new hips, knees and heart valves. But eventually, we will all wear out!

This kind of "custodial care" is not covered by Medicare or supplements, although they do cover a limited amount of "skilled" nursing home care after a period of hospitalization. But custodial care means help doing basic activities, such as bathing, dressing, feeding, toileting. This year, it costs nearly $80,000 on average to provide full-time custodial care, at home or in a nursing facility.

Long-term care insurance is not necessarily about nursing homes. In fact, if you have either enough money or insurance against the cost of care, you could get care at home or in your choice of an assisted living facility.

But if you cannot pay for your care, the alternative that Medicaid offers is becoming less and less appealing. Most government-funded care is provided in nursing facilities, not in your home. Those are the places where funding is being cut.

Claude Thau is a long-term care insurance expert who helped create policies offered by some major insurance companies and now helps insurance brokers understand the products. Thau says: "Nursing homes are extremely anxious because of recent reductions in Medicare and Medicaid payments to them, along with the administration's stated intent to squeeze them further to finance health care reform. We can expect nursing homes to lay off staff, cut services, convert to nongovernment funding sources and/or close their doors." Continued...