Plan for possible long-term care needs

Q: If my husband ends up in a nursing home, can they take my 401(k) to pay for it? We live in Minnesota.

A: Yes, so it pays to get a game plan ready now for how you will handle these costs if a lengthy nursing home stay is necessary. Spouses can be sued by nursing homes to recover unpaid bills.

Often, nursing home residents try to qualify for the federal Medicaid program to cover the costs, but that program generally requires recipients to be impoverished to receive the aid.

Last year Minnesota began allowing spouses of Medicaid applicants to keep annuity income payments and still have the other spouse qualify for Medicaid to pay for nursing-home stays, said Douglas Peterson, an attorney in Albert Lea.

Generally, spouses can keep their homes, one car and up to $120,900 as assets. Now, they also may convert assets above that level into monthly annuities for the spouse.

"We're able to convert an excess asset into an income stream," Peterson said.

Some 401(k) plans allow participants to convert liquid savings to annuities, or they can be rolled into an IRA that can hold annuities, but you'll need to make sure that the annuities used conform to IRS and Medicaid rules, he said.

In 2016, the national median monthly cost of a semiprivate nursing home was $6,844, according to insurer Genworth.

Despite the staggering cost, most people aren't doing much to delay ill health as they age, a new survey from Transamerica Center for Retirement Studies shows.

While almost 9 in 10 Americans said health is a key concern in old age, just 58 percent reported healthy eating habits, 56 percent are exercising and 48 percent think about their long-term health when making lifestyle choices, the June survey found.

The survey also found 45 percent of workers identified "declining health that requires long-term care" as one of their greatest retirement fears. And of the 63 percent of workers with a written or unwritten retirement strategy, just 27 percent have factored long-term care needs into their strategies.

"It really is scary how little people are planning for the possible need for long-term care and the extraordinary expense involved," said Transamerica's Catherine Collinson.