How Much Does Long-Term Care Cost in San Diego?

Quick Answer

The cost of long-term care in San Diego can vary significantly depending on the type of care you need, where that care is provided, how frequently you need assistance, and how long care is required.

In-home assistance, assisted living, memory care, and skilled nursing care can all come with very different costs. For some families, long-term care expenses may become one of the largest financial considerations they face during retirement.

That is why I believe long-term care should be considered as part of your broader retirement and financial plan well before care is actually needed.

Planning ahead does not mean assuming you will need a particular type of care. It means understanding the potential financial impact and deciding how you would want to prepare for it.

Why Long-Term Care Costs Deserve a Place in Your Retirement Plan

When people think about retirement expenses, they usually start with the obvious ones.

Housing. Travel. Food. Taxes. Healthcare. Lifestyle expenses.

But one potentially significant expense is sometimes left out of the conversation: long-term care.

Long-term care generally refers to ongoing assistance that may be needed when someone has difficulty independently performing everyday activities. Depending on an individual’s circumstances, care could be provided at home, in an assisted living community, in a memory care setting, or in a skilled nursing facility.

The financial impact can become substantial, particularly when care continues for an extended period.

This is why I encourage clients to think about long-term care as more than an insurance question.

It is a retirement planning question.

If a long-term care need develops later in life, where will the money come from?

Will it come from retirement accounts? Other financial assets? Income? Insurance? Home equity? Family members? Or some combination of these resources?

Those are questions that are much easier to consider before a crisis occurs.

What Determines the Cost of Long-Term Care in San Diego?

There isn’t one universal price for long-term care.

The amount a person or family may ultimately spend depends on several factors.

The Type of Care Needed

Someone who needs assistance for a few hours each week may have dramatically different expenses than someone who requires around-the-clock supervision.

Potential care arrangements can include:

• In-home care
• Adult day care
• Assisted living
• Memory care
• Skilled nursing care
• Short-term or temporary care
• Full-time residential care

The appropriate level of care can also change over time.

Someone may initially be able to remain at home with occasional assistance and later require a higher level of support.

That progression is one reason long-term care costs can be difficult to predict precisely.

How Long Care Is Needed

Duration is another major consideration.

Even a manageable monthly expense can become financially significant when it continues for several years.

When creating a financial plan, I don’t believe the right question is simply:

“What would care cost this year?”

A better question is:

“What could several years of care mean for my overall financial plan?”

That change in perspective is important.

Where You Receive Care

The setting also matters.

Receiving assistance at home is financially different from moving into an assisted living community or skilled nursing facility.

And even within the same category, costs can vary based on the facility, location, services provided, room arrangements, and level of assistance required.

For San Diego families, local costs should be considered when developing a long-term care strategy rather than relying exclusively on broad national averages.

How Expensive Can Long-Term Care Become?

It is tempting to put one number here and tell you that is what you should expect to spend.

But I don’t think that would be particularly helpful.

Long-term care costs change over time, and individual circumstances vary considerably.

More importantly, the financial-planning issue isn’t just the monthly price.

It is the cumulative effect.

Imagine needing an additional source of money every month for several years.

Even if your retirement plan was originally designed to support your normal lifestyle, substantial additional care expenses could change:

• How quickly retirement accounts are withdrawn
• Your taxable income
• Portfolio decisions
• Cash-flow needs
• Your ability to leave assets to your family
• Your spouse’s financial security
• Housing decisions
• Other retirement goals

This is why the potential cost of care needs to be viewed in the context of the entire retirement plan.

In-Home Care Can Still Become a Significant Expense

Many people tell me they would prefer to remain in their own home as they age.

That’s understandable.

But staying home does not necessarily mean care will be inexpensive.

Someone may eventually need help with activities such as:

• Meal preparation
• Transportation
• Bathing and dressing
• Medication routines
• Household activities
• Mobility
• Personal care
• Supervision

A few hours of help may initially fit comfortably within a retirement budget.

But if the number of hours increases, so can the financial impact.

Eventually, someone who requires extensive daily assistance could face a very different financial situation than someone receiving occasional help.

This is why planning should consider not only where you hope to receive care, but also what would happen financially if your needs became more extensive.

Assisted Living and Memory Care Create Different Financial Considerations

Assisted living can provide housing along with varying levels of personal assistance.

Memory care typically provides additional support and supervision for individuals experiencing cognitive decline.

These arrangements can create significant recurring expenses, and costs may increase as someone’s care needs change.

For couples, there is another important consideration.

What happens financially if one spouse needs care while the other spouse is still living independently?

The household may effectively be supporting two different living arrangements.

That can put pressure on even a retirement plan that initially appeared very comfortable.

This is one of the reasons I encourage married couples to discuss long-term care together rather than viewing it solely as an individual concern.

Skilled Nursing Care Can Have an Even Greater Financial Impact

A skilled nursing facility generally provides a much higher level of medical and personal support.

Depending on the situation, skilled nursing care can become one of the more expensive forms of long-term care.

The important planning question is not whether you can predict that you will someday require skilled nursing care.

None of us can predict the future with certainty.

Instead, the question is:

Would your financial plan be able to adapt if a significant care need occurred?

That is something we can prepare for.

Don’t Assume Medicare Will Pay for Long-Term Care

One of the biggest misconceptions I see around retirement healthcare is the assumption that Medicare will simply cover long-term care expenses.

Medicare may cover certain qualifying medical or skilled-care services under specific circumstances, but it generally should not be viewed as a comprehensive way to fund ongoing custodial long-term care.

That distinction is extremely important.

Someone can have Medicare coverage and still face substantial out-of-pocket costs related to extended personal care.

Understanding what Medicare does—and does not—cover should therefore be part of retirement planning.

I’ll explore this subject more deeply in a separate article because it deserves its own discussion.

How Long-Term Care Can Affect Your Retirement Savings

This is where long-term care planning and retirement planning intersect.

Suppose you enter retirement with a carefully constructed income strategy.

Your Social Security, portfolio withdrawals, pension income, cash reserves, and other resources are coordinated to support your lifestyle.

Then an unexpected care need adds a significant new expense.

Where does that money come from?

If additional withdrawals must be taken from retirement accounts, they may affect more than your account balance.

Depending on the type of account and individual circumstances, additional withdrawals can potentially influence:

• Taxable income
• The longevity of your portfolio
• Future retirement income
• Asset allocation
• Medicare-related costs
• Estate and legacy goals
• The financial resources available to a spouse

This is why long-term care cannot be treated as an isolated planning issue.

A comprehensive retirement planning in San Diego strategy should consider how healthcare and long-term care needs could affect the rest of your financial life.

Long-Term Care Can Affect the Entire Family

The financial consequences of long-term care often extend beyond the individual receiving care.

Adult children may become caregivers.

A spouse may need to take on additional responsibilities.

Family members may reduce work hours or make changes to their own lives to provide support.

Important decisions may suddenly need to be made about housing, finances, transportation, medical needs, and personal care.

That’s why I believe long-term care planning is also a family conversation.

I’ve discussed this in more detail in How Long-Term Care Affects Families.

Having conversations before care is needed can help family members better understand your wishes and the financial resources available to support them.

How Can You Prepare for Long-Term Care Costs?

There isn’t one strategy that is appropriate for every family.

Depending on your circumstances, planning could involve some combination of:

• Personal savings
• Retirement assets
• Brokerage accounts
• Insurance strategies
• Income planning
• Home equity
• Estate planning
• Family resources

The important part is determining how long-term care fits into your overall financial picture.

For some people, the priority may be protecting assets.

For others, it may be preserving financial security for a spouse.

Others may be particularly concerned about maintaining independence, staying at home, or preserving a legacy for children or grandchildren.

Your strategy should reflect what matters to you.

Our existing guide to planning your long-term care options provides additional considerations when thinking through these choices.

When Should You Start Planning for Long-Term Care?

Ideally, the conversation happens before you need care.

Waiting until a health event occurs can significantly reduce your options and turn what could have been a planning decision into an emergency decision.

You don’t necessarily need to know exactly how your future will unfold.

You simply need to start asking the right questions.

For example:

• Where would I prefer to receive care?
• Who would I want involved in my care decisions?
• How much could I reasonably afford?
• Which assets would be used?
• Would a major care expense affect my spouse?
• What happens to my retirement income strategy?
• What role might insurance play?
• What happens if care lasts several years?
• What assets do I hope to preserve for my family?

Those questions can help turn an uncomfortable subject into a practical financial conversation.

Long-Term Care Planning Is Really About Having Choices

I understand why people sometimes avoid this topic.

Nobody wants to imagine losing independence or needing assistance.

But I don’t believe long-term care planning needs to come from a place of fear.

To me, planning is about creating choices.

If you eventually need help, having financial resources and a strategy may give you greater flexibility in deciding where you receive care, who provides that care, and how your family is involved.

Without planning, those decisions may be dictated largely by circumstances.

That’s why the importance of long-term care planning goes beyond simply estimating future healthcare expenses.

It is about protecting the retirement you’ve worked so hard to create.

Long-Term Care Should Be Part of Your Retirement Income Strategy

Long-term care planning becomes particularly important when we begin thinking about retirement income.

Your retirement income plan may need to support you for 20, 25, 30 years or longer.

During that time, your expenses are unlikely to remain exactly the same.

Healthcare needs can change.

Inflation can increase costs.

Housing needs can change.

And long-term care may eventually become part of the picture.

That’s why I prefer retirement plans that are designed with flexibility.

A thoughtful retirement income planning strategy considers not only how much income you need today, but also how your financial needs could change later in retirement.

Working With a Fiduciary on Long-Term Care Planning

Long-term care decisions can touch many areas of your financial life.

That’s one reason working with a professional who looks at the entire picture can be valuable.

As a fiduciary financial advisor in San Diego, I help clients look at retirement decisions in the context of their income needs, assets, taxes, family priorities, risk, and long-term goals.

Long-term care is one piece of that larger conversation.

The objective isn’t to predict exactly what will happen.

It’s to understand your options and build greater flexibility into your financial life before you need it.

Recommended Reading: Retirement By Design

One of the reasons I wrote Retirement By Design: How To Avoid Running Out of Money and Create the Income You Need, To Live the Way You Want! is because retirement involves much more than accumulating a portfolio.

Your retirement plan ultimately needs to support your life.

That includes the expected expenses as well as the financial challenges you may not be able to predict.

Long-term care is one of those considerations.

In Retirement By Design, I discuss creating retirement income, protecting your financial future, preparing for risks, and making more informed decisions about the money you’ve worked hard to build.

Learn more about Retirement By Design.

The Cost of Long-Term Care Is About More Than a Monthly Number

So, how much does long-term care cost in San Diego?

The answer depends on the type of care, how frequently it is needed, where it is provided, how long it lasts, and your individual circumstances.

But the more important question may be:

What would those costs mean for your retirement plan?

A long-term care expense does not exist in isolation. It can affect retirement income, taxes, your portfolio, family members, housing decisions, and the legacy you hope to leave.

You may not know whether you will need long-term care.

But you can decide whether your financial plan is prepared for the possibility.

Let’s Talk

If you are approaching retirement and wondering how potential long-term care costs could affect your financial future, I would be happy to help.

If you are exploring what it looks like to work with a San Diego fiduciary advisor, I invite you to schedule a complimentary consultation.

Elisabeth Dawson
619-640-2622
San Diego, CA 92108

FAQs

How much does long-term care cost in San Diego?

Long-term care costs vary considerably based on the type of care, location, frequency of assistance, and level of support required. In-home care, assisted living, memory care, and skilled nursing facilities can have very different costs. Rather than relying on one estimate, families should consider how several years of potential care expenses could affect their retirement plan.

Does Medicare pay for long-term care?

Medicare may cover certain qualifying skilled-care services in specific circumstances, but it generally should not be considered comprehensive coverage for ongoing custodial long-term care. Understanding potential out-of-pocket care costs is an important part of retirement planning.

Is long-term care planning part of retirement planning?

It can be an important part of retirement planning because significant care expenses may affect retirement savings, portfolio withdrawals, taxes, income needs, a spouse’s financial security, and estate goals.

When should I start planning for long-term care?

It is generally better to begin considering long-term care before care is actually needed. Planning earlier can give you more time to evaluate your financial resources, preferences, insurance options, family considerations, and the potential effect of care costs on your retirement.

Can I pay for long-term care from my retirement savings?

Retirement assets may be one potential source of funding, but large or prolonged withdrawals can affect the rest of your retirement strategy. The appropriate approach depends on your assets, income sources, taxes, insurance coverage, family circumstances, and financial goals.

Should I buy long-term care insurance?

Long-term care insurance may be appropriate for some individuals but not others. The decision can depend on age, health, assets, premiums, policy benefits, financial goals, and your ability or preference to self-fund potential care expenses. It should be evaluated as part of your broader financial plan.

Can a financial advisor help with long-term care planning?

A financial advisor can help evaluate how potential long-term care expenses fit into your retirement income, portfolio, insurance, tax considerations, family priorities, and estate goals. The goal is to understand how a future care need could affect the rest of your financial plan.