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Intermediate
A couple with USD 40 million wants to self-insure all long-term care costs. One spouse has a family history of dementia, and most liquid assets are earmarked for charitable and estate goals. What is the key planning question?
Whether net worth exceeds the maximum policy benefit, because that alone proves self-insurance is optimal.
Whether the family can stress-test liquidity, care setting, caregiver burden, tax effects, and impact on charitable and estate goals.
Whether Medicare will cover all dementia-related custodial care after age 65.
Whether the couple can deduct all future care costs now by setting aside a reserve.
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