Optimizing Retirement Financial Strategies: Integrating Annuities, Defined Contribution Plans, and Long-Term Care Costs

Nursing home costs in the United States now exceed $100,000 per year, and government assistance programs such as Medicaid help out only when retirees are largely destitute. Moreover, health shocks driving the need for such care can arise suddenly in old age, are frequently permanent in nature, and can be associated with declining mental and physical abilities. These facts raise the important question of how households can best prepare to finance this final phase of life. Building on past research, we determine how retirees should manage payouts from defined contribution plans to balance trade-offs between consumption and health care cost shocks, using both retirement plan assets and annuitization. Our analysis explicitly integrates the role of taxes, required minimum distributions, bequest motives, and the possibility of retiree insolvency. We conclude that payout annuities, especially deferred and variable annuities, can be quite valuable for retirees, even when they face health shocks in later life.