If the person is expected to return home or if there is a noninstitutionalized spouse, Medicaid exempts the home and a vehicle below a certain value. Many states place a lien against the home to repay the state after the patient dies. The investment is guaranteed to earn a minimum rate of interest, say 4 percent. This builds up a cash reserve to cover nursing home or at-home care. Money not spent goes to heirs as a life insurance death benefit.
Some policies cover both husband and wife.
If one spouse uses only a portion of the benefit, the remainder is available for the other spouse. This covers all or part of needed care. The choice is to spend money on premiums now on the chance it will save money later. One rule of thumb is to add up all the premiums you would pay until age 85. Usually this is less than the cost of one year in a long-term care facility.