Unless you have reliable retiree health care from your employer, the growing cost of medical care is probably on your fret list. Protecting your retirement accounts from the cost of long-term health care in a nursing home may or may not be completely possible, depending on the other assets you have, your age, and your marital status.

The thought of losing your hard-earned savings, not to mention carefully cultivated retirement accounts, to the high costs of a nursing home can be terrifying. Seemingly every day, we read about how much nursing homes can cost. And if you’ve ever visited a loved one in a nursing home, you’re probably pretty sure you want to be able to afford the best one you can, should the time come.

But will that time come for you? The U.S. Department of Health and Human Services recently reported on the website www.Medicare.govthat by the time a person reaches age 65, there’s a 40 percent chance he’ll need to enter a nursing home. Health care is important, and high medical costs can do a lot of damage to one’s financial security if he doesn’t plan ahead. The trick is to use your head when you’re planning and don’t get carried away by emotion.

If you’re young and working, you hopefully have sufficient health insurance to pay medical costs if you get sick or hurt and a disability insurance policy that you or your employer pays for that will protect some of your wages if your illness or injury keeps you out of work. And you have your youthful good health. Health is the key here because as long as the sickness is relatively short-lived or you recover from your injury, your insurance policies will keep your money and your retirement accounts safe. The problem arises when you don’t get better or if your injury leads to a long period of decline or disability. That’s when the insurance starts to fall short of the need. This circumstance becomes more likely the older or less healthy you are.

If you have assets or income and you want a product or service, you’re naturally expected to pay for it. There are few other ways to acquire those things you’d like. Unfortunately, the huge potential cost of a long-term chronic illness is probably the one thing few of us have sufficient assets to pay for completely ourselves. The government recognizes this and provides two separate health-care programs to help: Medicare and Medicaid.

If you’re over age 65, you have access to subsidized health insurance through Medicare. Medicare pays costs similar to what you expected from your health insurance provider when you were working. If you were sick or injured and needed medical treatment, your health insurance would pay for it—or at least pay toward it—and you would pay the difference through a co-pay or a co-insurance amount. Medicare health insurance works the same way. Very simply, if you need medical care, Medicare pays, within various policy limits and subject to deductibles.

Medicare doesn’t pay much toward long-term care costs, though. Long-term care is health care to nurse a chronic condition that you wouldn’t fully recover from and would need long-term health care to help maintain your quality of life at the highest level possible. This health care can be delivered in your home, at an assisted living facility, or in a nursing home. Unfortunately, prolonged care like this can be expensive. People are expected to use much of their savings or a retirement nest egg to pay for their own care. When their assets are depleted, they become eligible for care on the government’s dime under the Medicaid program.

You’ve worked hard to accumulate your retirement nest egg. One of the hopes is that your accounts will be large enough to keep your retirement comfortable in times of poor health as well as good. Protecting your nest egg so it lasts through a time of prolonged illness is an important part of that comfort.

If you’re single, you might simply plan to use your assets to pay for your care when you need it. Assets can include your home—you might decide to sell your home and buy into a continuing care community, for example—and your retirement accounts.

If you’re married, you don’t have as much flexibility. Your spouse may want to continue living in your family home and may also need the income from your retirement accounts to live on. There are a few ways you can plan to help the ill person’s spouse, often called the community spouse, maintain a comfortable standard of living should his partner need long-term care.

One way is to supplement your assets with the benefits of long-term care insurance (LTCI). LTCI pays a benefit if you need long-term medical care for a certain period of time. Like other policies, LTCI policies have waiting periods that serve a similar purpose to the deductible on your health insurance coverage, during which you’ll need to pay for care before benefits start. Policies pay benefits usually in increments of a specified number of dollars per day, as either a flat rate per day or as a limit per day on expenses they will reimburse.

Higher-premium policies pay for a longer number of years and could even continue to pay for the rest of one’s life. Because most people spend less than five years in a nursing home, many people who buy coverage save premiums by buying policies that pay for three or four years. Like your health insurance and your car insurance, you must pay most LTCI premiums forever, and you don’t get anything back even if you don’t use the coverage.

Medicaid eligibility is based on both your income and your assets. As an individual, you’re expected to use most of your income and almost all of your assets toward your care. You can preserve your assets by giving them away before you need care, but that usually isn’t the best option because, along with the assets, you give away your power to choose where you live and the level of care you receive.

Another option is placing your assets in an irrevocable trust, with a trustee to manage your accounts for you. This can be costly and complex, so it may not be the best choice when you’re younger and just starting retirement. But as you get older and would prefer having a trustee to manage your affairs for you, a trust might be worth considering.

Ultimately, long-term care expenses are much like other expenses you have to plan for in retirement. For many people, earmarking the home equity or a retirement account that can be annuitized or liquidated to pay for care is the best option.

If you’re married, the government realizes that it’s harmful to impoverish the community spouse when this spouse needs long-term care, so certain assets are protected from the eligibility test you must pass to qualify for Medicaid. If you’re worried about long-term care costs, these strategies might help protect some of the assets of the community spouse: