A new way to pay for the single biggest expense in retirement When it comes to long-term-care costs, your options vary with location. There are more than 30 “continuing care at home” offerings across the country, says Karen Skeens, executive director of Goodwin House at Home in Alexandria, Va. Contact your state insurance department to see if any of these still-evolving programs exist where you live. But don’t get too excited: Aside from the steep upfront fee, you must be in fairly good health as you may undergo a medical screening to qualify. In the past few years, another promising grassroots trend is spreading across America: the so-called village movement. There are now nearly 250 villages in 47 states, where seniors benefit from neighbors who contribute their time and talents.