Hale Law Blog

Long-term Care: Keeping Your Life’s Legacy Intact


How do you break down a life well spent? We spend our early years charging through bushes and mapping
exotic creek beds near our backyards. As we grow older we winnow our list of potential careers from
the more fashionable fields of shark wrangling and astronautics to lowly careers in lawyering and the like.

But no matter the business we choose, we derive a great deal of satisfaction and distinction from working hard for an honest wage. We start a family with ideas of giving them all the breaks we never caught and all the ones we did. And then we hope to retire into the sunset casting a fishing line with one hand and building birdhouses with the other. And then one day we abruptly pass away in our dreams without even a cold to lead the way.

Never once does an extended stay in a nursing home enter the formula. Even as I write this article, I find my mind pushing hard against the very idea of my wife or my parents, let alone myself, requiring nursing home care.

Unfortunately, the statistics bear out the realities many families have already faced. There are currently around 1.5 million nursing home residents across the United States and the average stay is around two and a half years. The average nursing home cost per month is around $4,000. Further, the majority of Americans are unaware that Medicare does not cover these long-term care expenses.

My own grandfather spent the last years of his life in a nursing facility with Alzheimer’s disease. The financial effects of those years were catastrophic. He passed away impoverished leaving behind my grandmother, three adult children, seven grandchildren, and fond memories of the times we shared.

So the question becomes, how do we plan for the potential of long-term care? How can we assure quality care for life without going bankrupt in the process? The planning can be simple or complex, but in almost every scenario, whether you are just entering retirement or you are in need of immediate care, an elder law and estate planning attorney can help you protect your health and your assets.

There are only three ways to pay for long-term care. The first is long-term care insurance. We encourage every client approaching retirement age to consider a long-term care policy as an important component of a complete estate plan. An advantage of an LTC policy is that it will usually provide for skilled nursing at home in addition to institutionalized care. The drawback is that the premiums on these policies can be expensive, so it is important to shop around for the coverage that best fits your circumstances. The alternatives to long-term care insurance are “private pay” and Medicaid.

For wealthy clients, it can be more advantageous to privately pay than to try to qualify for Medicaid. However, for clients with modest estates, Medicaid planning can be critical to avoid the financial and emotional trauma that accompanies a costly stay in a nursing home.

Medicaid is a jointly funded state federal program designed to assist the elderly and disabled. The Medicaid program imposes strict income and resource limitations on applicants and most of our clients arrive with the preconception that they must “spend down” their life savings in order to qualify. This is not true.

The Medicaid rules are expansive and complex, but the legislature has purposefully allowed for the careful repositioning of one’s assets in order to qualify. It is important that the planning be done artfully because Medicaid imposes stiff penalties for improper transfers. A good estate planning and elder law attorney can help navigate these rules to effectively preserve the property of the nursing home resident and ensure that their spouse’s standard of living is not diminished. Further, the attorney can make certain that these assets are subsequently passed down to the next generation rather than to the government.

While a comprehensive Medicaid planning strategy is beyond the scope of this article, a free initial case evaluation and consultation with an estate planning and elder law attorney should uncover how one’s assets and income can be legally repositioned to obtain long-term care Medicaid benefits and keep a life’s legacy intact.

A life well spent doesn’t always play out as we expect, but financial peace of mind is well within your reach. When long-term care becomes an issue in your family, don’t delay in discovering the opportunities an estate planning session can provide.

Download full article (pdf)

  Our Services Our Firm