Planning for Long-Term Care FAQs

• • What is included in the definition of “long-term care”?

• • The U.S. Senate Special Committee on Aging defined long-term care as follows: “It [long-term care] differs from other types of health care in that the goal of long-term care is not to cure an illness, but to allow an individual to attain and maintain an optimal level of functioning. Long-term care encompasses a wide array of medical, social, personal, and supportive and specialized housing services needed by individuals who have lost some capacity for self-care because of a chronic illness or disabling condition.”

• • Are there alternatives to a nursing home facility if I need long-term care?

• • Fortunately, we now have a variety of options that may be able to hold off the need for nursing home care. Seniors who need assistance with the daily tasks of living or who require less extensive medical care, may be able to make use of options such as home health care, adult day health care, and assisted living facilities instead of needing to enter a nursing home facility.

• • If I do need nursing home care, how can I pick the right facility?

• • Always take your time and do your homework when searching for a nursing home. Along with asking friends and relatives for recommendations, there are several excellent resources available to help you make the right choice, including Medicare.gov (the federal government’s official site for Medicare) and the FloridaHealthFinder.gov.

• • How expensive is long-term care?

• • The high cost of LTC is one of the primary reasons why you should include a LTC planning component in your estate plan long before you need care. As of 2021, the average cost of a year in long-term care is over $100,000. For Florida residents, the average cost of LTC was just above the national average, at around $115,000 per year, that same year. Keep in mind that experts estimate that in 20 years the cost of LTC will likely double. Being forced to pay out of pocket for the cost of LTC can put your retirement nest egg at risk.

• • What is Medicaid?

• • Medicaid is a healthcare program that is primarily funded by the U.S. federal government; however, it is administered by the individual states and may receive supplemental funding from the states. Consequently, the eligibility guidelines and benefits offered can vary somewhat from one state to the next. Typically, Medicaid covers healthcare services for low-income children and families, pregnant women, and for the aged and disabled.

• • How can Medicaid planning help me plan for long-term care?

• • Most basic health insurance plans will not cover LTC expenses nor will Medicare. Unless you can easily pay for LTC out of pocket, you will likely find yourself turning to Medicaid for help, like over half of all seniors in nursing home facilities. Medicaid Will help with your long-term care expenses if you are eligible for benefits. Eligibility depends, in part, on the value of your “countable resources.” Excess countable resources will cause your application to be denied while transferring assets in anticipation of applying will likely lead to a waiting period. Either way, you will be responsible for covering your LTC expenses using your own assets.  Medicaid planning can prevent such an unwanted outcome.