I had the pleasure to meet with Mary F. Trotter at a recent event and ask her if she would share her expertise on long term care planning with my readers. Mary F. Trotter is a Florida Bar Board Certified Elder Law attorney located in The Villages, Florida. She provides personalized, professional services dedicated to the needs of the elderly and their families. She specializes in legal services which focus on the specific challenges faced by the elderly, including Elder Law, Estate Planning, and Medicaid.  She has outlined some valuable information below for those who need or want to begin putting plans together for when the time comes when they may need the support of full time in home care, assisted living or nursing home.  While it is easy to think this will not happen for decades to come, or that family will step in when needed, the reality is that events happen in life when you least expect them. Having a plan in place of how you will ensure peace of mind and quality care is best done when you are healthy and able to think financially and realistically through the options and how to afford them. While we love our children and extended families, they also have lives and unexpected events that occur which may prevent them from becoming caregivers at our greatest time of need. It is just the way life happens.
Planning for long-term care for yourself or a family member is not something that many people like to think about. As a result, planning for potential long-term care needs is often put off until it’s too late. For many, long-term care is not even a consideration until it’s required for themselves or a loved one. By then, long-term care options are often limited by a lack of information, improper legal guidance, insufficient financial resources, and the immediate need to obtain the required long-term care services.
Long-term care planning is very important for anyone at or near retirement. Statistics show that the majority of people age 65 or older will need some level of long-term care during their lifetime, and the likelihood of needing care increases as one ages. The cost of this care can quickly deplete the average family’s life savings. According to a recent survey of long-term care costs, the national average rate for a private room in a nursing home is $248 per day, or $90,520 per year, and the semi-private room rate is $222 per day, or $81,030 per year. Nursing home rates are higher for patients suffering from Alzheimer’s or dementia. Rates for assisted living facilities averaged approximately $4,088 per month, or $49,056 per year.
Paying for long-term care expenses is typically accomplished through the use of personal assets (private pay), by using established long-term care insurance, or through Medicaid and Veteran’s benefits. Contrary to popular belief, Medicare does not pay for long-term care expenses provided by a nursing home or assisted living facility. Medicare does provide coverage for rehabilitative care, however, this care benefit is only available to individuals who have spent at least three days in a hospital for medically necessary care, must be initiated immediately upon discharge from the hospital, and only covers up to 100 days of care.
Of the different methods for paying long-term care expenses, using personal assets is the least attractive option. Nursing home care is expensive and with the average nursing home stay at approximately 835 days (a little over two years), its costs can easily consume the savings of most middle class families. Assisted living costs, while typically half that of a nursing home, are still quite expensive. Privately paying for long-term care expenses opens up the very real possibility of an individual outliving their savings.
Long-term care insurance is another option for meeting long-term care expenses and newer policies that incorporate partnership provisions. However, finding and establishing a long-term care policy that meets your specific needs can be a challenge and the premium payments for policies that provide the appropriate level of care benefits may be costly. Another consideration is that long-term care insurance must be obtained while the individual is still young and healthy enough to meet the insurance company’s qualification standards. This often requires an individual to pay expensive long-term care insurance premiums for years before the need to use policy benefits arises.
Veteran’s benefits can also be used to pay long-term care expenses. Long-term care benefits for wartime veterans are provided by a program known as Aid and Attendance. This program provides monthly pension payments of up to $1,759 for a single veteran, $2,085 for a married veteran, and $1,130 for the surviving spouse of a veteran. These pension payments can be used to pay for home health care, assisted living costs, or nursing home expenses and are designed to help those who choose to privately pay their long-term care expenses. While a valuable benefit, Aid and Attendance pension payments only cover a fraction of these costs.
For many people, Medicaid benefits are the only viable option for meeting long-term care expenses. These benefits have become a valuable resource for helping middle class families pay long-term care costs. There are several different Medicaid programs, but one of most relevant to seniors is known as the Institutional Care Program. For those who qualify, this program can pay for almost all nursing home expenses and different benefit rules apply depending on the marital status of the applicant. In order to meet the qualification criteria for program benefits, applicants must have assets of less than $2,000 and a maximum monthly income of $2,163. Other specific qualification criteria also apply. While meeting these requirements can be challenging, there are techniques available that may allow individuals who are over the asset or income limits to still meet program qualification criteria.
Understanding and meeting Medicaid qualification criteria can be daunting and the services of a qualified Elder Law attorney can help you navigate the Medicaid application process. An Elder Law attorney can help applicants and family members qualify for program benefits while helping to preserve a portion of the applicant’s assets and income to help meet the living expenses of the applicant’s spouse, if required. While this can be accomplished to meet immediate long-term care needs, prior planning provides a wider range of options and more choice and control for Medicaid applicants and their families.
Engaging the services of an Elder Law attorney to perform long-term care planning may help you save assets and income for uses other than long-term care expenses. Planning can provide a way to involve family in decisions without depending on them to bear the burden alone. For many people, one of the most important advantages of performing long-term care planning is to ensure greater independence should they need care. The choices for receiving care outside of a facility and being able to stay at home or receive services in the community for as long as possible are greater if an individual has planned ahead.
Finding an Elder Law attorney can be easily accomplished by visiting the Florida Bar website. To help you choose an attorney who is an expert in Elder Law, the Florida Bar confers board certification on certain Elder Law attorneys who have met rigorous education, experience, and professional requirements and who have a demonstrated knowledge in the core areas of Elder Law, including wills, trusts, probate, and Medicaid long-term care planning.
For questions or comments, contact Jane Bloom, The Other Daughter www.theotherdaughter.org, email
janeinthevillages@gmail.com, or give her a call (425)-299-6020.
