How to Pay for Long-Term Care


Most Americans today have not thought about how they will pay for a future that includes the need for long-term care. The concept that we may not be able to live independently, in our own homes, free of mobility and cognitive challenges, is not a reality that many of us want to face, let alone plan for. It comes as no surprise, especially when you consider that less than half of all Americans today have completed their estate planning, that planning for short-term or long-term disability coupled with the potential need to live in a nursing home is not something that most of us want to plan for.

This possible future, however, is one that we should actively be planning for. We are living longer, health care costs are increasing, and the lack of government resources make it imperative for us to find a way to both identify the right long-term care support for our own unique needs and a way to pay for the care we desire.

Unfortunately, many Americans mistakenly believe that the Medicare system will pay for this cost of care, but that is not the case. Medicare is an acute payor system. As such, it will help cover part of the cost of care on a short-term basis, e.g., a hospital stay for surgery, part of your doctor’s bill, and a brief rehabilitative stay in a rehabilitation center or nursing home. It will not, however, pay for long-term care or custodial care when you are not able to improve over time or need round the clock care based on your physical or cognitive needs.

Armed with the information we have shared, how then do you pay for long-term care? Let us share the guidance you need to begin as you work to ensure you and your loved ones are protected.

1. Understand your needs. Your needs are unique to you. Take stock of your overall health, along with that of your partner, to understand where you are right now. Do you have preexisting conditions that could affect your health now or in the future? Do you have a new diagnosis that could lead to future disability? Are there physical or cognitive issues you know of but have not wanted to plan for yet? Getting a baseline in place for your needs is critical to understanding how to plan for long-term care.

2. Determine if you can pay for your own care. The average cost of care in the home begins, in most states, at $4,500 per month while the average cost of a semi-private room in a nursing home is $9,000. This is dependent on where you live; you can learn more about the options in your specific zip code using the Genworth Cost of Care Study by clicking this link. Do you have the money, right now, to pay for this care while still maintaining your home, your existing expenses, and ensuring your spouse and children are not impoverished? For most, the answer is no, and therefore we need to plan as soon as possible.

3. Invest in long-term care insurance. If long-term care insurance is available to you, you may want to consider it. This insurance can help you pay for care at home, in an independent or assisted living facility, or in a skilled nursing home. There will be an assessment of your physical condition, so you want to begin as soon as possible. Be sure to look at variables surrounding when the policy is activated, the total amount of the benefits to be paid, and how long you need to pay in before it can be used.

4. Talk to your family. Long-term care is a conversation to have with your entire family. Although most of us do not have family members who could stop a job to care for a family member who needs long-term care or who have the training to provide this care, you may. This is an important discussion to have sooner rather than later so the entire family can be on the same page as to what needs to be done.

5. Identify what public benefits you could be eligible for. There are a number of state and federal programs that could help you pay for long-term care. The condition, however, is that you need to qualify based on both your healthcare needs and your financial resources. One such program, which you may have heard of, is the Medicaid program. This program, should you qualify, may be able to take much of the monthly burden of paying for long-term care off your and your family’s shoulders.

6. Meet with an experienced elder law attorney. Your elder law attorney will be able to guide you through the complex maze of long-term care planning. Your attorney will understand your unique situation and be able to provide a plan to not only find the right care for you but identify ways to pay for it. Keep in mind that by preparing early there are often more planning options available to you and your attorney. Although there are steps that can be taken in a crisis, the earlier you can make a plan and implement it, the better.

We know this topic may raise more questions than it answers. The long-term care conversation is a serious one and one that you should have sooner, rather than later, so you are able to take advantage of the planning opportunities available to you. Our law firm takes a very different approach from what you might have come to expect. Our goal is to create lifelong relationships with each of our clients, to guide and manage your legacy for the rest of your life. Please contact our offices in Stuart and in Palm City to learn more.

Main Menu