Long-Term Care and Medicaid Planning – An Introduction

Introduction to Paying for Long-Term Care in Louisiana

With Americans living longer than ever before, planning for the high cost of long-term care is critical to preserving a family’s hard-earned savings. Most seniors will likely require some form of long-term care, but many are unprepared for the significant financial burden it places on their family. Whether long-term care is to be provided at home, in a nursing home, or in an assisted living facility, the cost of such care is high and will continue to rise. We can advise you of your options to protect your assets from the high cost of long-term care as well as the most appropriate long-term living arrangements for your situation. There is much confusion among seniors and their families about how to pay for long-term care. John E. Sirois, Houma Elder Law attorney, can help you determine if you should purchase long-term care insurance, self-insure, or how to qualify for Medicaid or Veterans Benefits. There are many strategies we can implement to allow you to prepare well in advance of needing long-term care. Planning ahead by consulting early with an Elder Law attorney is critical in preserving the maximum amount of your assets should placement in a nursing home be necessary. In addition, we help seniors preserve their assets during a Medicaid crisis, when no pre-planning has been done and they are currently in a nursing home or will be admitted soon. Regardless of the type of planning you need, estate and elder law attorney, John Sirois, can help you preserve assets and avoid costly mistakes. Click here for John’s Long-Term Care Planning Checklist. If you have questions about paying for nursing home expenses contact John at 985-580-2520 or by email at john@jsiroislaw.com.

Long-Term Care Insurance

For most individuals, insuring against the risk of long-term care is the preferred alternative as it provides the most options for care. Because an extended long-term care need can quickly wipe out your retirement assets, long-term care insurance planning is an essential part of retirement planning. Ideally, you insure against this risk while you are in your low to mid-fifties rather than in your sixties or seventies. Purchasing long-term care insurance at a younger age will help increase the probability of meeting the underwriting requirements and may result in lower cumulative premium payments. Unfortunately, many individuals are uninsurable or the insurance is cost prohibitive. If this describes your situation, planning early to avoid Medicaid spend-down is critical.

Paying Out of Pocket for Long-Term Care

Self-financing long-term care is an option for some people; however, it is not always the best option. Your retirement portfolios earmarked for income during your golden years may be consumed by long-term care expenses. If long-term care expenses exhaust your retirement portfolio, your spouse will be left with insufficient means to maintain his or her standard of living. Self-financing is the most feasible for individuals with significant assets due to their ability to pay for long-term care expenses out of pocket for long periods of time. However, even the wealthy should consider insuring against this risk as they insure against other risks. For example, although a wealthy individual may have the financial resources to rebuild their home many times over in the event it is destroyed by fire, they still insure against this risk through homeowner’s insurance. The risk of an extended long-term care stay should also be insured as the probability of your needing long-term care far exceeds the probability of your home catching fire.

The reality is that while some seniors are able to afford private pay care, the cost of long-term care will often devastate the savings of all but the wealthiest families. Individuals without adequate long-term care insurance and requiring care in a nursing home will ultimately meet the financial criteria for Medicaid as a result of one of two outcomes:

  1. Because an individual may not be aware of their options, the most common outcome is to do nothing and pay the care cost by spending down their assets until they meet the Medicaid asset requirement.
  2. The second outcome is to seek the advice of an Elder Law attorney who can advise you of permissible steps you can take to preserve your assets.

Louisiana Medicaid

Medicaid is a joint federal-state program that provides medical assistance to low-income individuals, including those who are 65 or older, disabled or blind.  Medicaid is the single largest payer of nursing home expenses in America; however, it is wrought with complex, often-changing rules for eligibility. An experienced Medicaid attorney can help you navigate the myriad of regulations involving look-back periods, income caps, transfer penalties and waiting periods to plan around. In addition, the Louisiana Medicaid program has many state-specific rules that must be met for eligibility. Prior to making any decisions regarding Medicaid eligibility in Louisiana, contact Thibodaux Medicaid and Elder Law attorney, John Sirois, at 985-580-2520.

As your advocate, John Sirois analyzes your current income and assets, estate planning documents and medical expenses to create a detailed explanation of your available Medicaid qualification options. We can then implement a Medicaid Asset Protection Plan and complete the Medicaid application for you. Often we can preserve anywhere from half to all of your assets for your spouse and/or children while qualifying for Medicaid benefits. Depending on your situation, Medicaid planning is either Crisis Planning or Non-Crisis Planning.

Contact John E. Sirois, Houma Medicaid Attorney, at 985-580-2520 to learn how you can legally protect your assets from nursing home spend-down or to set an appointment. 

Click here to download John’s Long-Term Care and Medicaid Planning Checklist. 
Read John’s book, Louisiana Retirement and Estate Planning, for more information about long-term care and Louisiana Medicaid planning.