The Baby Boomers Guide To Long-term Care Planning And Estate Protection

Every day for the next 19 years 10,000 Americans will reach age 65. We started out as Baby Boomers, now suddenly we are the “Silver Tsunami”.

It’s clear that, as we face the difficult challenges of aging, like dealing with incapacity and long term care for ourselves or a loved one, taking advantage of needed resources is confusing, complex and requires advance planning.

Why an Elder Law Attorney?

Elder Law Attorneys help families deal with the issues that are unique to an aging population.  Often these issues have to do with helping a family pay for long term care costs while preserving assets.  A family spends a life time building their estate, and long term care is the biggest threat to their hard-earned wealth.  The goal of an Elder Law Attorney is to protect those assets as much as possible using the tools of long term care estate planning.

The Crushing Cost of Long-Term Care

“The greatest threat to the financial security to Middle-Americans isn’t a bear market, but an extended stay in a long term care facility.”  This according to Kiplinger’s Personal Finance Magazine, March 2009.

According to, a service of the U.S. Department of Health and Human Services, 70% of the people who turn 65 will need some form of long term care.  The length of long term care varies with circumstances, but averages between 2.4 and 3 years.  In the Seattle/Tacoma/Bellevue area the cost of care runs from $60,000 per year for assisted living to over $114,000 per year for a private room in a nursing facility.

What is Long-Term Care Planning?

Most people understand that Estate Planning covers what happens to your assets when you die.  Long term care planning, however, involves what happens if you live, and require professional in-home care or a stay in a long term care or assisted living facility.   Our health care system was not set up to provide for us when we become incapacitated. If you’re diagnosed with a chronic illness, like Parkinson’s, stroke or dementia, you’re pretty much on your own, and it’s scary. To complicate matters, Baby Boomers are sometimes called “The Sandwich Generation,” because often they are still caring for their children at the same time as they need to care for their parents.  Often, they’re caring for a spouse or partner.  It is the goal of long term care planning to make hard-earned assets, accumulated over a lifetime, last as long as possible.

The Difference between Medicare and Medicaid.

Often these two government programs are mistaken for each other – but they are very different.

Medicare is a federal program that provides health insurance for those 65 and over, or those with a severe disability, no matter your income.  Medicare can cover some rehabilitation costs, but not long term care.

Medicaid is a federal program administered by the state that helps with medical costs for some people with limited income and resources.  Medicaid can help pay for long term support and services and personal services.

How to Pay for Long Term Care.

  1. Be poor or be rich. People a low income can usually qualify for help from Medicaid.  Those with a great deal of wealth can afford their choice of private care facilities.  For those on Medicaid only, the choice of care facilities is limited
  2. Have long term care insurance.
  3. Some limited long term care benefits are available under Medicare.  For instance, if you’ve had a hospital stay of at least 3 days, and then you are admitted to a skilled nursing facility, Medicare may pay for a while.  This coverage lasts for no more than 100 days and has strict qualifying rules.  Often a substantial deductible is involved as well.
  4. Medicaid or a Combination of Private Pay and Medicaid. Though Medicaid is fundamentally a program for low income people, it has now become a major source of long term care funding for the middle class.  Many private pay care facilities will accept Medicaid after the resident has lived there for a period of time, usually 2 or 3 years.  Since private pay facilities offer a broader range of choices than those that rely only on Medicaid, a good strategy is to start there, then switch as funds start to run out.

Medicaid Planning

Many people are under the impression that they have to be impoverished to qualify for Medicaid.  We’re aware of people who have given up investments, retirement funds, and even homes in the care of a loved one.  This does not need to happen.  Medicaid actually allows for a number of assets to be kept.  These can include a home, a car, personal belongings and household goods, burial spaces and prepaid funerals, and other assets.  Medicaid also has an anti-impoverishment clause for the spouse of the Medicaid recipient, which includes the retention of income and a substantial amount of countable assets.

Medicaid Planning, an Elder Law Attorney and Saving Tens of Thousands of dollars.

Don’t try this at home.  Medicaid rules are extremely complicated and confusing.  Often they make no rational sense.  Also penalties for improper reporting are severe. This is where an Elder Law attorney steps in.  It is their goal to structure your estate in such a way that you get to keep the maximum amount of your assets allowable under law.  It’s not an exaggeration to say that an Elder Law attorney can save tens of thousands of dollars.


In order to provide clarity to all these complicated issues, we offer our clients a custom Long-Term Care Plan.  We take the time to go over finances, resources, and all the details of each special situation.  We then create a “road map”, if you will, of the steps to take, and when to be take them, in order to best prepare you and your loved ones to take maximum advantage of your resources should you ever need long term care.

This Long-Term Care Plan is portable and may or may not be part of your Estate Plan.  In fact, other Estate Planning attorneys work with us.  We create the Long-Term Care Plan, which they can then incorporate into the estate plan for their clients.  We’re happy to provide this service.