Most families don't plan to need nursing home care-until they have no choice. And by then, the financial and emotional toll can be devastating. Pre-planning for long-term care is one of the most important steps you can take to protect your savings, your independence, and your family's future. Contact us by either using the online form or calling us directly at 414-253-8500 for legal assistance.
The Reality: Nursing Home Care Is More Common Than You Think
According to data from the U.S. Department of Health and Human Services:
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70% of people age 65 and older will need some form of long-term care.
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Over 35% will eventually require care in a nursing home facility.
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The average stay in a nursing home is approximately 2.2 years, but 1 in 5 individuals will stay longer than 5 years.
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Women are more likely than men to need nursing home care and to stay longer-often due to outliving their spouses.
These numbers aren't just statistics-they're warning signs for families who don't yet have a plan in place.
The Financial Cost of a Nursing Home
The costs of long-term care are staggering and rising every year. According to the Genworth Cost of Care Survey:
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The average cost of a private room in a nursing home in the U.S. is over $9,000 per month.
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Semi-private rooms cost around $7,900 per month.
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In some states and cities, costs exceed $120,000 per year.
At those rates, even a modest retirement savings can be drained in a matter of months.
Medicare Doesn't Cover Long-Term Nursing Home Stays
One of the most common misconceptions is that Medicare will pay for long-term care. In reality:
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Medicare only covers up to 100 days of skilled nursing care-and only under specific conditions.
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After that, you're responsible for the full cost unless you qualify for Medicaid or have long-term care insurance.
Without a plan, you may be forced to spend down nearly all your assets to qualify for Medicaid coverage-leaving little for a spouse or heirs.
What Does It Mean to "Pre-Plan" for Nursing Home Care?
Pre-planning means putting strategies in place while you're still healthy and independent-not waiting until you're in crisis. It includes:
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Reviewing assets and income
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Understanding Medicaid eligibility rules
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Exploring legal tools to protect property
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Planning for the potential need for assisted living or skilled nursing care
By acting early, you preserve options and avoid costly mistakes.
What Are the Risks of Not Planning?
If you delay planning until after nursing home care is needed, your family may face:
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Asset depletion to pay for monthly nursing home bills
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Forced home sales to qualify for Medicaid
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Delays in care due to lack of legal decision-making authority
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Ineligibility for Medicaid due to transfers or gifts made within the "look-back" period
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Stress and confusion when emergency decisions must be made without guidance
With proper planning, these risks can be avoided-and your family can stay focused on care, not crisis management.
Legal Tools That Help You Plan Ahead for Nursing Home Care
Pre-planning for long-term care often involves using specific legal strategies and documents to protect assets and preserve eligibility for Medicaid. These are among the most effective:
1. Irrevocable Medicaid Asset Protection Trust (MAPT)
This trust allows individuals to transfer assets out of their name while still preserving them for beneficiaries. After a 5-year look-back period, the assets in the trust are not counted for Medicaid eligibility.
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Protects the family home, savings, and investments
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Allows you to still receive income or live in the property (if structured properly)
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Helps avoid the need to "spend down" all your assets
Learn more about this option on our page: Medicaid Asset Protection Trusts
2. Long-Term Care Insurance
Though not for everyone due to health or cost, this type of insurance can help pay for nursing home or in-home care costs. The best time to purchase is in your late 50s or early 60s.
3. Spousal Protection Strategies
When one spouse enters a nursing home, special planning can protect the well spouse from becoming impoverished. Medicaid allows for community spouse resource allowances, and legal structuring can ensure the at-home spouse retains essential assets.
4. Durable Power of Attorney and Health Care Documents
These documents ensure someone you trust can make decisions for you if you become incapacitated-without requiring court approval.
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Financial Power of Attorney: For managing bank accounts, real estate, insurance, and Medicaid applications.
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Health Care Power of Attorney & Living Will: For making or refusing medical treatment on your behalf.
Learn more about these options at our healthcare directives page.
5. Strategic Spend-Down Planning
If your assets exceed Medicaid's limits, you may need to spend down your assets legally and strategically to qualify. But this must be done with care to avoid penalties. Some allowable strategies include:
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Making necessary home repairs or modifications (e.g., wheelchair ramps, new roof)
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Purchasing a Medicaid-compliant annuity for a spouse
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Paying off debts or pre-paying for funeral expenses
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Upgrading a vehicle if needed for medical transport
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Buying personal property such as clothing, eyeglasses, or hearing aids
These are considered exempt or non-countable uses of funds and can help bring your estate in line with Medicaid limits without unnecessary waste.
6. Gifting Strategies-Use With Caution
Gifting assets to family members can reduce the value of your estate, but it's essential to understand how the Medicaid look-back period affects this. Improper gifting may result in months-or even years-of Medicaid ineligibility.
However, with proper planning:
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Gifts made more than five years before applying are generally excluded from penalties.
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Gifting to disabled children or placing assets in special needs trusts may be permissible.
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In some cases, the "caretaker child exception" allows a parent to transfer a home to a child who lived with them and provided care for at least two years.
Work with an attorney before making any gifts. Timing, documentation, and strategy are crucial to avoid disqualification.
The Medicaid "Look-Back" Period: What You Need to Know
Medicaid has a 5-year look-back period (2.5 years in California for certain cases), which means:
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Any asset transfers or gifts made within 60 months before applying may result in a penalty period of ineligibility.
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Planning early allows time for assets to age out of the look-back window.
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Last-minute gifts or transfers can lead to significant legal and financial complications.
The sooner you begin planning, the more options are available.
The Emotional Value of Pre-Planning
Planning ahead isn't just about protecting dollars-it's about preserving dignity and relieving emotional burden on your loved ones. With a plan:
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You avoid rushed decisions in crisis moments.
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Your family knows your wishes for care and finances.
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You stay in control of your legacy and your future.
The peace of mind that comes from having a plan is invaluable.
Contact a Medicaid and Long-Term Care Planning Attorney Today
At Heritage Law Office, we help individuals and families protect what matters most before it's too late. Whether you're concerned about nursing home costs, Medicaid eligibility, or preserving assets for your spouse or children, we're here to guide you through every option available.
Start planning now-while you still have the power to choose.
Call us at 414-253-8500 or contact us online to schedule a confidential consultation. Together, we'll create a custom plan that protects your health, your assets, and your peace of mind.
Frequently Asked Questions (FAQs)
1. How likely is it that I will need nursing home care?
According to the U.S. Department of Health and Human Services, 7 out of 10 adults over age 65 will require some form of long-term care. More than 35% will spend time in a nursing home. The average stay is about 2.2 years, though some stays last 5 years or longer.
2. Does Medicare pay for nursing home care?
No. Medicare only covers up to 100 days of skilled nursing care and only after a qualifying hospital stay. It does not cover long-term custodial care in a nursing home. That cost typically falls to private pay, long-term care insurance, or Medicaid if you qualify.
3. What is the Medicaid look-back period, and why does it matter?
The look-back period is 5 years before a Medicaid application. During that time, Medicaid reviews any gifts or transfers of assets. If they find gifts made during that period, they may impose a penalty period of ineligibility. Planning early helps you avoid or outlive the look-back.
4. Can I give money to my children to qualify for Medicaid?
Not without risk. While giving money may reduce your countable assets, if those gifts are made within the 5-year look-back period, you may be penalized. However, with proper legal guidance, certain gifting exceptions and trust strategies can be used effectively.
5. How can I protect my home from being taken to pay for nursing home care?
You may be able to protect your home by transferring it to a Medicaid Asset Protection Trust, using the caretaker child exemption, or planning for the community spouse to retain it. Each option depends on your timing and circumstances, so consult with an attorney before acting.