Estate Planning Blog Articles

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Protect Your Parents’ Savings From Nursing Home Expenses

As parents age, the possibility of needing long-term care becomes a genuine concern. Nursing home expenses can exceed $100,000 per year, making it easy for a lifetime of savings to disappear within a few short years. Many families assume Medicare will cover these costs. However, Medicare only pays for short-term skilled nursing care, not long-term stays.

To protect your parents’ financial future, proactive planning is essential. With the right legal and financial strategies, it’s possible to preserve assets while ensuring quality care.

Understanding the Risk of Nursing Home Costs

Most seniors will need some form of long-term care, whether through in-home assistance, assisted living, or a nursing home. Unfortunately, many families wait until a crisis occurs before considering how to pay for care, leading to last-minute decisions that can be financially devastating.

Without planning, families may be forced to:

  • Sell assets or liquidate savings to cover care costs
  • Drain retirement funds, leaving a healthy spouse with limited income
  • Lose their home if proper legal protections aren’t in place

Medicaid is the primary payer for long-term nursing home care. However, strict asset limits can make it difficult to qualify without careful preparation.

Legal Strategies to Protect Assets

1. Medicaid Planning and Asset Protection

Medicaid requires individuals to spend down their assets before qualifying. However, strategic asset planning can help preserve wealth. Key Medicaid planning techniques may include:

  • Medicaid Asset Protection Trusts (MAPTs) – Transferring assets into a trust can shield them from Medicaid’s asset count, but this must be done at least five years before applying to avoid penalties.
  • Spousal Protections – If only one spouse needs care, the community spouse (the one staying at home) can retain a portion of the couple’s assets without affecting Medicaid eligibility.
  • Exempt Assets – Certain assets, such as a primary residence (up to a state-set value), are excluded from Medicaid’s limits. However, planning is necessary to ensure proper protection.

Without a clear Medicaid strategy, families may unknowingly deplete their assets before qualifying for benefits.

2. Long-Term Care Insurance

For those who plan early, long-term care insurance can provide financial relief by covering nursing home and assisted living costs. However, premiums increase with age, making it critical to explore policies before health issues arise. Some hybrid policies combine life insurance with long-term care benefits, offering a more flexible financial tool.

3. Gifting and Transfers

Some families consider gifting assets to children to reduce countable wealth for Medicaid. However, Medicaid enforces a five-year look-back period on asset transfers. If assets are given away during this time, Medicaid will impose a penalty period, delaying benefits.

Instead of outright gifts, placing funds into an irrevocable trust or making structured transfers can help protect assets while maintaining Medicaid eligibility.

Steps to Take Now to Protect Your Parents’ Savings

Waiting until a health crisis occurs limits options for preserving assets. Families should take these steps as early as possible:

  1. Assess current assets and long-term care needs – Understanding financial resources and care preferences allows for early intervention.
  2. Meet with an elder law attorney – Legal professionals can help create Medicaid-compliant trusts and asset protection plans.
  3. Discuss long-term care options – Exploring in-home care, assisted living, or nursing home facilities ensures informed decision-making.
  4. Review estate planning documents – Wills, powers of attorney and healthcare directives should align with long-term care goals.

Proactive planning provides financial security and peace of mind, ensuring that parents receive quality care without jeopardizing their savings.

Key Takeaways

  • Nursing home costs deplete savings quickly: Without planning, families may be forced to sell assets or exhaust retirement funds to pay for care.
  • Medicaid has strict asset limits: Failing to plan may result in losing wealth before qualifying for benefits.
  • Asset protection strategies can preserve savings: Medicaid Asset Protection Trusts and exempt asset planning help safeguard wealth.
  • Long-term care insurance offers financial relief: Early enrollment in a policy can help offset nursing home costs.
  • Early planning provides better options: Starting the conversation now prevents financial hardship and ensures better care choices.

Reference: Elder Law Answers (Jan. 16th, 2025) “Protecting Your Parents’ Assets from Nursing Home Costs”

When Should a Trust Be Reviewed?

Life changes, and laws change too. The great trust created two decades ago may not be a good idea today and may no longer be suitable for you or your beneficiaries. As a general rule, you should review your estate plan and trust every other year, according to the article “Revisit trust on a regular basis” from the Santa Cruz Sentinel.

Start with the Table of Contents, if there is one. There should be language concerning “Successor Trustees.” Are the trustees you named still alive? Are they still part of your life, and do you still trust them? How are their money skills? If they don’t get along with the rest of the family, or if they have been embroiled in a series of petty disputes, they may not be appropriate to manage your trust. Don’t be afraid to make changes. Your estate planning attorney will know how to do this smoothly and properly.

Next, find the paragraph that discusses “Disposition on Death” or “Disposition on Death of Surviving Spouse.” Does it still make sense for your loved ones? Have any children or family members who are listed as receiving benefits died? Are any heirs disabled and receiving government benefits? Have any of your children developed addictions, problems handling money, married people you don’t trust, or are preparing to divorce their spouses? Changes can be made to protect your children from themselves and from others in their lives.

Look for a “Schedule of Trust Assets.” When was the last time this was updated? If you’ve moved and the trust still lists your last residence, you need to change it. Is your new home in the trust? Are retirement accounts correctly listed? Do you have new assets you’ve never placed in the trust? This is a common, and costly, oversight.

If married, how does the trust address what occurs between the death of the first spouse and the surviving spouse? Do you have an A/B trust to divide everything between a Survivor’s Trust and a Bypass Trust or Exemption Trust? Maybe you don’t need or want an A/B trust anymore. Talk with your estate planning attorney to be sure this is structured properly for your life right now.

How is your health? If you or a spouse are in a nursing home or if one of you is ill and likely to needs nursing home care, it may be time to start planning for a Medicaid Asset Protection Trust.

While you’re reviewing your trusts, trustees and beneficiaries, don’t forget to review the people named as beneficiaries for your retirement accounts and life insurance policies. These should be reviewed regularly as well.

Reviewing your trust and estate plan on a regular basis is just as necessary as an annual physical. Leaving your accumulated assets unprotected is easily fixed, while you are alive and well.

Reference: Santa Cruz Sentinel (Nov. 20, 2021) “Revisit trust on a regular basis”

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