Long Term Care & Medicaid Planning

Most individuals will require some type of long term care. Helping individuals and families plan for long-term healthcare needs is a critical component of estate planning. Ensuring there are sufficient funds and options available through health insurance, Medicaid, and Medicare can ease the financial burden and stress of loved ones when long-term care is needed.

At North Carolina Estate Planning and Fiduciary Law, our attorneys keep up to date with the ever changing laws surrounding elder care including long-term health care needs. By understanding the complex requirements of Medicaid and Medicare, we can implement planning strategies in estate plans that provide for long-term care needs while preserving the maximum amount of assets for loved ones. Often this is accomplished through the use of the following documents:

  • Wills
  • Irrevocable and/or Special Needs Trusts
  • Medicaid Asset Protection Trust or MAPT
  • Annuities
  • Advanced Directives for Healthcare Decisions
  • Durable Power of Attorney

Long-term care is expensive with costs expected to continue to rise. The 2021 Genworth Cost of Care reports the average cost of a nursing home facility in Charlotte, North Carolina is $7,756 per month and the average in-home healthcare and assisted-living can range from $4,400 to $4,668 per month. (https://www.genworth.com/ ) The staggering cost of care can be devastating and not many families can cover the significant cost of long-term care without depleting their entire estate.

Medicare is a federal health insurance plan paid into by individuals during their working years. Medicare Part A coverage provides payment for hospitalization, home health services and hospice services. In addition, it provides for limited, short term skilled nursing care facilities, if care is medically necessary and follows a hospital stay. Medicare does not pay for most long-term care needs. To make matters worse, private health insurance generally does not cover the entire cost either. This often leaves a huge gap for most families.

Most individuals have to turn to assistance from Medicaid. Medicaid is a benefit program funded by the government to provide certain low income individuals and families with benefits who have limited resources. North Carolina has strict rules and requirements as to the income and resource limits an individual may have to qualify for coverage. The eligibility requirements and benefits vary and deciphering them can be complex. Planning ahead with a knowledgeable attorney can help you qualify for Medicaid without depleting the entirety of your estate.

For those who believe that they won’t need any type of long term care, the U.S. Department of Health (https://acl.gov/ltc/basic-needs/how-much-care-will-you-need) estimates the following statistics:

  • A 65 year old individual has a 70% chance of needing some type of long-term care.
  • 20% of individuals will need long-term care for more than 5 years.
  • Women will need long-term care longer than men, approximately for 3.7 years vs. an average of 2.2 years for men.

Working with a knowledgeable estate planning attorney can help you understand the Medicaid eligibility and benefits you may be entitled to. In addition, an attorney can help implement effective estate planning techniques for asset protection, so you don’t have to spend down your estate to qualify for benefits. The sooner you begin planning for your long-term care needs the more options you will have. When seeking Medicaid there is a five-year look-back period. This prevents individuals from disposing or transferring assets to qualify for coverage within five years of applying. For example, transfers of property to children within the time frame is not excluded and will delay your ability to qualify for benefits. Optimally, one should start planning at least five years before you anticipate needing to apply for Medicaid benefits.

Even if you require Medicaid benefits immediately, either due to already being admitted to a nursing home or will be in the near future, there are still tools that can be utilized to help you legally preserve assets and qualify for benefits.

Regardless of your situation, planning for long-term care can be complex. The attorneys at North Carolina Estate Planning and Fiduciary Law are experienced in all facets of estate planning matters. We can help you overcome challenges that may arise while helping you navigate the complex process to qualify for care benefits while preserving the most assets possible.

Whether you need assistance with long-term planning, Medicaid, or Medicare issues, our attorneys will provide you with all viable options. To schedule a confidential consultation with one of our experienced estate planning attorneys, call our office at (704) 248-6325 or complete our online form.


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