Category: Long Term Care Planning

Get long term care planning options through a qualified attorney

On behalf of Kaplin Stewart Meloff Reiter & Stein, P.C. posted in Long Term Care Planning on Jul 14, 2016.

Long term care in Pennsylvania does not necessarily connote the need for medical attention. The concept also applies to needing assistance in the daily activities of life, such as bathing, getting dressed, taking medicine, grocery shopping, paying bills, managing money, house cleaning and cooking. Several studies indicate that out of those who are 65 or older right now, a whopping 70 percent will need some form of long term care for an average of three years. This connotes the need for long term care planning. Some of that care will not have to be associated with institutionalization and can pertain instead to in-home care. Whether it be minor in-home assistance or full housing in a nursing home, the facts show that this kind of service is expensive by any standards. One of the biggest misconceptions that people have is that the care that they will need will be paid for by Medicare. That is not true. There are a few minimal programs under Medicare, but the only federal government program that funds long term care is Medicaid. This assistance for Medicaid, however, comes with strings attached. A person must consult with an elder law and estate planning attorney to put Medicaid planning into effect. Medicaid planning involves spending down or transferring assets so that one qualifies for the government assistance. There is a five-year look-back provision which requires that the person stay alive for that five-year time in order for the transfer of properties to be final and thus allow […]


Aspects of long term care planning for Baby Boomers

On behalf of Kaplin Stewart Meloff Reiter & Stein, P.C. posted in Long Term Care Planning on May 20, 2016.

Members of the Baby Boomer generation are now entering retirement at a rate of approximately 3.5 million each year. As these Pennsylvania residents continue to age, they will begin to have specific needs that must be addressed. Those needs can best be looked after through through and informed long term care planning, as part of a larger estate planning package. A common issue that many older people face is the fact that they created their estate plans many years before those plans would need to be called into effect. Early planning efforts are admirable, but many people fail to alter those plans as circumstances shift. An example is found in the common choice of each spouse naming the other as their agent in the event of an incapacitating illness or injury. A problem arises when a couple is fortunate enough to grow old together, and then begin experiencing cognitive decline at around the same time. This could result in a situation where one spouse requires the other to act as his or her health care or financial proxy, but when the named spouse is not capable of fulfilling that role. That outcome will defeat the intended purpose of naming a power of attorney. The best way to address this issue is to periodically review existing estate planning documents, and to make alterations as time goes on. At some point, it may make sense to name a child or other trusted party as power of attorney for both spouses, so that […]


Review long term care planning early and often

On behalf of Kaplin Stewart Meloff Reiter & Stein, P.C. posted in Long Term Care Planning on Jul 16, 2015.

When it comes to estate planning, many Pennsylvania residents focus exclusively on how to pass down wealth from one generation to another. While this is a valid concern, families must also consider how to integrate long term care planning into the greater estate planning approach. Doing so can help ensure that loved ones are able to secure the proper level of care if and when that time comes. The cost of residential medical care continues to rise, and many families cannot afford to pay for these expenses out-of-pocket. Medicaid is the primary resource for those who need help covering the cost of nursing home or residential rehabilitation care. That said, there are a number of rules and restrictions that must be adhered to before Medicaid coverage will kick in. Individuals or couples are expected to “spend down” their own assets before Medicaid coverage will begin. This leaves a family in a difficult position, as the bulk of accumulated wealth must be depleted in order to secure assistance. When one spouse dies and leaves the bulk of his or her assets to the surviving spouse, the end result can be the fast depletion of that wealth by paying for nursing home care. A better approach is to place assets into an irrevocable trust, and name one’s spouse as a beneficiary. This gives him or her access to the wealth held within the trust, but protects those assets from creditors, lawsuits or the need to spend down existing wealth prior to qualifying […]


To sleep, perchance to dream – but where, and for how much? p3

On behalf of Kaplin Stewart Meloff Reiter & Stein, P.C. posted in Long Term Care Planning on May 17, 2015.

As we have said — and as most everyone knows — part of an estate plan is preparing for retirement and the health issues that come with age. It’s hard to plan for the next generation if you haven’t already planned for this one, so understanding some of the issues that are facing retirees now should help as we deal with aging loved ones or face our own later years. We have more options these days when it comes to caring for the elderly. Nursing homes are still around — and more expensive than ever — but there are also assisted living facilities and home care programs, too. One deciding factor is certainly the level of care necessary. Another, unfortunately, is the cost of care. To develop an effective plan for those years, you have to understand what the payment options are. Perhaps the least attractive is paying out of our own pockets. Some of us will rely on long-term care insurance when the time comes. What we may not realize is that the policy may not cover less expensive care, like home care. It is easy to assume that Medicare will pay for everything, but there is no such guarantee. Medicare is just as complicated as every other type of health insurance, laden with conditions and exceptions. For example, Medicare covers home health care only if the patient’s medical team also requires visits from a “higher ranking” health care worker like a registered nurse or physical therapist. Custodial care […]


To sleep, perchance to dream – but where, and for how much? p2

On behalf of Kaplin Stewart Meloff Reiter & Stein, P.C. posted in Long Term Care Planning on May 2, 2015.

We are picking up the discussion about nursing home and home care expenses started in our April 17 post. It almost goes without saying that none of this care is getting any cheaper. The question for older individuals and families — or, for that matter, younger people putting together an estate plan — is how much will those costs increase between now and when they’re needed? Genworth Financial Inc., an insurance company that sells, among other things, long-term care coverage, recently released a study comparing the costs of nursing home care, adult day care, assisted living facility care and home care. According to Genworth’s analysis, the cost of nursing home care has increased by 4 percent every year over the past five years, landing at a nationwide median of more than $91,000 a year for a private room. Pennsylvania outpaces the national median. Nursing home care here increased 5 percent year-over-year. A private room now costs $113,150 (again, median) per year. In Philadelphia, it’s even higher: $127,750 annually. Other care arrangements are less expensive, and the difference offers a good deal of food for thought. If your care will cost more than $125,000 a year in a nursing home, for example, you may want to talk with family and your health care team to determine if that level of care is really necessary. An assisted living facility in Philly would cost $58,626 annually; home-based care would cost a little less, and adult day care would run to about one-third the […]

To sleep, perchance to dream – but where, and for how much?

On behalf of Kaplin Stewart Meloff Reiter & Stein, P.C. posted in Long Term Care Planning on Apr 17, 2015.

Survey after survey has told us that the majority of Americans want to grow old in their own homes. Healthy or infirm, seniors want to be in a familiar environment, surrounded by their belongings and their loved ones. There are cases, too, when the loved ones drive the decision: Living independently has become difficult, impractical, or dangerous. For many, taking care of your parents in their old age is just what you do; keeping a sister stricken with ALS at home because it is easier for friends and family to be with her. Finances may also drive the decision. Nursing homes and assisted living facilities are expensive, and the rules for Medicare are complicated, even, at times, outright punitive. For a long time, though, moving into a place like that was the only way to make sure a nurse checked on the senior on a regular basis. The increasing availability of qualified in-home health workers has taken some anxiety out of the equation. Having someone come to a person’s home means the patient need not leave the house for a care visit — it’s a twofer: convenience and reduced costs of care. And, of course, the patient and family can avoid the costs of an in-patient care facility — it’s really a threefer.  Healthcare costs are often described in terms of Medicaid reimbursements. The reimbursement is uniform and, in theory at least, reflects best practices. According to the Pennsylvania Department of Health, home care is dramatically less expensive, in Medicaid […]


Long-term care planning and Medicaid planning

On behalf of Kaplin Stewart Meloff Reiter & Stein, P.C. posted in Long Term Care Planning on Feb 9, 2015.

We’ve spoken before on this blog about the importance of long-term care insurance as an adjunct to estate planning. As we noted before, most of us will require long-term care at some point in our lives. So, given that long-term care planning is an important task for all of us, especially for those in retirement, what types of strategies are we talking about in long-term care planning? Long-term care insurance, as some readers may know, has been a popular option for funding long-term care planning over the years. The specific terms of long-term policies vary, but the basic goal is to reimburse the policyholder for long-term care services up to a pre-selected daily limit. Because long-term care insurance can be rather expensive, though, it is important to consider alternatives.  Unfortunately, alternatives to long-term care insurance are rather sparse. On the self-help side of the alternatives, there are insurance policies and annuities with long-term care riders. For those who can’t afford these options–and many cannot–the next best option is to make use of government funding, particularly through Medicaid. Medicaid planning, sometimes considered a specialty all its own, is important because of the fact that eligibility depends on meeting certain financial requirements. Without planning in advance how to protect one’s assets, those who end up needing long-term care usually end up draining their estate in order to pay for care, until they qualify for Medicaid. With a bit of planning, though, one can keep important assets within the family. To be effective, […]


Long-term care planning: Understanding its importance

On behalf of Kaplin Stewart Meloff Reiter & Stein, P.C. posted in Long Term Care Planning on Dec 26, 2014.

Estate planning is something that all Pennsylvania residents should make time for. However, you may also be wondering if you need to plan for the possibility that you will need long-term care. Estate planning covers what will happen to your assets and possessions after your death. Long-term care planning, on the other hand, helps you make provisions in case you become incapacitated while you are still living. According to the U.S. Department of Health and Human Services, approximately 70 percent of people age 65 will need long-term care at some point. While this type of planning is important for everyone, certain factors may increase the possibility of needing long-term care. Age is one of the most important factors. The older a person gets, the more likely it is that he or she will need long-term care. Because the life expectancy pf women is longer, they are more likely to need this type of care than men. Anyone will a long-term disability or chronic health condition is also at an increased risk of needing long-term care as they get older. It is important to keep in mind that your health often declines as you get older, and it is also possible to have an accident later in life that leads to a disability. Even if you are in good health now, it is important to plan for the unexpected. Whether you already thinking about long-term care planning or are just becoming familiar with the term, an estate planning attorney can help […]