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Long-Term Care Planning

The Cost​.  According to the 2015 Medicare Handbook70% of persons over the age of 65 will need long-term care services at some point in their life.  But, this is a very broad statement.  Some people need home health services, while others need a long-term care facility for an extended period of time, perhaps years.   It could be that you, or your loved one, needs a specific type of medical treatment, or custodial care, such as bathing, feeding, dressing, and the need for other similar activities of daily living.  What is the result?  A drastic difference in the cost of care based on the circumstances of each person.

According to a report published by Genworth Financial after an extensive national survey by providers, the average costs of care in the St. Louis region in 2014, by category, are as follows:

Type of Care    

Home Care

Homemaker Services

Home Health Aide

Assisted Living Facility

Private, One Bedroom

Nursing Home (Skilled Nursing


Semi-Private Room

Private Room

  Annual Average Cost 










Monthly Average Cost










The five primary ways to pay for long-term care, are as follows:


  1. Private pay.
  2. Long-term care insurance.
  3. Medicare (limited).
  4. Medicaid.
  5. VA Benefits.

Solutions. If you can afford to privately pay, this is a great option— but not realistic for many people.  The private pay option can deplete a lifetime of savings within a few years. Long-term care insurance is also very appealing, and if you can afford the premiums, it is highly recommended.  Unfortunately, the cost of long-term care insurance has been on the rise for the last couple of years.  If you have not already purchased a plan, the cost of premiums for a new plan can be very high.  In addition, if you have health problems, you may not qualify.  As a result, this often is not a feasible option for many people. Next, is the Medicare option.  This is limited to some home healthcare services or 100 days in a skilled facility.  The 100 days is not a guarantee, but the maximum.  Therefore, it serves a great purpose for short-term rehabilitation and other problems that are only expected to last for a couple of months, but it does not answer the cost of care issue for a person who is likely to need care in a facility for the remainder of their life or for an extended period of time. The final two options, Medicaid and VA benefits, are options that we regularly deal with in our office.   (See Medicaid Planning and Veterans Benefits pages of this website for more details.) There are many ways to tackle the issue of paying for the cost of long-term care, and many proactive things our clients can do to ensure the best level of care and effectively preserve assets.  First, we can help you identify your goals.  Second, we must understand your assets, your income, your health, your family situation, how soon the care will be required (if not already) and where the client requires care.  After that, we can identify solutions and strategies to meet your goals.   The sooner you plan, the more options you have.   For example, if your goal is to eventually qualify for Medicaid to help with the payments of long-term care costs and you, or your loved one, do not need care immediately, we will review the Medicaid planning options through the estate plan.  If, on the other hand, your loved one is already in a facility, we will look at a number of variables and options available for immediate Medicaid planning.