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Planning for Long Term Care – An Introduction

Long term care is the type of care you will need if you are unable to perform some of the normal daily activities (such as dressing, eating, bathing, and toileting) without assistance, and if it is anticipated that you will need this help for an extended period, often for the rest of your life.

This kind of care is often needed due to chronic illness, aging, or injury, and almost all of us will need it for at least some time before we die. But it is not just for the elderly; many younger, working-age adults are currently receiving long term care due to injury, accident, or illness.

Long term care can be provided in-home, in an assisted living facility, or in a nursing home. Wherever provided, it can become very expensive.

Home health care can get expensive quickly. Just 25 hours a week, at $16 per hour would cost $20,000 per year. Depending on the level of skill required, the number of hours needed and where you live, it may cost considerably more.

Assisted living facilities routinely cost more than $25,000 per year; the greater number of services you require, the higher the cost. Nursing homes, with round-the-clock care, easily can cost $50,000 or more a year. These costs will only go higher, thanks to increasing medical costs.

Remember, too, that you may end up paying these costs for a considerable amount of time. On average, a nursing home stay is about three years. If the patient has Alzheimer’s, the stay is typically even longer.

Did you know that health insurance, disability income insurance, and Medicare do not cover long term care claims?

Some health insurance plans do cover nursing home expenses but only for the short-term recovery of an illness or injury.

Disability income insurance replaces part of your income if you are unable to work after a specific length of time, but once again, it will not pay for long term care.

And finally, Medicare, which provides coverage for most people over 65, extends limited coverage for specialized care for a maximum of 100 days which begins as soon as a person is hospitalized. After the 100 days, the bill is all yours.

After reading the facts of this article, the question becomes: if long term care is needed, who will pay my bill? There are really only three options: 1. you (or your loved ones) pay out-of-pocket, 2. Long Term Care Insurance, or 3. Medicaid.

Long Term Care Insurance is the best alternative for many people. It is an especially good option for those who wish to avoid being a financial burden to others, those who have assets and income they wish to protect, and those who wish to have choices in the care they receive. Long Term Care Insurance gives you the option of receiving in-home care as well as care at a private pay facility. The premiums for Long Term Care Insurance are lower when a person is younger and in better health. The longer you wait, the likelihood of you not qualifying or the cost being prohibitive is much greater.

Medicaid pays the medical bills for hundreds of thousands of people in nursing homes around the country. However, since the program is intended to provide assistance to those who cannot support themselves (i.e. children, those with disabilities, the poor), it is mandatory for a person hoping to qualify for benefits to “spend down” their assets until they are practically penniless. If you are married, Medicaid limits your spouse on the amount of assets he or she can have in order for you to qualify. If you would prefer to have Medicaid pay for the cost of your long term care, rather than your personal assets, it is imperative that you make plans now. There are legitimate ways to structure your affairs so that, in the event you need long term care someday, your personal assets do not have to be spent on your care.

The experience and advice of a qualified professional can be most helpful when planning for long term care. If you have thought about trying to qualify for Medicaid, talking to an attorney who practices Elder Law before you do anything may be the best decision you could ever make. A simple, innocent mistake could disqualify you from receiving benefits for many months, or even years.

If you would like to review how long term care costs can affect you and learn how you can protect your assets, please contact us to arrange for a complimentary consultation.



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Serving the greater San Antonio, Bexar County, Comal County, Guadalupe County, and South Texas areas, the attorneys at the Voeller Law Firm have over 35 years of experience helping families plan for their futures, protecting surviving spouses, and safeguarding assets for children and grandchildren.

James Voeller
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