1. Protecting Your Assets from the High Cost of Long Term Care
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Protecting Your Assets from the High Cost of Long Term Care

2. What Does Long Term Care Cost?
Assisted living and in-home care averages about $2, $4, per month.
The average monthly cost of “attendant” nursing care in Michigan for 2015 is $8,
Skilled nursing care can be three times as much.
1 MI Department of Human Services
A proper estate plan should provide for you and your loved ones, not only at your death, but also in the event of your incapacity.
The possibility that you will become disabled and require assistance with the management of your assets, and even with your personal care, is surprisingly high.
U.S. Census Bureau records reveal that nearly half of us will suffer some disability during our lifetimes. Over 10% of adult Americans ages are severely disabled, and this percentage rises dramatically as we grow older. Approximately 1 in 5 men and 1 in 4 women between ages 55 and 64 are severely disabled. Between ages 65 and 79 the rate for severe disability reaches 1 in 4 for men and 1 in 3 for women.
Dealing with incapacity is never easy. It can be even harder if you haven’t planned for it.

3. In Home & Assisted Living Options
Long term care insurance coverage or hybrids (i.e. – life insurance with LTC rider), if any
Life Settlements - access death benefit before death
Programs to save on prescription drugs, to free up their own income
Veterans Programs to provide extra income
Non-nursing home Medicaid programs, to pay for some of the cost; such as the “Waiver” program
A proper estate plan should provide for you and your loved ones, not only at your death, but also in the event of your incapacity.
The possibility that you will become disabled and require assistance with the management of your assets, and even with your personal care, is surprisingly high.
U.S. Census Bureau records reveal that nearly half of us will suffer some disability during our lifetimes. Over 10% of adult Americans ages are severely disabled, and this percentage rises dramatically as we grow older. Approximately 1 in 5 men and 1 in 4 women between ages 55 and 64 are severely disabled. Between ages 65 and 79 the rate for severe disability reaches 1 in 4 for men and 1 in 3 for women.
Dealing with incapacity is never easy. It can be even harder if you haven’t planned for it.

4. VA Disability Program (Service Connected)
Veterans Programs
VA Disability Program (Service Connected)
Pension Program or “Death Pension” for surviving spouse (Non-Service Connected; e.g. – “Aid & Attendance”)
Dependency & Indemnity Compensation (DIC) Program - by surviving spouse/dependent
Programs can provide extra income to Veteran and/or their spouse.
A proper estate plan should provide for you and your loved ones, not only at your death, but also in the event of your incapacity.
The possibility that you will become disabled and require assistance with the management of your assets, and even with your personal care, is surprisingly high.
U.S. Census Bureau records reveal that nearly half of us will suffer some disability during our lifetimes. Over 10% of adult Americans ages are severely disabled, and this percentage rises dramatically as we grow older. Approximately 1 in 5 men and 1 in 4 women between ages 55 and 64 are severely disabled. Between ages 65 and 79 the rate for severe disability reaches 1 in 4 for men and 1 in 3 for women.
Dealing with incapacity is never easy. It can be even harder if you haven’t planned for it.

5. Medicaid “Waiver/Bridges” Program
Medicaid has a program that can assist pay for in-home and pre-nursing home level care.
Program historically underfunded/unavailable. There is a movement to fund/encourage use of “person-centered care” to reduce nursing home level care costs and promote independence.
Applicant must have income below $2,199.00/month and must meet same “countable asset” test as with NH Medicaid.
A proper estate plan should provide for you and your loved ones, not only at your death, but also in the event of your incapacity.
The possibility that you will become disabled and require assistance with the management of your assets, and even with your personal care, is surprisingly high.
U.S. Census Bureau records reveal that nearly half of us will suffer some disability during our lifetimes. Over 10% of adult Americans ages are severely disabled, and this percentage rises dramatically as we grow older. Approximately 1 in 5 men and 1 in 4 women between ages 55 and 64 are severely disabled. Between ages 65 and 79 the rate for severe disability reaches 1 in 4 for men and 1 in 3 for women.
Dealing with incapacity is never easy. It can be even harder if you haven’t planned for it.

6. Nursing Home Care Options
Without a LTCi policy, explore VA and other programs.
Usually, nursing home Medicaid program is the best option, but requires planning to become eligible without losing everything first.
Don’t need to have acted more than five years prior.
A proper estate plan should provide for you and your loved ones, not only at your death, but also in the event of your incapacity.
The possibility that you will become disabled and require assistance with the management of your assets, and even with your personal care, is surprisingly high.
U.S. Census Bureau records reveal that nearly half of us will suffer some disability during our lifetimes. Over 10% of adult Americans ages are severely disabled, and this percentage rises dramatically as we grow older. Approximately 1 in 5 men and 1 in 4 women between ages 55 and 64 are severely disabled. Between ages 65 and 79 the rate for severe disability reaches 1 in 4 for men and 1 in 3 for women.
Dealing with incapacity is never easy. It can be even harder if you haven’t planned for it.

7. Medicaid Eligibility Rules
Medicaid eligibility rules differ for single or married persons.
However, for both must satisfy three tests to qualify:
Medically Need Test (LOC Determination)
“Countable” Income Test (below private pay rate)
“Countable” Asset Test
First two tests are usually not an impediment. The “Asset Test” is what causes most people difficulty.
A proper estate plan should provide for you and your loved ones, not only at your death, but also in the event of your incapacity.
The possibility that you will become disabled and require assistance with the management of your assets, and even with your personal care, is surprisingly high.
U.S. Census Bureau records reveal that nearly half of us will suffer some disability during our lifetimes. Over 10% of adult Americans ages are severely disabled, and this percentage rises dramatically as we grow older. Approximately 1 in 5 men and 1 in 4 women between ages 55 and 64 are severely disabled. Between ages 65 and 79 the rate for severe disability reaches 1 in 4 for men and 1 in 3 for women.
Dealing with incapacity is never easy. It can be even harder if you haven’t planned for it.

8. Becoming Medicaid Asset Eligible
Asset eligibility can be achieved by:
Transforming countable assets into excluded assets
Transforming countable assets into unavailable assets
Strategic gifting programs (account for the “penalty”)
Maximizing the “Protected Spousal Amount” or “PSA”
Using a “Solely For The Benefit of” & Special Needs Trusts (Type A & B)
A proper estate plan should provide for you and your loved ones, not only at your death, but also in the event of your incapacity.
The possibility that you will become disabled and require assistance with the management of your assets, and even with your personal care, is surprisingly high.
U.S. Census Bureau records reveal that nearly half of us will suffer some disability during our lifetimes. Over 10% of adult Americans ages are severely disabled, and this percentage rises dramatically as we grow older. Approximately 1 in 5 men and 1 in 4 women between ages 55 and 64 are severely disabled. Between ages 65 and 79 the rate for severe disability reaches 1 in 4 for men and 1 in 3 for women.
Dealing with incapacity is never easy. It can be even harder if you haven’t planned for it.

9. Making “Countable” Assets “Unavailable”
Purchase pre-paid funeral and burial plans
“Gift Plus” Planning (with SPIA)
OBRA qualifying SPIA for qualified accounts
Utilize “formal” personal care or property maintenance contracts
Maximizing the Spousal “PSA”
Solely For the Benefit of Trusts
Special Needs Trusts
A proper estate plan should provide for you and your loved ones, not only at your death, but also in the event of your incapacity.
The possibility that you will become disabled and require assistance with the management of your assets, and even with your personal care, is surprisingly high.
U.S. Census Bureau records reveal that nearly half of us will suffer some disability during our lifetimes. Over 10% of adult Americans ages are severely disabled, and this percentage rises dramatically as we grow older. Approximately 1 in 5 men and 1 in 4 women between ages 55 and 64 are severely disabled. Between ages 65 and 79 the rate for severe disability reaches 1 in 4 for men and 1 in 3 for women.
Dealing with incapacity is never easy. It can be even harder if you haven’t planned for it.