How Estate Planning Can Help Prepare for Long Term Care

How Estate Planning Can Help Prepare for Long Term Care

October 14, 2022

The cost of long-term care can vary widely based on location (both city and state) and level of care needed. However, one thing is for certain: with 7 in every 10 people requiring long-term care at some point, preparing for this care is vital.1

With the median cost of an assisted living facility topping $4,500 per month in 2021, and the median price of a private room in a nursing home costing just over $9,000 per month, deciding to simply wing it can prove costly in multiple ways.1  Here we discuss a few estate planning tools that can help you prepare (and pay) for long-term care. 

Why is Estate Planning Needed?

Generally, only the very wealthy have enough assets to pay a $9,000-per-month nursing home bill out of pocket. In most cases, someone in an assisted living facility or nursing home will first spend most of their own assets, then enroll in their state's Medicaid program to help pay for long-term care. Unfortunately, if one spouse goes into a nursing home while the other lives independently, the cost of this nursing care can quickly bankrupt the independent spouse. 

Estate planning can help protect assets for a spouse or loved ones while ensuring that the person who requires long-term care receives needed services. 

What Estate Planning Tools are Available?

The estate planning tools you will need depend on your financial situation—estate planning for long-term care purposes definitely is not one-size-fits-all. However, there are tools more commonly used to help preserve assets.

Irrevocable Trust

These trusts hold legal title to the settlor's (or trust creator's) assets. Because the assets belong to the trust, not the individual, they do not "count" for Medicaid purposes. However, any income from this trust can be considered an asset. Plus, the five-year Medicaid look-back period means that you will need to start early: only after assets have been held in the trust for five years or longer are they no longer considered "yours" for Medicaid purposes.2 


An annuity is similar to a private pension. In exchange for a lump sum that's invested, the annuity provider will send you a specific amount of money each month. Because the lump sum is no longer in your control, it will not be counted for Medicaid purposes. But like an irrevocable trust, the income from the annuity is considered an asset, and the annuity is subject to a five-year lookback period. 

Another alternative is to purchase an annuity in your spouse's name. Because the income is directed to your spouse, not to you, it will not be considered yours for Medicaid purposes.

Because estate planning for long-term care purposes can be complicated, it is a good idea to see a financial professional before making major money moves. 


Important Disclosures

The opinions voiced in this material are for general information only and are not intended to provide specific advice or recommendations for any investment product. To determine which investment(s) may be appropriate for you, consult your financial professional prior to investing.

Annuities are long-term, tax-deferred investment vehicles designed for retirement purposes. Withdrawals prior to 59 ½ may result in an IRS penalty, and surrender charges may apply. Guarantees are based on the claims-paying ability of the issuing insurance company.

This information is not intended to be a substitute for individualized legal advice. Please consult your legal advisor regarding your specific situation.

This article was prepared by WriterAccess.

LPL Tracking #1-05313109.



Cost of Care Survey, Genworth,

Understand Medicaid’s Look-Back Period, American Council on Aging,