The simple answer to this question is “yes.” Everyone is at risk of needing long-term care and if you plan ahead you are likely to receive better care at less cost to yourself and your family. Of course, nothing is really that simple.
First, there’s a distinction between advance planning and crisis planning. Advance long-term care planning generally involves either purchasing long-term care insurance (LTCI) or transferring assets, often into a trust, to protect them both from having to be spent down to qualify for MassHealth and from MassHealth’s right to recover its costs from the probate estate of the beneficiary. Crisis planning involves taking steps to qualify for MassHealth once you or a loved one already needs care or is likely to in the not-to-distant future.
Whether you should take advance planning steps depends on answers to a number of questions, including the following:
• Can you afford to pay LTCI premiums and maintain your current lifestyle?
• Do you have any preexisting conditions that would preclude you from qualifying for LTCI?
• What is the health history of your parents and grandparents? Did any of them suffer from Alzheimer’s disease?
• If you were to transfer your home or other assets into an irrevocable trust, would you still have enough income and assets left to pay your expenses for the following five years?
• Do you have children or others to whom you would like to pass your estate?
• Or is it more important to you that you have resources available to pay for your own needs?
• How important to you is it that you stay at home? Or are you comfortable with receiving care in another setting, such as assisted living or a nursing home?
• Do you have sufficient funds to pay for any care you may need without significantly affecting your financial security or that of loved ones?
• Do you have family members who would care for you if necessary?
Everyone is different in terms of their circumstances and their desires, values and goals. No long-term care plan is right for everyone. Answers to these questions can help you, with your attorney, fashion a plan that best matches your wishes, whether that involves purchasing LTCI, sheltering assets in trust, or simply executing a durable power of attorney and health care proxy.
