What is long-term care?

When most people think of long-term care, they think of nursing homes. However, long-term care refers to any type of care that is designed to help someone who has a chronic illness or disability and cannot care for themselves over a long period of time.

Long-term care may refer to nursing home care, in-home care, assisted living facilities, or a combination of services.

How to Pay for Long-Term Care

The average nursing home stay is two to three years. With the cost of nursing home care approaching $10,000 per month or more in some parts of the country, many people may be concerned about how they are going to pay for long-term care.

Many people may start out paying one way, and eventually need to transition to another type of payment.

Private Pay

If you have saved a great deal of money or if you are wealthy, you may be able to privately pay for long-term care out of your own funds. Unfortunately, nursing home care costs over $100,000 per year – an expense that many of us cannot afford. So what other options are available?


Medicare is health insurance provided to those age 65 or older. While it will cover some hospital stays, Medicare is not designed to cover the cost of long-term care. In fact, even for those who qualify for Medicare coverage, Medicare will only pay for 100 days of long-term care – and even during that time, you may be required to pay a deductible.


Medicaid is a needs-based federal program which is administered by each state to help pay for nursing home care and some types of in-home care waiver programs only. It does not cover assisted living facilities.

Medicaid has strict income and asset requirements. Most people will be required to do extensive pre-planning or will have to spend down their assets to qualify for Medicaid. It is important to see an experienced elder law attorney immediately if you think that a Medicaid application may be in your future.

Veterans’ Benefits

If you are a veteran or the spouse of a veteran who served during a wartime period, you may be eligible for the Aid & Attendance pension. Although this pension also has income and asset requirements in order for a veteran to be eligible, these requirements are not as narrow as Medicaid eligibility rules.

This pension will not cover the entire cost of your care (the maximum pension for a married veteran is around $2,300 per month), but it can provide an important supplement to your income, allowing you to avoid having to go on Medicaid. Because VA benefits can be used to pay for any type of long-term care, you may be able to prolong your stay at home or in an assisted living facility rather than living in a nursing home that accepts Medicaid.

What can I do today?

While no one likes to think that a chronic illness or disability will happen in their family, the fact is that one in two people will need long-term care at some point in the future. It is crucial that everyone has a plan for how they will pay for this care in the event that a family member needs long-term care in the future.

Get an Airtight Estate Plan

Each person over the age of 18 needs some type of estate plan. If you do not record your wishes for how you want your assets distributed after you die or how you want to be taken care of if you are incapacitated, the state will make these decisions for you.

An experienced estate planning attorney can help you create a trust or show you other ways of protecting your assets from the cost of long-term care in the future.

Apply for Long-Term Care Insurance

If you are relatively young and healthy, you may want to consider purchasing long-term care insurance. This type of insurance will cover some or all of the cost of any long-term care in the event that you need it in the future.

Visit an Elder Law Attorney

If you or a loved one is facing the immediate possibility of long-term care, it is crucial that you visit an experienced elder law attorney as soon as possible. Elder law attorneys can help you shield between 50 and 100% of your assets from being spent down on Medicaid – even if you need to go into a nursing home within the next month.

Hire an Elder Care Coordinator

Many caregivers and children of seniors needing long-term care do not live nearby or have work or family obligations that prevent them from being the advocate their family member needs when looking for long-term care options. At Alperin Law, we have an elder care coordinator on staff who can help coordinate with nursing homes, provide you with facility information and options, and lend a helping hand in all aspects of this difficult process.

Do You Need Help With An Elder Law Issue In Virginia?

If you need to speak with an experienced elder law attorney in Virginia please feel free to contact us online or call our Virginia Beach office directly at 757.490.3500 to schedule your free consultation. We have offices throughout Virginia including Chesapeake, Newport News, Norfolk and Suffolk.

Scott Alperin
Experienced Estate Planning & Elder Law Attorney Serving Virginia Beach Area Clients Since 1994.
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