Elder Law, Medicaid Planning & Guardianship

Elder law is an aspect of estate planning that focuses primarily on the changing needs of people as they age. Issues of aging include senior housing and home care, long-term care, or nursing home care, guardianships, health care documents, Medicare planning, and Medicaid planning.

Senior Housing & Long-Term Care Options

The Long-Term Care Dilemma

As our population ages, more and more people will confront elder law-related issues. One of the most pressing issues is long-term nursing home care, which usually is not covered by traditional health insurance or Medicare. Depending on where you live and the level of care needed, nursing home care can cost anywhere from $35,000 to $150,000 a year, with the average cost in Florida being about $76,000 per year. The average nursing home stay is slightly more than three years. Most people end up paying for nursing home care until their personal (or family) assets are depleted. At that point, then they may qualify for Medicaid benefits and have Medicaid pay for continued nursing home care. With careful planning, you may be able to avoid spending down your assets on long-term care. Options for doing so include irrevocable trusts specifically designed for long-term care planning, or purchasing long-term care insurance. It is also very important to ensure you are receiving all benefits for which you are entitled under Medicare and Medicaid.


Medicare is an entitlement program, a federal health insurance program in which most people enroll when they turn 65 years old. There are no financial qualification rules. Medicare has two primary parts: Part A and Part B. Medicare Part A covers in-hospital care, extended care after a hospital stay, some home health care services, and hospice services. The rules for nursing home coverage are very strict and, in fact, Medicare pays for less than 9% of nursing home care in this country.

Florida Medicaid

Medicaid is a joint federal-state program, subject to certain federal requirements, with each state implementing its own regulations that govern how the program is managed. Medicaid is not an entitlement program like Medicare — it is a form of welfare. Medicaid eligibility is determined after an application is submitted to the state. There are many Medicaid insurance programs available in Florida, from basic medical coverage to nursing home programs.  The Florida Department of Elder Affairs provides a wealth of information for seniors and caregivers. We assist seniors and their families in making decisions regarding long-term care planning, including the exploration of Medicaid eligibility option and the use of irrevocable trusts.

Senior Housing Options

Moving to senior housing may be a daunting and emotional task. The death or declining health of a spouse may trigger the need for such a move. Finding a new home that is appealing and appropriate is no easy task, and neither is culling through a lifetime’s accumulation of personal belongings. Moreover, the emotional strain of moving from a comfortable home, coupled with the disappointment of the loss of independence, can be extremely difficult to bear. Here are some tips to help make the transition easier:
  1. Plan ahead. Do not wait for a health crisis to start the transition process. Begin now to discuss your wishes and plans with your spouse, family and friends. Meet with your estate planning attorney to ensure these wishes are properly documented and that you are ready to take full advantage of any government benefits available to you.
  2. Get a full assessment of the current situation. Review any physical care needs and financial resources. Consider the costs of staying in place, including renovation and ongoing maintenance. Add the cost of rising utility bills and taxes, and don’t forget transportation and food. Make a list and decide whether it’s cheaper to stay or move to a community designed for seniors.
  3. Take a step-by-step approach. Remember, it usually takes longer than a year to actually make a move to senior housing. Start now and take one step at a time.
  4. Fully explore new housing options. Senior living offers a broader range of options than ever before. Learn about some alternatives that may be right for you.

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South Florida Estate Planning Attorney Brian C. Perlin, assists clients with Estate Planning, Elder Law, Probate Court, Probate & Estate Administration, Long-Term Care, Medicaid Planning, Veterans Benefits, Charitable Planning, Special Needs Planning, Estate Tax Planning, Business Succession and Asset Protection, in the cities of Miami, Coral Gables, and Kendal, Florida, and the surrounding areas.


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