It's 2:47 PM on a Tuesday when your phone rings. It's your sister, and you can hear it in her voice before she even says the words. "We need to talk about Mom. The doctor says she can't live alone anymore. We need to find a memory care facility."
Your heart sinks. Your mind races. And suddenly, you're facing questions you never wanted to answer: How will we pay for this? How long will her savings last? What happens to the house? Will there be anything left for us kids?
If you're reading this, you're probably living this nightmare right now. And I want you to know something important: you're not alone, and there are answers.
The Reality of Long-Term Care: It's Not If, It's When
Here's what most families don't realize until it's too late.
According to a paper published by Richard W. Johnson on April 3, 2019, from the U.S. Department of Health and Human Services titled "What Is the Lifetime Risk of Needing and Receiving Long-Term Services and Supports," over 70% of adults who live to age 65 will need long-term services and support. This can include everything from a home-health aide, to assisted living, to memory care, to a nursing home stay.
The report states: "The prospect of becoming disabled and needing long-term services and supports (LTSS) is perhaps the most significant risk facing older Americans."
Let that sink in. Seven out of ten people will need this care. This isn't rare. This is normal. But it's expensive normal.
The Shocking Cost of Care (And Why It Matters to Your Family)
Let me share some numbers that might make your stomach drop.
According to Genworth Financial's 2024 Cost of Care Guide (one of the largest providers of long-term care in the country):
In Minnesota:
- Home health aide: Over $96,000 per year
- Assisted living: Over $74,000 per year
- Nursing home: Over $146,000 per year
- Memory care: Even more expensive
In Florida (Gulf Coast):
- Home health aide: Over $82,000 per year
- Assisted living: Over $63,000 per year
- Nursing home: Over $128,000 per year
- Memory care: Even more expensive
I remember meeting with Tom and Susan last year. Tom's father had just been diagnosed with Alzheimer's. They assumed their dad's savings of $400,000 would be plenty. But when we did the math together, Tom went pale. At $12,000 a month for memory care, his dad's entire life savings would be gone in less than three years. And Alzheimer's often lasts much longer than that.
"We thought he was set," Tom told me. "We had no idea."
The "Long Goodbye" - When Memory Care Becomes Your New Reality
Memory care is uniquely heartbreaking. Unlike other health crises that come and go, dementia is what many families call "the long goodbye."
You watch your parent slowly slip away. Some days they recognize you. Other days they don't. The person who raised you, who taught you to ride a bike, who helped you through your first heartbreak - they're still physically here, but they're also somehow... gone.
And while you're grieving this loss, you're also:
- Sorting through paperwork you don't understand
- Making medical decisions you're not qualified to make
- Arguing with siblings about what Mom would want
- Emptying bank accounts to pay for care
- Lying awake at night wondering when the money will run out
One of my clients, Jennifer, told me through tears: "I feel like I'm failing her. I'm spending all her money, and I don't know how to stop it. She worked her whole life to have a nest egg, and it's disappearing in months."
This is the reality for thousands of families every single day.
The Big Medicare Myth (That Costs Families Everything)
Here's the sentence that shocks almost every family I meet with:
Medicare does NOT cover long-term care.
I can't tell you how many times I've sat across from adult children who assumed Medicare would take care of everything. It doesn't. Not home health aides. Not assisted living. Not memory care. Not nursing homes (except for very brief skilled nursing stays after hospitalization).
So if Medicare doesn't pay, who does?
The Three Ways to Pay for Long-Term Care (And Why Two Don't Work for Most People)
There are only three ways to pay for long-term care:
Option 1: Your Personal Savings
This is the default for most families. You pay out of pocket until the money runs out. At $10,000 to $15,000 per month for memory care, even substantial savings can disappear quickly.
Option 2: Long-Term Care Insurance
This sounds great in theory, but here's the problem:
- Not everyone qualifies (pre-existing conditions disqualify many people)
- Those who do qualify often can't afford the premiums
- The policy may not cover the type of care someone needs or all of it
I've seen countless policies that pay $4,000 per month with a two-year cap. But if you need memory care at $15,000 per month that lasts for five years? That policy barely makes a dent.
Option 3: Government Benefits (Medicaid)
Here's what most people don't know: Government benefits are now the number one way middle-class families are covering long-term care costs.
But there's a catch. Actually, several catches.
The Medicaid Spend-Down: Why the Government Makes You Go Broke First
The government program that covers long-term care is Medicaid (not Medicare - they're completely different). But Medicaid requires you to spend almost all your own money before you can qualify for benefits. This is called the "spend-down."
In Minnesota: You need to be below $3,000 in assets to qualify.
In Florida: You need to be below $2,000 in assets to qualify.
Think about that. A lifetime of savings. Gone. Before you get any help.
What About the House? (This Is Where It Gets Complicated)
Some assets, like your primary residence (provided the equity is below Medicaid's equity limits), are initially protected from the spend-down.
However - and this is critical - if you go into a nursing home and are unable to return home, your primary residence can become an available asset.
And even if your home is initially protected, here's what happens after you pass away: The government can put a lien on your home and take the proceeds from its sale to pay itself back for the value of any benefits it paid for your care.
This is called "estate recovery," and it's how the government gets its money back.
I'll never forget the look on David's face when he learned this. His mother had been in a nursing home for three years, paid for by Medicaid. She had just passed away, and he assumed he and his siblings would inherit the family home. Then he got the letter from the state claiming over $380,000 against the house.
"I thought the house was safe," he said. "Nobody told me they'd come after it later."
The Dangerous Mistakes Families Make (That Cost Them Everything)
When families learn about the spend-down rules, their first instinct is usually: "Let's just give everything to the kids."
Or: "We'll sell Mom the house for $1."
Please don't do this.
These strategies can actually cause you to lose benefits you would otherwise have been entitled to. The government has rules specifically designed to catch these transfers, and they will penalize you for them.
The 60-Month Look-Back Period (Why Timing Is Everything)
Here's something most people don't know: The government looks back 60 months (five years) at all your financial transactions when you apply for Medicaid.
Any gifts, transfers, or sales below fair market value during those five years can result in a penalty period where you're denied benefits - even though you've already given the money away.
That's why it's so important to have planning in place before a medical emergency happens and you need care. The sooner planning is done, the more likely you are to protect your home and life savings.
When to Plan: The Ideal Timeline (And What to Do If You're Already in Crisis)
Best Case Scenario: Planning in Your 60s
For many of our clients, we suggest planning in their 60s. That way, when they reach their 70s (when the need for care becomes more likely), the five-year look-back period has already run. This gives you maximum protection options.
Still Good: Planning in Your 70s
If you're in your 70s, it's not too late - but you do need to act sooner rather than later. We can still implement strong protection strategies, but the window is closing.
Crisis Planning: When Care Is Needed Now
Once a parent or loved one needs care right now, there are still planning strategies available to protect your home and life savings. However, I'll be honest: it's more expensive to do at that point, and often you're able to protect less than if the planning had been done sooner.
But "less" is still better than "nothing." I've helped many families save tens or even hundreds of thousands of dollars, even in crisis situations.
The Will and Trust Myth (Why Estate Planning ≠ Asset Protection)
Here's another dangerous assumption I see all the time:
"We already have a will."
"Mom worked with an estate planning attorney years ago."
"We have a revocable living trust. We're protected, right?"
Wrong.
Estate planning and elder law are completely different areas of the law.
A will or revocable living trust tells people who gets your assets after you die. They do not to protect those assets from long-term care costs while you're alive.
Just because you worked with a great estate planning attorney does NOT mean you've done planning to protect your home and savings from long-term care costs. These are separate legal specialties requiring separate planning.
Think of it this way: You wouldn't go to a foot doctor for a heart problem, even though they're both doctors. Similarly, estate planning and elder law planning serve completely different purposes.
There Are Legal Ways to Protect Your Assets (The Government Provides Them)
Here's the good news: There are ways that the government officially provides for under the law that you can use to protect your assets from spend-down and recovery.
These aren't loopholes. These aren't tricks. These are legitimate planning strategies built into the law itself.
Over my nearly 30 years of practice, I've helped thousands of families protect their homes and life savings using these strategies. I've taught these methods to other attorneys, financial professionals, and even government agencies including the IRS, the Office of Management and Budget, and the Treasury Department.
This planning is legal, ethical, and effective.
Why Families Choose Our Firm (Experience + Personal Touch)
When you're facing a crisis with a parent's health and finances, you need someone who:
- Has deep experience - I've been practicing nearly 30 years. I've been interviewed by USA Today, The Epoch Times, Live Life Large, and other national media. I teach continuing education to other lawyers and financial professionals across the globe.
- Provides sophisticated planning - I started my career at a large law firm and was previously the chair of the estate planning department of a large firm. You get large-firm experience.
- Gives personal attention - But unlike those big firms, you're not a number here. Our team in both Minnesota and Florida knows you, cares about you, and walks with you through every step.
- Understands both states - I'm licensed in both Minnesota and Florida with offices and staff in both states. If you have family or property in both places, we can help coordinate everything. So if you are “up north” and mom and dad have retired to Florida, we can help.
What Happens Next: Your First Step to Protection
If you're reading this and thinking, "This is us. We need help," here's what to do:
Call us today to schedule a consultation to discuss your own planning:
- Florida office: 941-909-4644
- Minnetonka, Minnesota office: 763-420-5087
Or fill out the contact form on this page, and a member of our team will reach out to schedule your consultation.
Free Resources to Get Started
Not ready to call yet? I understand. Here are some ways to learn more:
Download our free guide: "Save Our Home: How to Protect Your Home and Life Savings From Long-Term Care and Nursing Home Costs" - Click here to download your copy
Join our free masterclass: I reveal strategies for protecting your home and savings from long-term care and nursing home costs. Click here to register
You Don't Have to Face This Alone
That phone call - the one about Mom needing memory care - it changes everything. I know because I watched my parents go through it with my grandparents when I was younger and I've walked alongside many families through this exact situation as their attorney.
The stress is real. The grief is real. The confusion is real.
But you don't have to watch helplessly as a lifetime of savings disappears. You don't have to lose the family home. You don't have to choose between quality care for your parent and financial security for your family.
There are answers. There are strategies. There is help.
We're here when you're ready.
Contact Roulet Law Firm, P.A. today:
- Florida: 941-909-4644
- Minnesota: 763-420-5087
Let's protect what your parents worked their whole lives to build.
