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Long-Term Care Planning

Long-term care planning includes making legal and financial arrangements to prepare for your personal care and living arrangements in case you become frail or have a serious illness. It may also involve planning to help your survivors know your wishes after you are deceased.

Medicare does not pay for Home Care
unless you also need skilled nursing care.
How do I pay for home care?

Below is information about some of the steps you may want to take in advance of a serious illness:

Assigning a Durable or Springing Power of Attorney

A durable power of attorney is a written authorization to represent or act on another’s behalf in private affairs, business, or some other legal matter regardless of your competence. You may want to assign if you need help managing your affairs or are concerned that you will become unable to manage them.  Durable Power of Attorney form that is legal in New York State.

A power of attorney is a legal document that lets you (the “principal”) appoint another person(s) (your “agent” or “attorney in fact”) to make decisions about your personal financial and legal affairs. It becomes effective when it is signed, but is revoked when – or if – you become mentally incompetent.

A durable power of attorney indicates that the powers will remain in effect even after/if you become incompetent and unable to make decisions yourself. Among items included in a durable power of attorney may be matters related to the management of property, financial assets, personal relationships and affairs, taxes, and insurance including health insurance.

NOTE:  In New York State, a durable power of attorney does not include the power to make health care decisions. In order to have someone make health care decisions for you if you cannot make these decisions for yourself, you need to appoint a health care agent by completing a New York State Health Care Proxy form.

You can also execute a springing power of attorney.  This document takes effect (‘springs’ into effect) at a future time specified in the document when a specific event occurs. Often that event is a serious illness or disability. The document may state that your physician will determine whether you are competent to handle your financial affairs.If you decide to execute a durable or springing power of attorney and want to allow your agent to make gifts, you must also execute a Power of Attorney Gifts Rider.  While it is not required that an attorney be consulted about these documents, it is highly advisable.

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Preparing a Last Will & Testament

A Last Will & Testament is a legal declaration by which a person (the “testator”) names one or more persons to manage his or her estate and provides for the transfer of his or her property at their death. Most people have a lawyer help them with their Last Will & Testament.

If you have limited resources to hire a lawyer to assist in drafting a will you can contact the Westchester County Bar Association’s Lawyer Referral Service. It offers low-cost or pro bono services to those who need them.

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Purchasing Long-Term Care Insurance

Personal care for aging individuals or those with serious illness is not provided by Medicare or other health insurances if only bathing, dressing or using the bathroom are needed. These are considered to be non-medical services, and are called Activities of Daily Living (ADL). You may want to consider long-term care insurance to cover these services. Long-term care insurance must be purchased before the diagnosis of a chronic or serious illness.

Click on the following links to learn more about some of the factors that go into the decision to buy Long-Term Care Insurance, how you may be able to keep the cost down, advice from AARP (American Association of Retired Persons), what the federal government says, and what New York State says.

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Reviewing Other Payment Options for Long-Term Care

Depending on your age and health status, your concerns about paying for long-term care may be near or far in the future. Being aware of available options to cover possible future needs may help your planning at all stages in life.

Private pay. If you have financial assets and real estate, you may want to explore ways that can help you receive a monthly payment if you no longer have a regular income and need to pay for care. You will need to speak with a lawyer or financial advisor to set up these financial mechanisms. Learn about private pay methods, such as reverse mortgages, annuities and trusts.

Life insurance. A life insurance policy may help you pay for long-term care services. Learn more about options such as combinations of life and long-term care insurance, accelerated death benefits, and certain “settlements.”

Medicare, Medicaid, the Veterans Administration, and some New York State programs may offer benefits that you can take advantage of.

Additional details on the How to Pay for Care at Home page.

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Pre-Planning your Funeral or Memorial Service

You may want to leave instructions about your funeral or memorial service, and you may want to pre-pay some of the expenses. Your local funeral home can be helpful with planning and can accept pre-payment of services.  Learn more about your rights before prepaying for your funeral, and additional details in the Consumer Guide to Arranging a Funeral in New York State.

If you do not wish your legal next of kin to make decisions about how your body will be handled after death and where you will be buried, or if you think there may be disputes among family members, you can assign your preferred person to make those decisions.  See Form.

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Consulting an Elder Law Attorney

Long-term care planning is highly individual, based on your personal and financial situation. Some of the questions you may want to ask yourself and those close to you are:

  • How do I see myself aging?
  • How much will care cost?
  • How can I pay for it?
  • What care options are available?

To find answers to these questions you may want to consult with an elder law attorney or financial planner, who can help you with many of the items you need for long-term care planning. An elder law attorney is an attorney who specializes in providing legal services for the elderly, especially in the areas of estate planning, Medicaid planning, and other long-term care planning issues. If you discuss your long-term care planning goals with an elder law attorney, consider bringing these important documents with you. Most elder law attorneys will provide their own checklist of items and may have you fill out a worksheet to bring with you when you meet.

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Reviewing your Plans Regularly

As you age or serious illness develops, you, your family, and your physicians and other care providers may need to revisit your conversation about your choices. Depending on your financial situation and access to family caregivers, you may need to revise how you manage your affairs and your plans for additional services.

Being prepared is an ongoing process. Like your life, planning is fluid and ever changing.Make sure you update your choices relating to medical care and all other areas as your situation changes.

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