Ensure Your Elder Law Attorney Understands Medicaid Planning

Takeaways

• Working with an experienced elder law attorney who understands Medicaid is crucial for long-term care planning and applications.

• Red flags indicating an attorney’s inexperience include a lack of specific Medicaid knowledge, inadequate assessment of individual situations, and insufficient planning for asset protection.

• Unprofessional consultations and a lack of clarity regarding legal timings and processes can also signal an attorney’s inexperience in handling Medicaid cases effectively.

Navigating the Medicaid program can be daunting. You may be seeking help with long-term care planning for a senior family member or are ready to apply to Medicaid yourself. In either case, working with an experienced elder law attorney who understands the complexities of Medicaid is crucial.

Why You Need an Expert in Medicaid Planning

Nursing home care in the United States can cost more than $10,000 a month depending on where you live. Medicaid has become the default form of long-term care coverage for millions of aging Americans. However, an estimated $1 trillion in Medicaid cuts are likely in store over the next decade.

Meanwhile, many people mistakenly believe that Medicare, a different program, will cover the costs of long-term care. However, Medicare does not cover long-term custodial care. (Custodial care includes assistance with daily living activities such as getting dressed, eating, and moving from place to place safely, such as from a bed to the bathroom. It does not encompass medical treatment that requires a licensed nurse or doctor.)

Medicaid planning is a complex area of elder law that focuses on qualifying for Medicaid benefits without depleting one’s assets unnecessarily. To be eligible for the program, you must meet strict income and asset limits. In most states, you cannot receive Medicaid benefits if you have more than $2,000 in countable assets to your name.

In part, this is why Medicaid planning is so important. Planning involves reviewing all your assets, including bank accounts, retirement accounts, real estate, vehicles, and life insurance. A professional can help you with this and with distinguishing between your “countable” and “noncountable” assets. In addition, with the help of an expert, you can pursue legal strategies that allow you to spend down your assets so that you can qualify for the program.

5 Hidden Red Flags

Here are five red flags that may indicate an attorney’s inexperience with Medicaid planning.

1. Lack of Specific Medicaid Knowledge

Elder law is a specialized field, and not all attorneys have the expertise required to handle Medicaid cases effectively.

• Vague answers on Medicare coverage. If the attorney cannot clearly explain what Medicaid covers with regard to long-term care services, this may signal a lack of familiarity with elder law nuances.

• Ignorance about recent program changes. Medicaid policies can change frequently. An adept elder law attorney should be aware of and able to discuss the latest updates and their implications.

2. Inadequate Assessment of Individual Situations

Every Medicaid consultation requires a personalized approach, given that financial and health care needs vary widely among seniors.

• Generic advice. An elder law attorney lacking experience might offer broad, generalized advice instead of recommendations tailored to your individual circumstances.

• Failure to ask detailed questions. A seasoned attorney in this area of law will dig deep into the client’s financial well-being, health needs, and family circumstances to offer precise guidance.

3. Insufficient Planning for Asset Protection

Protecting assets while qualifying for Medicaid is a key aspect of elder law.

• No strategy for asset transfers. If an attorney cannot provide a clear plan for how to legally transfer or protect assets, this can indicate a lack of expertise.

• Ignoring look-back periods. An attorney experienced with Medicaid knows the importance of the Medicaid look-back period and should clearly explain how it affects eligibility.

4. Unprofessional Consultations

The manner in which consultations are conducted can reveal much about an attorney's professionalism and experience.

• A lack of documentation. An attorney’s failure to provide written summaries or detailed documentation post-consultation can be a red flag.

• Poor communication skills. An inability to communicate complex concepts in an accessible way may reflect inexperience or insufficient expertise.

5. Misunderstanding Legal Timings and Processes

Understanding the timelines and processes involved in Medicaid applications is crucial.

• Confusion about application timelines. If an attorney is unsure about when or how long it takes to file a Medicaid application, this can indicate inexperience.

• Inaccurate processing guidance. Misguidance about the steps involved can jeopardize the outcome of your application.

Additional Reading

Engaging with a skilled elder law attorney who is well-versed as a Medicaid planner is vital. Checking for these red flags can help ensure you or your loved ones receive knowledgeable and effective legal support.

Learn more about the various aspects of Medicaid as well as long-term care. Visit the Medicaid website to determine whether you are eligible and check out the following articles:

• Survey Shows Long-Term Care Costs Continue to Rise

• Medicaid’s Benefits for Assisted Living Facility Residents

• Pros and Cons of a Medicaid Asset Protection Trust

• Medicaid Applicants: Protecting Your Healthy Spouse in 2025

• What a Good Long-Term Care Insurance Policy Should Include

• Medicaid’s Coverage of Nursing Home Care

Get Help With Medicare Enrollment Through Your Local SHIP

Takeaways

• State Health Insurance Assistance Programs (SHIPs) offer free, unbiased guidance to Medicare beneficiaries, helping them navigate complex options and avoid costly mistakes.

• Recent budget cuts and proposed structural changes to the Administration for Community Living (ACL), which oversees SHIP, threaten its operations and could lead to reduced services and access for vulnerable populations.

Anyone who has shopped for health insurance plans knows that a plethora of options is available. Yet trying to find the plan that best fits your needs can be daunting. Not only do the plans have many features but what they cover and how much they will cover can also be hard to discern.

The federal government’s health insurance program, Medicare, can be as confusing as the open market. If you are eligible for Medicare and need help navigating the system, you can turn to your local State Health Insurance Assistance Program (SHIP).

What Is SHIP?

Congress established SHIP in 1990 to give free, unbiased guidance to help people understand their Medicare options. The SHIP network receives federal funding via the Administration for Community Living (ACL), which is part of the Department of Health and Human Services (HHS).

More than 12,000 paid and volunteer staff serve at over 2,200 SHIP sites across all 50 states, plus Puerto Rico, Guam, the U.S. Virgin Islands, and Washington, D.C. In 2022, SHIP counselors provided one-on-one assistance to over 4 million Medicare recipients and caregivers.

SHIP Services

SHIP provides valuable services to current Medicare recipients and those who are eligible for Medicare. Individuals who are new to Medicare, such as those who are turning 65 or who have a qualifying disability, can get help figuring out whether Original Medicare or Medicare Advantage is best for them. They can also obtain guidance on the various parts of Medicare, such as Part D and Medigap.

Medicare enrollees can get assistance from SHIP each year during open enrollment to review and switch plans if needed. SHIP also offers support with appeals and grievance processes, provides education on resources that help pay for Medicare, such as the Extra Help program, and may also hold local outreach events and share fraud prevention tips.

Why SHIP Matters

SHIP provides value in various ways for all those who use it.

Complexity of Medicare

With multiple parts (A, B, C, D), plus supplemental (“Medigap”) coverage, private Medicare Advantage plans, and various savings program options, Medicare can be bewildering. SHIP provides guidance in the form of neutral, trustworthy help.

Unbiased Advice

SHIP counselors do not receive commissions or indirect incentives tied to plan enrollment. As a result, they are generally considered more trustworthy and less biased than brokers or agents who may have financial ties to insurers.

Access and Local Help

SHIP can be a valuable resource in many rural or underserved areas for personalized help. Local offices know the particulars regarding local providers and which plans may be effective in a specific area. This information can help enrollees avoid mistakes, like picking a plan that doesn’t include the local pharmacy or certain specialists.

Cost Savings and Preventing Harm

By preventing enrollment mistakes, helping people get needed coverage and benefits, and aiding with appeals or understanding rights, SHIP can help prevent higher downstream costs, such as unexpected out-of-pocket costs and uncovered services. SHIP also helps protect older adults from being steered into inadequate or expensive plans.

Recent Budget Cuts and Policy Changes

In recent several months, some proposals and actions have put SHIP at risk.

ACL’s Reorganization

The HHS is dissolving the ACL and moving its programs into a new division. ACL currently houses SHIP, among many other aging, disability, and elder care support programs. Roughly half of ACL’s staff has been laid off, affecting staff levels in leadership, policy, budget, and regional offices.

Potential Cuts to SHIP Funding

A leaked budget draft from the HHS’s Office of Management and Budget proposes eliminating SHIP’s $55 million in discretionary funding. This roughly 80 percent cut in overall funding for the program would leave only $15 million in mandatory funds intact. However, as of early September 2025, the discretionary funding remains in the budget for 2026.

Discretionary funding supports key parts of the program, such as training, advertising and outreach, organizational infrastructure (phone lines, local offices, websites), and volunteer support. Without such funding, state and local SHIP offices would have to scale back operations or possibly shut down.

Flat Funding and Rising Demand

SHIP has been operating with relatively flat federal funding for years, while the number of Medicare beneficiaries has grown. That means per-beneficiary resources have been shrinking. Inflation, rising medical costs, greater complexity (more Medicare Advantage plans, more drug options, changing regulations) all increase the cost of counseling and outreach tasks.

Effects of Staffing Cuts and Structural Reassignments

Amid these changes, administrative oversight and support functions, such as grant administration and guidance to states, are at risk. These operations are essential for ensuring coverage of SHIP services across the many local offices.

Reassigning SHIP supports to a new agency may introduce disruptions, delays, or loss of institutional memory. Local sites depend on stable funding, consistent guidance, and coordinated training. Sudden policy shifts may degrade that.

Consequences of Staff and Funding Reductions

If the proposed cuts go through, several harmful effects could follow, such as:

• Reduced access to in-person or personalized help. Many smaller or rural SHIP offices might close, reduce hours, or shift to more virtual-only help. People without good internet access or who prefer face-to-face assistance would suffer.

• Longer wait times and less assistance for appeals and complex cases. Without enough trained staff or volunteer infrastructure, SHIP may be unable to serve people with complicated needs, such as changing plans and filing appeals for coverage denials.

• Reduced outreach and education. Without discretionary dollars, less money will be available for advertising SHIP services, and less outreach means fewer people benefiting.

• Greater risk of being steered toward less-desirable options. Without reliable, neutral, local sources of advice, people may rely on agents or brokers who have financial incentives or knowledge only on Medicare’s centralized resources (which may not be sufficient or tuned to the local context). This may lead people to make choices that are less financially or medically optimal.

• Worsening inequities. Vulnerable populations, including low-income, rural, and non-English-speaking people and individuals with disabilities, may be disproportionately harmed. They tend to rely more on free local help and may be less able to navigate complex systems without assistance. If SHIP offices scale back, these groups will likely lose this support.

• Potential for higher health costs downstream. Errors in enrollment, misunderstandings leading to lapses in coverage, or failure to access the most beneficial plan could cause higher out-of-pocket spending, more use of emergency health services, and lower preventive care uptake.

Policy and Political Status

Though current budget proposals include cutting discretionary funding for SHIP and dissolving ACL, Congress still controls appropriations. In some recent appropriations bills, discretionary funding remains intact.

The Older Americans Act (OAA) , which authorizes many ACL programs, needs to be reauthorized by Congress. Continuing resolutions have provided funding for OAA programs through fiscal year 2025. However, SHIP’s future relies on timely reauthorization, adequate appropriation levels, and other statutory mandates.

SHIP plays a vital role in helping millions of older Americans, people with disabilities, and caregivers make sense of a complicated and shifting Medicare landscape. Because it provides unbiased, individualized, and locally based advice, it fills a gap that other entities, like insurers and brokers, can’t or won’t fill as effectively.

However, the combination of flat funding, proposed discretionary budget cuts, staff cuts, and ACL’s dissolution and restructuring threatens SHIP in significant ways. Many local SHIP offices may be forced to cut back or close, reducing access at a time when more people are relying on them.

Life After Caregiving: What Family Caregivers Can Do to Heal

Takeaways

• Family caregivers often experience a dual loss — the loss of their loved one as well as the loss of their caregiving identity — which can lead to profound grief, guilt, and burnout.

• Moving on involves acknowledging these losses, addressing guilt, reclaiming a personal identity beyond caregiving, prioritizing self-care, and finding new purpose.

Caring for a family member who is unable to fully care for themselves can offer a sense of purpose and meaning. However, it can be an all-consuming responsibility. For one, many family caregivers sacrifice their careers to care for a loved one who has a chronic illness or disability.

In some cases, forfeiting work isn’t a factor, such as with retired couples. Nevertheless, the caregiver may still end up sacrificing their social life, hobbies, and even time to relax and recharge. But what happens to the caregiver when the care recipient dies?

How Loss Affects Family Caregivers

When a caregiver loses the loved one they have been caring for, whether it was a parent, a spouse, or another family member, the grief can be profound. Not only is there the pain of losing someone they love, but many caregivers also experience a second, less obvious loss: the loss of their role and identity as a caregiver. For months or years, their lives may have revolved around appointments, medications, meal preparation, and emotional support. When that ends, the sudden quiet can feel disorienting.

At the same time, former caregivers may feel drained from years of constant responsibility, experiencing physical and emotional burnout even after their duties are over. Feelings of guilt – for not doing enough, for feeling relief, or even for wanting to move forward – may also surface.

These experiences are normal and valid. The challenge lies in acknowledging them and finding a path to healing, self-compassion, and renewed purpose.

Acknowledge the Dual Loss

The loss of one’s loved one and the loss of one’s caregiving role both deserve recognition. Suppressing or minimizing either can make it harder to heal. Journaling, talking with a trusted friend, or joining a grief or caregiver support group can provide space to name and process these feelings.

Navigating Feelings of Guilt

Family caregivers may also experience guilt after their care recipient dies. You may replay decisions in your mind, question whether you did enough, or feel guilty for any moments of frustration or exhaustion.

Remember that caregiving is a long process in which most caregivers are learning how to do it as they go along. No caregiver can do it perfectly. Accepting that you did your best under challenging circumstances can help ease self-criticism. If guilt lingers, speaking with a counselor, therapist, or faith leader can offer guidance and perspective.

Reclaiming Identity Beyond Caregiving

Caregiving often becomes central to a person’s identity. When the caregiving role ends, there may be a sense of “Who am I now?”

The answer begins with rediscovering yourself outside that role. Consider the things that brought you joy before your caregiving role started. Whether you were interested in painting, gardening, or traveling, revisit those passions.

Consider new opportunities you can explore, such as volunteering, taking a class, or joining a community group. These activities can open fresh pathways for connection and meaning.

Reflect on how you want to invest your time now. You have given a portion of your life in service to someone else. This is a chance to turn some of that energy back toward yourself.

Caring for Yourself After Burnout

Years of stress and responsibility can leave caregivers physically and emotionally exhausted. After the responsibility of caregiving has passed, be sure to prioritize your own health.

Schedule medical appointments you may have postponed. Take time to focus on rest and recovery. Sleep, exercise, and nourishing meals are all restorative.

Before rushing into new obligations, give yourself permission to pause. Healing takes time, and self-care is not indulgent — it is necessary.

Moving Toward a New Chapter

Some former family caregivers find purpose in helping others by volunteering with hospice organizations, supporting other unpaid caregivers, or advocating for elder care resources. Others find meaning in pursuing long-set-aside goals or simply enjoying time with family and friends.

Every caregiver will face their own unique circumstances; there is no single right way to move forward. What matters is allowing yourself to grieve. Acknowledge the complexities of the caregiver’s journey and gently create space for who you are beyond caregiving.

Resources and Additional Reading

Caregiving is an act of love and sacrifice. When it ends, the transition can be overwhelming. By acknowledging the depth of both loss and burnout, processing feelings of guilt with compassion, and slowly reclaiming identity, former caregivers can begin to heal. Life after caregiving does not mean forgetting; it means honoring what was given while allowing space for what comes next.

Organizations such as Family Caregiver Alliance and National Alliance for Caregiving provide resources for caregivers.

For additional reading on topics related to caregiving, check out the following articles:

• The Effects of Family Caregiving on Older Adults

• Support for Family Caregiving Gains Momentum

• Unpaid Family Caregiving Is Worth a Six-Figure Salary

• Becoming a Family Caregiver for an Ailing Loved One

• How Parents Can Provide for a Caregiver Child

• Healthier Living for Seniors Through Adult Day Care Services

Seniors and the Benefits of Downsizing

You spend a large portion of your life and your hard-earned money on the concept of the American dream, buying and living in your forever home. Your home is a special place, filled with memories, love, and laughter. As you age, you might start asking yourself whether your home works with your evolving daily routines and needs. 

To ease challenges and simplify living, you may want to consider downsizing. Downsizing can offer many financial and lifestyle benefits for seniors.

Why Downsize?

Downsizing is the idea that your current space is more than you need and moving to a smaller space may fit your future needs better. Minimizing your living space and the amount of stuff you have can lead to less stress, lower living expenses, and a simpler overall life.

The first step is deciding to sell your current home or exit your current lease and look for a new, smaller living space. Seniors might want to downsize to a single-floor residence, to a smaller dwelling after losing a spouse, or to a more community-focused living space. Many couples no longer use certain spaces in their home and could put extra money saved from downsizing toward retirement.

What to Look For

As a downsizing senior, create a list of your needs and wants in a new home. First and foremost, make sure you are moving to a space where you feel safe and comfortable. If you are going from a single-family home to a condo, consider that you will now have neighbors and the style of living will be different.

Also consider your future health needs. You may no longer want or be able to go up and down the stairs easily, so consider a ranch-style home or a first-floor unit. Ensure you have optimal mobility in your living space to help prevent accidents and falls.

Whether you are buying a home or renting an apartment or condo, seek out a supportive community. This could be in the way of a retirement community, a small town, or a top-rated neighborhood.

There are many benefits to a retirement community, such as meeting new people who are looking to live a similar lifestyle. This will allow you to foster friendships and stay active with community events. Also, you will have low maintenance, as lawn and basic home care are typically included.

How to Downsize

When deciding to downsize, have conversations with your significant other or loved ones about what you envision needing in a living space going forward. Take a look at your health, your care needs, and your finances to understand what your options are.

Once you have made the decision to downsize, research your living options. If you plan to buy a new, but smaller home, start with a mortgage preapproval to see what you can afford.

Other options are renting, moving in with a loved one if they have the space, or looking into other senior living ideas. Seniors looking to sell their current home and buy one simultaneously will want to hire a real estate attorney to ensure a smooth transition and that their assets are safe.

Next, clean out your current living space. This can be tough. It’s hard to get rid of items you have accumulated over the years or that have sentimental value.

Start by going through and putting together any items that must be kept. This could include family photos, documents, and special jewelry or clothing. Then go through the rest of your home and mark the items you are willing to part with by donating or selling.

Moving as a senior can’t be done alone. You will need to get assistance from your friends and family to help. When moving time arrives, you can hire a moving company to assist.

When to Downsize

There is no right or wrong time to downsize. It’s a decision only you and your partner can make. Your family might have differing opinions, but ultimately you have to decide if downsizing is needed to live your best life as you age.

The Effects of Family Caregiving on Older Adults

Many older adults become caregivers for their spouses or partners. This can be challenging as the caregiver may also be dealing with their own age-related health issues.

• Family caregivers are providing more intense and longer-term care, often involving physically demanding tasks and complex medical duties, for which they rarely receive training.

• Older caregivers often experience physical strain, emotional stress, and isolation, and neglect their own health.

Most people tend to marry someone who is within a few years of their own age. As a result, many married couples share the same cultural touchstones, social memories, and general values. Certain phases of life often coincide as they grow older together, as they may share similarly timed career paths and enter retirement around the same time. These overlapping life trajectories can also mean that they develop age-related ailments around the same time.

Age-related ailments often require long-term care. This can include needing help with bathing, dressing, feeding, handling finances, scheduling appointments, and transportation. In many cases, an unpaid family caregiver provides this support.

According to the Caregiving in the U.S. 2025 report published by AARP and the National Alliance for Caregiving, nearly a quarter (22 percent) of family caregivers in the U.S. are 65 or older. Fifteen percent of them are caring for a spouse or partner.

The scenario in which a spouse or partner fills the role as family caregiver may seem ideal. After all, no one knows the care recipient better than the person they have lived with for years. However, if the caregiver and care recipient are close in age, as is often the case, the caregiver may be sacrificing their own well-being by trying to fulfill the needs of their closest loved one.

Care Recipients and Common Age-Related Ailments

Care recipients are mostly older adults, with nearly half being 75 or older. Many older adults are living with multiple chronic health conditions, such as mobility limitations and general age-related decline. Cognitive issues are prevalent among care recipients, with 27 percent of caregivers reporting that their care recipient has Alzheimer’s, dementia, or another memory-related impairment.

High-Intensity Care

The day-to-day support that family caregivers are providing has become more intense and a longer-term commitment. According to the report, 30 percent of caregivers provided care for five or more years, a significant increase from 2020. Caregivers spend an average of 27 hours per week providing care, and 24 percent provide 40 or more hours per week.

Two-thirds of caregivers assist with at least one activity of daily living (ADL). For many caregivers, these tasks, which can include bathing and moving the care recipient, are physically demanding. Twenty-three percent of caregivers reported that they struggle with these tasks.

More caregivers are also helping with multiple instrumental activities of daily living (IADLs) than 10 years ago. IADLs can include shopping, preparing meals, managing finances, and providing transportation. In addition to handling ADLs and IADLs, many caregivers shoulder medical tasks such as giving injections, managing catheters, and monitoring vital signs. More than half of caregivers perform these types of tasks, yet only 22 percent have received training for them.

Forty percent of caregivers reported providing a level of care that can be considered high-intensity. This can mean that the caregiver is providing many hours of especially involved or physically taxing support each week. High-intensity care includes:

Medical and Nursing-Type Tasks

• Wound care or dressing changes

• Giving injections (e.g., insulin)

• Managing IV lines or feeding tubes

• Monitoring and operating medical equipment, such as oxygen machines

Hands-on Personal Care

• Bathing and dressing the care recipient

• Helping with toileting and incontinence care

• Assisting with eating and drinking, especially if there are swallowing difficulties

• Transferring the care recipient in and out of bed, a wheelchair, or a car

Extensive Health Management

• Tracking multiple medications with complex schedules

• Coordinating with multiple doctors, therapists, and specialists

• Handling medical crises or frequent trips to and from a hospital

Around-the-Clock Supervision

• Staying alert to prevent falls or wandering (common in dementia care)

• Being on-call overnight for emergencies or symptom management

These tasks are especially challenging for older caregivers because they may require physical strength, medical skills, and sustained vigilance — all while the aging caregiver is likely managing their own health conditions.

How Caregiving Affects Older Caregivers

Though caring for a loved one can give a family caregiver a sense of purpose and possibly strengthen the bond they share, it can also negatively affect the caregiver. According to the report, 20 percent of caregivers rated their health as fair to poor. Nearly a quarter of them indicated that their caregiving responsibilities prevented them from adequately caring for themselves.

Providing care can cause physical strain, especially in older caregivers whose bodies may be just as old as the people they are caring for. The study found that 45 percent of caregivers experience moderate to high physical strain. Research has shown that older family caregivers, Alzheimer’s or dementia caregivers, those who are living with their care recipient, and caregivers who provide care for a year or longer are more likely to rate the strain of caregiving as high.

In addition, family caregivers have to manage the emotional stress that comes with observing a loved one’s decline while trying to meet the loved one’s needs. Among the caregivers in the Caregiving in the U.S. 2025 report, nearly two-thirds reported moderate or high emotional stress.

A feeling of isolation can be common with caregivers as well, especially in situations where the care recipient has dementia and family members who could help live far away. Nearly one in four caregivers reported feeling alone in the 2025 study.

Despite these costs, 51 percent of the family caregivers surveyed said that caregiving gave them a sense of purpose in life. The Guardian tells the story of Australian Don Cameron, who is nearly 80 and cares for his wife, Marjorie, who lives with dementia and mobility issues.

Cameron told The Guardian that he no longer has time for himself and neglects doing things that he enjoys. His biggest concern, though, is what would happen to his wife if he had a health issue that prevented him from caring for her.

Ways to Support Family Caregivers

Family caregivers provide countless hours of unpaid care every year while facing considerable personal and financial challenges. As more Americans require long-term care, the need for meaningful support for caregivers will increase. The Caregiving in the U.S. 2025 report highlights some policies that can benefit family caregivers, including:

• Financial support policies. These could be in the form of an income tax credit for caregivers, payment for at least some of their caregiving hours, or a partially paid leave of absence from work for employed caregivers.

• Respite services. Breaks from caregiving duties can help family caregivers rest, recharge, and tend to their own health.

• Check-ins with medical professionals. Family caregivers expressed an interest in a doctor, nurse, or social worker asking them about what they need to help care for their loved one as well as themselves.

• Training and information. The report found that many family caregivers would benefit from training on topics such as managing stress, keeping their care recipient safe at home, managing personal finances, and making end-of-life decisions.

Older family caregivers, many of whom are facing their own health challenges, limited financial resources, and social isolation, are performing critical work that often goes unrecognized. When older adults give care, they often pay the price — physically, financially, and emotionally. Recognizing this growing phenomenon and finding ways to address it will help family caregivers and their care recipients live healthier, less stressful lives.

Join us on Tuesday September 16th from 5:00-6:00pm at 1920 Ebenezer Rd, Rock Hill for Khaled Elder Law’s Caegivers’ Support Group facilitated by, Yolanda Thornton, KEL’s Certified Elder Care Coordinator.

Call 803-980-1199 to register.

Don't Rely on Medicare or Medicaid for Your Long-Term Care

Takeaways

• Many Americans misunderstand Medicare and Medicaid's limited coverage for long-term care, often overestimating their reliance on these programs.

• The cost of long-term care insurance is also frequently overestimated, leading many to forgo crucial coverage.

• Proactive planning, including exploring private insurance, home modifications, and consulting professionals, is essential for addressing future long-term care needs.

Americans are living longer than ever, and this trend is expected to continue. According to the U.S. Census Bureau, the number of Americans aged 100 and older is expected to quadruple over the next 30 years, from an estimated 101,000 in 2024 to about 422,000 in 2054.

With this increase in longevity comes an increase in the need for long-term care, as well as the need for it for a longer period of time. Though long-term care services are often associated with nursing homes and assisted care facilities, they can help seniors live in their homes longer, which most prefer to do.

Long-Term Care Services

Long-term care (LTC) services can include assistance with activities of daily living (ADLs) such as bathing and dressing but can also include help with medical-related tasks, such as managing complex daily health care regimes. Older adults often use LTC services for housekeeping tasks as well, such as doing laundry, cooking, and shopping. LTC services are often essential for many older adults who want to continue living on their own and can help delay or avoid institutionalization in a nursing home.

Paid professionals or unpaid family members or friends may provide LTC services. Most older adults rely heavily, or exclusively, on unpaid support.

Although some people who need LTC services rely on them for a short time, such as when recovering from surgery, many older adults rely on them for an average of three years, with 20 percent needing them for more than five years. Even though many older adults rely on unpaid LTC provided by family members or friends, many others must rely on paid help for some or all of their long-term care services.

Counting on the Wrong Safety Net for LTC

The 2025 Nationwide Retirement Institute Long-Term Care survey reveals the startling misconception that 58 percent of Americans believe Medicare will cover the costs of long-term care—despite it covering only limited, skilled or post-hospitalization care for up to 100 days. Medicare doesn’t pay for extended custodial care, which includes activities like bathing and dressing that older adults often need, and daily co-pays begin after just 20 days.

As a result of the increasing cost of LTC, 59 percent of survey respondents said they think they will rely on Medicaid to help pay for LTC expenses. This suggests that either some people don’t fully understand the requirements for qualifying for Medicaid or they intend to spend down their savings to poverty level so they will qualify for Medicaid. Unfortunately, funding for Medicaid is under threat.

The Threat to Medicaid

The Trump Administration’s budget, dubbed the "One Big Beautiful Bill," proposes nearly $800 billion in Medicaid cuts over the next decade. This would not only reduce Medicaid spending but would also result in 10.3 million fewer people enrolled in Medicaid by 2034, including 1.3 million people who are also eligible for Medicare.

Nursing home operators warn that Medicaid cuts could force nursing homes to lay off staff members or close their doors. These drastic measures would reduce the quality of care or, potentially, remove this care option from some areas. This means that individuals planning to rely on Medicaid for long-term care in a nursing home may find that safety net significantly undercut.

The Coverage Gap: Long-Term Care Insurance

According to Nationwide’s survey, 22 percent of Americans 29 years old and older say they have long-term care insurance (LTCI). However, data show that actual ownership of such coverage is much lower. People often mistakenly believe their health insurance or long-term disability insurance will cover any long-term care costs they incur. Alarmingly, it is estimated that only 3 to 4 percent of Americans aged 50+ have actual long-term care insurance.

Many people cite cost as a barrier to purchasing LTCI. Of those surveyed, 38 percent said the perceived high cost was the main deterrent to getting LTCI. However, many overestimate LTCI premiums. Nearly two‑thirds of those surveyed believe it costs more than it actually does.

Aging in Place vs. Moving

In addition to wanting to age in their own homes, many people view staying in their homes for as long as possible as a way to save money. Though 77 percent of Americans would prefer to receive long-term care in their homes, 41 percent think their current home is probably not safe or accessible enough for them to age in place. Nearly half of those surveyed think that modifying their home so that they can age in place safely would be too expensive.

Moving to a home that would be better suited for aging in place seems like a viable option, but this path can also have obstacles. Fifty-four percent of those surveyed believe the current real estate market makes it too difficult to move or find an ideal home for retirement. Based on the survey, it can be projected that Americans 61 and older are planning to remain in their current homes without making aging-related modifications after they retire, despite the risks involved.

Strategies for LTC Planning

Some things you can do to plan to cover your long-term care needs include the following.

• Get clear on Medicare: Medicare does not cover long-term custodial care. Think of it as a short-term post-acute solution rather than a long-term care solution.

• Consider getting private LTC insurance early: Premiums are more affordable and coverage more accessible before health issues arise. A good age range to start a long-term care insurance policy is 50 to 55.

• Explore hybrid solutions: Some life-insurance and annuity products come with LTC riders that offer flexibility while addressing both retirement income and long-term care funding.

• Tap home equity sensibly: Reverse mortgages or home equity lines of credit can help fund home modifications or in-home care, but they come with risks. Consult with an advisor before borrowing against your home.

• Boost savings and diversify: Maximize retirement contributions early, build emergency funds, and diversify across account types (taxable, Roth, HSA) for flexibility.

• Delay retirement: Working longer improves income and care options, reducing reliance on savings.

• Remodel for safety early: Investing in accessible home features such as ramps and no-step showers now can avoid future major expenses.

• Consult professionals: Proactive planning with a financial planner and an attorney experienced in elder law and estate planning can prevent pitfalls and extra costs.

Start Planning for Long-Term Care Now

Consider it likely that you will need long-term care at some point in your life. The sooner you start planning for it, and especially how you will pay for it, the better. You shouldn’t rely on Medicare or even Medicaid to cover your LTC costs.

For additional reading about Medicare, Medicaid, and long-term care planning, check out the following articles:

• Turning Age 65? What to Know About the 4 Parts of Medicare

• Medicare Coverage Basics: What You Need to Know

• Understanding Medicaid: What Does the Medicaid Program Cover?

• Cuts to Medicaid Benefits May Harm Millions of Older Adults

• What You Should Know About Long-Term Care

Scam Email Targets Social Security Recipients

A new phishing attack is targeting Social Security recipients with email messages pretending to be from the Social Security Administration (SSA), prompting them to download fake Social Security statements.

• These malicious downloads give hackers access to sensitive personal information, including bank account credentials.

• Individuals should be cautious of emails requesting statement downloads and verify the sender’s address to protect their Social Security account from potential compromise.

If you or a loved one are among the 71.6 million people receiving Social Security benefits, be careful of downloading email attachments. You could receive a dangerous email from hackers pretending to be the Social Security Administration (SSA), and the email looks convincing.

This official-looking email prompts recipients to download a fake Social Security statement. The download contains technology that allows hackers to take over the victim’s computer and access sensitive information such as  bank account login credentials, per MalwareBytes Labs. The hackers seem to be targeting financial information, but the scam could also be used for identity theft.

Knowing what to look out for and understanding how the scam works can help you protect yourself and your loved ones.

What Are Phishing Scams?

Phishing is a form of fraud. In phishing scams, cybercriminals often pretend to be from a known organization or individual to gain a person’s trust and access personal information.

Phishing typically occurs through technology that allows predators to hide their identity. Their messages, including emails, texts, and phone calls are like bait as they seek information and access.

Unfortunately, phishing emails are common, with more than 3.4 billion sent each day, per AAG IT Support. Every day, Google blocks 100 million phishing emails. While email services can filter and block spam, some phishing emails can get past these security measures and into your inbox.

The National Council on Aging (NCOA) reports that scams often target older adults. Scammers may believe that older adults have more wealth than other populations. Elder community members can be particularly vulnerable to online scams, with $3.4 billion in total fraud loss reported by Americans 60 and older in 2023.

What to Look Out For

Look out for an email that appears to come from the Social Security Administration. Typically, it says that “your statement is now available.” The email may look legitimate, with convincing font, formatting, and colors. While there are variations in these messages, the email typically says that your Social Security statement is available, thanks you for opting to receive electronic statements, and tells you to download the attachment.

This alert from the SSA Office of the Inspector General (OIG) shows what the scam email can look like. The OIG warns Social Security recipients to beware of scam emails asking to download statements. The warning notes that while these emails closely resemble official correspondence, they lack the .gov email address that indicates a genuine government sender.

How the Scam Works

The hackers are using a technology that allows them to control computers from afar. When individuals download the attachment, thinking it is a Social Security statement, they are actually downloading technology.

This technology, called ScreenConnect, is a remote support and access platform. ScreenConnect is commonly used to help IT professionals work on someone’s computer, such as to install software or troubleshoot issues. When used by cybercriminals, it can take complete control of the computer, facilitating access to personal information.

The Email Could Get Through Security Measures

This dangerous email could end up directly in your general inbox, not your spam folder. The Social Security statement email scam may appear legitimate — and bypass security measures — for several reasons, according to MalwareBytes Labs. These include using WordPress sites that appear legitimate, embedding content as an image to avoid scanning and blocking services, and using normal applications such as ScreenConnect.

Receiving a Suspicious Email

If you receive a phishing email, consider deleting it and blocking the sender. Never clink on a link or download files or attachments that appear in a potentially suspicious email message.

Unsure if an email is phishing? Always pause. Try running a Google search for scams and asking a trusted family member or friend for a second opinion. Review the SSA scam alerts. Take a careful look at where the email came from. To be genuine, it must have a .gov address, per the SSA OIG.

You can also report phishing to the Federal Trade Commission.

Your elder law attorney can also help you navigate correspondence with the SSA and understand how to look out for scam emails. If you are the victim of a scam, connect with an elder law attorney today for assistance so that you can do whatever possible to protect your finances and identity.

Why Aren't More Older Adults Thinking About Long-Term Care?

Many older adults underestimate their likelihood of needing sustained, day-to-day care in their later years, and a significant portion of adults aged 50 and older are not adequately planning for long-term care.

After decades of handling our daily personal care needs without giving them a second thought, it is hard to imagine needing help with these tasks. However, research shows that about one in seven adults aged 65 or older will need help with daily care. Help with daily personal care is referred to as long-term care and too many adults assume they won’t need it.

A recent survey of American adults aged 50 to 94 by the University of Michigan’s National Poll on Healthy Aging explored older adults' preparedness for long-term care. The findings indicate that many are unprepared for the financial and logistical aspects of care in a nursing home, assisted living facility, or similar type of setting, with widespread misconceptions about coverage options.

Key Survey Findings

The survey, which was conducted in August 2024, revealed some worrying data.

Perceptions and Planning:

• Only 43 percent of adults aged 50 and older think they will need long-term care.

• Forty-eight percent are unsure how to plan for long-term care needs.

• Forty-five percent said the potential need for long-term care seemed too far off to plan for.

• Just 27 percent have designated a durable power of attorney for medical care, and only 24 percent have identified potential caregivers.

• Only 11 percent have purchased long-term care insurance.

Financial Concerns:

• Most respondents said they were not confident they could afford long-term care services: 62 percent said they would not have enough money for nursing home care, 58 percent for assisted living care, and 51 percent for home care.

• Notably, 62 percent mistakenly believe that Medicare covers permanent nursing home care.

Communication Gaps:

• Only 5 percent have discussed care plans for their future with a health care provider.

• Discussions with family about long-term care are also limited, with just 33 percent talking with a spouse or partner and 30 percent talking with children about these topics.

Not surprisingly, older adults who have a health problem or a disability are more likely to think they will need long-term care versus older adults who aren’t experiencing such limitations (57 percent versus 34 percent). The survey also revealed that adults over age 65 were more likely to think they will need long-term care than adults between 50 and 64 (45 percent versus 40 percent).

Paying for Long-Term Care

Half of the survey participants said they would rely on either their or their family’s personal financial resources if they needed to move into a nursing home permanently. Nineteen percent said they would rely on long-term care insurance.

Twenty-nine percent said they would rely on Medicaid, and 62 percent said they expected their long-term care to be covered by Medicare. The large percentage of those surveyed thinking that Medicare will cover their long-term care needs shows there is a widespread misconception about what Medicare and Medicaid cover.

Medicare vs. Medicaid for Long-Term Care Coverage

Understanding the differences between Medicare and Medicaid  is important for planning for long-term care.

Medicare

Introduced in 1965, Medicare is a federal health care program primarily for Americans who are 65 or older, as well as many individuals with disabilities. There are four basic parts that cover different areas of health care or dictate what is covered and how.

Medicare’s Part A includes coverage of hospital stays and some limited care in a skilled nursing facility under certain circumstances. However, Medicare does not cover long-term care in a nursing home, for example.

Medicaid

Medicaid is a federal- and state-level program that provides comprehensive coverage for low-income adults, children, and individuals with disabilities. Since each state manages its own Medicaid plan, covered services vary across the country. Generally, coverage includes nursing home care, home and community-based services, e.g., personal care assistance, adult day care, and, in some states, assisted living facility costs.

Medicaid eligibility is based on a person’s income and assets. Individuals must often spend down assets well ahead of applying for benefits to qualify.

Care Preferences and Decision-Making

When asked about where they would prefer to receive support with daily activities, survey respondents expressed a range of options, including:

• Their home with family or family caregivers (52 percent)

• Their home with paid caregivers (21 percent)

• Their home without help (14 percent)

• The home of a family member or caregiver friend (6 percent)

• An assisted living facility (6 percent)

• A nursing home (1 percent)

When asked about making decisions about their long-term care, 39 percent said they would let their family make decisions for them, but 61 percent said they would not let their family make decisions for them.

Implications of Survey

This survey found that many older Americans do not think they will need long-term care and have not made plans for how to meet and pay for long-term care needs. This suggests that there is a large portion of the population that is behind on planning for long-term care.

Additionally, many older adults think that the possibility of long-term care is too far off to plan for, and many don’t know how to plan for it. Only about a third of the adults surveyed have discussed long-term care with their spouses or children.

One of the most worrying finds of the survey is that nearly two-thirds of those surveyed think that Medicare will cover their long-term care costs. This likely contributes to many over-50 adults not having an adequate plan in place for how to pay for potential long-term care.

Planning for Long-Term Care

The University of Michigan’s National Poll on Healthy Aging highlights a critical need for increased awareness and proactive planning among older adults regarding long-term care. Understanding the limitations of Medicare and the eligibility requirements of Medicaid is essential to avoid unexpected financial burdens.

Engaging in early discussions with family and health care providers, exploring insurance options, and becoming informed about available resources can better prepare individuals for future long-term care needs. Contact an elder law attorney in your area to learn about your options for long-term care planning.

For additional reading about long-term care planning, check out the following articles:

• Discussing Long-Term Care With Older Adults in Your Life

• 2024 Survey Shows Costs of LTC Continue to Rise

• What a Good Long-Term Care Insurance Policy Should Include

• The Role of an Elder Law Attorney in Medicaid Planning

• Medicare Advantage: An Alternative to Original Medicare

How Mental Health Apps Can Help Older Adults

What Are Mental Health Apps?

Mental health apps are mobile applications that provide support for emotional well-being. For older adults, these apps are often tailored to address age-specific challenges, such as loneliness, grief, chronic illness, and cognitive decline, which can all contribute to depression. The most effective apps combine psychological tools, behavioral health strategies, and easy-to-use interfaces.

Examples of some of the apps that are helpful for older adults include:

• MoodTools. Designed in collaboration with mental health professionals, MoodTools (available via the Apple Store) offers multiple tools, including a thought diary, safety plan, and guided activities with a mood tracker.

• Headspace and Calm. Headspace and Calm are mindfulness apps that include meditation exercises, sleep support, and stress-management strategies.

• Woebot Health. Informed by Cognitive Behavioral Therapy (CBT), Woebot Health offers a conversational chatbot that checks in on users and provides coping suggestions and tools.

• MyStrength. MyStrength offers a digital program with modules for depression, stress, sleep, and chronic pain.

How Do They Work?

Mental health apps use evidence-based techniques to help users manage their moods and thoughts. Here’s how many of them function:

• Daily Check-ins. Users are prompted to log their emotions, thoughts, and stress levels. This helps identify patterns and triggers.

• Guided Activities. Exercises such as journaling, breathing, and meditation are built into the apps to support mood regulation.

• Education. Short lessons teach users about depression and how to manage it through behavioral strategies.

• Reminders and Notifications. Gentle prompts help users stay engaged with their mental health plan.

• Social Connection Tools. Some apps help users schedule calls or virtual support sessions with loved ones or mental health professionals.

Are Mental Health Apps Covered by Insurance?

As more emphasis is put on mental health and as the desire for more accessible resources increases, health insurance providers are increasingly covering the use of mental health apps. But before paying for a mental health app, contact your health insurance provider to make sure it is covered.

Medicare

At the beginning of 2025, Medicare began covering certain FDA-approved digital mental health applications when prescribed as medically necessary. This includes apps designed for conditions like depression and generalized anxiety disorder. Coverage specifics can vary, so consult with your health care provider or check the Medicare Connected Apps Directory for approved applications.

Medicaid

Medicaid coverage for mental health apps varies by state. Some states have added telehealth services, including mental health apps, to their Medicaid programs. Check with your state's Medicaid office or health care provider for specific coverage details.

Private Health Insurance

Many private insurers are now beginning to cover mental health apps and online therapy platforms. For instance, Talkspace partners with several major insurance providers, including Cigna, Optum, Aetna, and others, to offer covered therapy services. Similarly, platforms like Amwell are included in the coverage plans of over 40 insurers. Be sure to consult your insurance provider to determine which apps and services are covered under your plan.

Why Are These Apps Especially Valuable for Older Adults?

To be useful for older adults, these apps need to accommodate their needs and usage preferences. They accomplish this in different ways.

Accessibility

Seniors may face barriers to in-person care, such as limited mobility, transportation challenges, or long wait times. Apps allow for support at home, at any time.

Cost-Effectiveness

Many mental health apps are free or low-cost, making them a budget-friendly alternative to traditional therapy sessions. In addition, some health insurance providers cover the use of certain mental health apps.

Privacy

Some older adults may be hesitant to discuss mental health conditions openly. Using an app offers a private and stigma-free way to explore emotions and seek help.

Ongoing Support

Depression can be a recurring condition. Apps provide tools that seniors can use daily, helping reinforce healthy habits between doctor or therapist visits.

What Older Adults and Caregivers Should Consider

Though mental health apps can be beneficial, they aren’t a replacement for professional care. Users should look for apps that are backed by clinical research and offer user-friendly interfaces with large fonts and simple navigation. It is also important to only use apps that have a privacy policy that protects personal health information. Finding an app that can be used alongside a professional treatment plan can make for a more seamless and effective user experience.

It’s also a good idea to consult with a health care provider before using any new mental health tool, especially for individuals with complex medical or psychiatric conditions.

Additional Resources

Mental health apps are becoming valuable tools for older adults, including those dealing with depression. By blending technology with psychology, these tools empower seniors to better understand their emotions, develop coping strategies, and maintain a sense of control over their mental health. In a world that can sometimes feel isolating, these digital tools offer connection, comfort, and hope.

Contact an elder law attorney in your area to learn about government-provided health benefits and how you can get the most out of them.

For additional reading about mental health as well as technology, check out the following articles:

• Plan Your Treatment Before a Mental Health Crisis

• The Loneliness Epidemic: Helping Seniors Stay Connected

• Report: U.S. Suicide Rate Highest Among Older Men

• How Does Telehealth Work, and What Are the Benefits?

• In-Home Senior Care Technology and Elder Law

Lawmakers Propose Well-Being Insurance for Older Adults

As the United States population ages, the need for affordable and sustainable long-term care solutions has become increasingly urgent. Many older adults prefer to age in place – that is, live independently in their homes and communities as they grow older. However, the high cost of long-term services and supports, such as home health aides or assisted living, remains a barrier.

In response to this growing issue, policymakers and advocates have been exploring innovative approaches to help seniors remain at home with dignity and independence. One such proposal is the bipartisan Well-Being Insurance for Seniors to be at Home (WISH) Act, introduced in Congress by Representatives Tom Suozzi (D-NY) and John Moolenaar (R-MI).

“Right now, our country is facing a looming long-term care crisis,” said Rep. Suozzi in a press release.

“Ten thousand Americans turn 65 every day; in five years, 6,500 seniors will turn 80 every day. Medicaid and nursing homes are already overburdened, and seniors have no other affordable options to pay for the care that they will need. We need to handle this problem before it becomes a crisis, and I believe a federal catastrophic long-term care insurance program coupled with a robust private sector insurance market is the way to do that.”