A Trial Attorney's Journey to Estate Planning: Protecting Families from Long-Term Care Cost
- Ken Connolly
- Jun 6
- 5 min read
Updated: 12 minutes ago
Key Takeaways:
Evaluate insurance options: Consider hybrid long-term care policies that preserve value if care isn't needed
Plan well in advance: Medicaid asset protection trusts require five-year advance planning but can preserve significant assets
Address blended family considerations: Ensure estate plans reflect your intentions for second marriages
Start conversations early: Estate planning provides immediate peace of mind and long-term asset protection
Aaron Miller reached a turning point in his legal career when he realized his approach to litigation was affecting his personal life. As a trial attorney, he had calculated that discovery questions would be due the day after Christmas, and initially felt satisfied about the timing. However, this moment led to important self-reflection.
"What am I doing? I don't want to be that way," Miller recalls. "I had one child before I went to law school, had one in the middle of law school, one right afterwards, and I'm like, you know, they didn't sign up for an absentee angry father."
This period of professional transition ultimately led Miller to estate planning, where his personal experience with family long-term care costs provides valuable insights for protecting assets and planning for future care needs.
Understanding Long-Term Care Costs: A Personal Perspective
Miller's interest in estate planning became deeply personal through his family's experience with long-term care expenses. His grandparents' situation illustrates common challenges many families face when planning for extended care needs.
"My grandfather paid for her care... that's what he did for the next 10 years of his life. And he basically eliminated his savings, spent through his retirement," Miller explains about his grandmother's nursing home care.
"And when my grandmother passed away, my grandfather... then he needed nursing home care. And my aunt, my uncle, and my dad, they all dipped into their savings and their retirement to pay for his care."
This pattern—where one generation's care costs affect the next generation's financial security—occurs frequently when families aren't aware of available planning options. Long-term care costs vary significantly by location, with nursing homes averaging $7,500 monthly in Texas and $12,000-$15,000 in states like New Jersey.
Important Coverage Considerations: Memory Care
An important gap in coverage that families should understand: "If you have dementia, Alzheimer's, anything like that, Medicaid doesn't cover it," Miller explains. "You could be in a memory care facility... and I was waiting for her health to deteriorate to a point where we can move her over to a nursing home."
This coverage limitation creates additional financial considerations for families dealing with memory-related conditions, which often require extended care periods.
Estate Planning Strategies for Long-Term Care Protection
Miller's practice focuses on three primary approaches that can help protect families from significant care-related expenses:
Strategy 1: Long-Term Care Insurance (The Gold Standard)
"I prefer long-term care insurance," Miller states emphatically. "That's my absolute favorite way to do it."
Modern hybrid policies offer significant advantages over traditional "use it or lose it" coverage. These policies, built on whole life insurance or annuities, provide care benefits while preserving value for beneficiaries if unused.
Miller's mother's story illustrates the cost of waiting. When she retired at 62, long-term care insurance would have cost around $200 monthly. Instead, the family later paid $7,500 monthly for memory care—a 37-fold increase over what prevention would have cost.
Strategy 2: Medicaid Asset Protection Trusts
For families who can't obtain insurance, Miller creates "Medicaid compliant asset protection trusts" five years before care is needed. "You park that money into the trust... and after that, the money is off the table. It's not part of accountable assets," he explains.
This strategy requires advance planning but can protect substantial family wealth from care costs.
Strategy 3: Emergency Medicaid Planning
Even without advance planning, Miller can often protect assets for married couples. "Even if we haven't done pre-planning for husband and wife, we can still protect the majority of the assets with different things through like a Medicaid compliant annuity," he notes.
Estate Planning Considerations for Second Marriages
Miller shares a case that demonstrates important estate planning considerations for blended families:
"I got a call one day... this lady who was a client of mine, her mom was about to sell her house... and the title company realized that her husband who was still on the title of the house, had passed away about 10 years ago. And he had some children from his first marriage... those kids are gonna get half of the proceeds."
The complicating factor was that while the husband had a will, it wasn't probated within the required four-year timeframe, making it legally ineffective. The son who had been specifically disinherited would now receive half the house proceeds through intestate succession laws.
Key Considerations for Blended Families
In Texas and many other states, intestate succession laws provide inheritance rights to a spouse's children from outside the current marriage. This can create unexpected financial complications for surviving spouses who may not be aware of these legal requirements.
Veterans Benefits and Regulatory Changes
Miller previously helped veterans access Aid and Attendance benefits—up to $2,000 monthly for qualifying veterans needing care. However, regulatory changes have made this assistance more challenging to provide.
"Unfortunately, Congress made it really, really hard for me to help veterans," Miller explains. "They actively made it harder for people to get qualified... they thought they were helping the veterans... but they just lumped us all in together, and they just made it very difficult to help people."
Despite these regulatory challenges, the benefit remains available for veterans who served 90 days active duty with at least one day during wartime, have an other-than-dishonorable discharge, and meet income and asset requirements.
Senior Financial Security and Fraud Prevention
Miller observes increasing sophistication in scams targeting seniors, particularly with advancing AI technology that can replicate voices convincingly.
"I think people shouldn't be ashamed of that if they do get scammed or if they get close to scammed because these are professionals. That's all they do," Miller says. "It's frightening to think like if they put a tenth of that effort into doing something good that they do into this, I mean, they'd be unstoppable."
Considerations for Future Policy Changes
Looking ahead, Miller notes potential changes to Medicaid funding structures, including possible block grant systems where states would receive lump sums to distribute among various programs.
"Hopefully we're not gonna be throwing our seniors out on the streets," he says. "But you know, we'll see. We'll see."
These potential policy changes emphasize the importance of current planning, as future benefit availability may become less predictable.
Taking Action: Planning Recommendations
Miller's career transition from litigation to estate planning reflects his observation that "there are so many people taking advantage of seniors, and there's so much bad information out there."
The benefits of comprehensive planning become apparent to families during the process. "You could see it when we get everything designed... they look so much, they feel and look so much lighter when they're done," Miller observes.
Author Bio: Ken Connolly is a licensed life and health insurance broker and host of the "Talking Retirement" podcast.
To learn more about Medicare, life insurance options and other supplemental health insurance options, talk to NJ Life and Health. Visit us www.njlifeandhealth.com or call their Toms River, NJ office at 848-226-6897.
Aaron Miller is a lawyer and owner of https://www.aaronmillerlaw.com/
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