Rochester Senior AdvisorHow do most Rochester families pay for assisted living?
Most pay privately at first, from a parent's income, savings and often the proceeds of selling a house, because Medicaid does not cover ordinary assisted living and Medicare never does.
The planning question is how long the money lasts. Divide available assets by the monthly gap between income and the residence's quoted rate, then add the likely increases for higher care levels. If the answer is under three years, plan the next step now.
How does long-term care insurance work in New York?
A long-term care insurance policy pays a daily or monthly benefit once the insured needs help with at least two activities of daily living or has a cognitive impairment, usually after an elimination period of 30 to 90 days.
The New York State Partnership for Long-Term Care, reached through the Department of Health at 1-888-NYS-PLTC, sponsored policies that protect assets from Medicaid once the policy benefits are used. Read the policy for whether it pays for assisted living, adult homes, and home care from family members.
Should a parent sell the house before moving to assisted living?
Selling often funds several years of care, but timing matters: a house sold before a Medicaid application turns an exempt asset into countable cash, while a house kept may be subject to estate recovery later.
Bridge loans and rental of the house are other options. For a couple, the house usually stays exempt while the spouse lives there. Talk to an elder law attorney before listing it if Medicaid may be needed within five years.
Can life insurance help pay for senior care?
Some policies have accelerated death benefits or long-term care riders that pay out while the insured is alive, and others can be sold or surrendered for cash, though usually for less than the face value.
The cash value of a whole life policy over a small threshold counts as a resource for Medicaid. Check the policy terms and get an independent opinion before selling a policy to a third party.
What tax breaks help with senior care costs?
Assisted living, nursing home and home care costs can count as deductible medical expenses when the person is chronically ill and the care is under a plan prescribed by a licensed practitioner, and an adult child who pays for a parent may be able to claim them.
A tax professional can confirm what applies. Keep invoices that separate care charges from rent, since only the care portion counts in some situations.
At a glance
| Private pay planning is | Private pay planning is not | |
|---|---|---|
| Goal | Making savings last as long as needed | Spending everything first |
| Insurance | Reading the benefit triggers now | Assuming every policy covers assisted living |
| House | A decision tied to Medicaid timing | Always sold first |
| Advice | Worth paying an elder law attorney for | Something this site provides |
Sources include the N.Y. Social Services Law and Public Health Law, 18 NYCRR Parts 487-494, 10 NYCRR Parts 415 and 1001, Department of Health GIS messages, CMS, the VA and CareScout, as cited above; see our editorial standards.
