Understanding the Rules, Protecting What Matters
Nursing home care costs $12,000+ per month in Bucks County. We help families understand the rules, coordinate with elder law specialists when needed, and handle the estate and probate issues that intersect with long-term care planning.
Ideally, at least 5 years before you anticipate needing long-term care. The 5-year lookback means strategies implemented today won't fully protect you until 2031. That said, crisis planning options exist even when the need is imminent — but they are more limited and more expensive.
Not while you're alive and living in it (or if your spouse or dependent lives there). But after death, the PA Estate Recovery Program can file a claim against your estate — including real estate. Advance planning with life estate deeds, irrevocable trusts, or caregiver child exemptions can protect the home.
You can, but if you apply for Medicaid within 5 years of the gift, you'll face a transfer penalty. At $421.20/day (2026), a $100,000 gift creates a 237-day penalty — nearly 8 months of privately paying for nursing care. And your children may face PA filial support liability.
Medicare is a federal health insurance program for people 65+. It covers some short-term rehabilitation (up to 100 days) but does NOT pay for long-term custodial nursing home care. Medicaid is a joint federal-state program for people with limited income and assets that DOES pay for long-term care — but only if you qualify financially.
No. A revocable living trust provides zero Medicaid protection. Because you can revoke it and access the assets at any time, Medicaid counts everything in a revocable trust as an available resource. Only irrevocable trusts — where you permanently give up control — can protect assets, and only after the 5-year lookback has passed.
Crisis planning is possible but more limited. Options include spend-down to exempt assets, spousal protection strategies, half-a-loaf gifting, Medicaid-compliant annuities, and caregiver agreements. Every situation is different. Consult an elder law attorney immediately — delays only reduce your options.
Under Pennsylvania's filial support law (23 Pa.C.S. § 4603), yes. It's not common, but it has been enforced — most notably in the Pittas case, where a son was ordered to pay over $90,000 for his mother's care. Medicaid planning helps prevent this scenario.
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