One day, Joe twists his ankle and falls, and he can barely get up and walk due to the excruciating pain.  Joe finally gets up, hobbles around a bit, and the ankle swells up so badly that he heads to the Emergency Room to have it checked out. 

The ER doctor sees Joe and thinks the ankle is broken.... 

The X-ray tech won't say much but quietly agrees with the ER doctor.... 

The orthopedist checks the x-ray to confirm it's broken....   

Well, not to be outdone, Joe contacts his primary care physician (PCP) for a quick telemedicine visit.  The PCP, without being given the whole story, says it's probably nothing, and Joe can head home and treat it with a little rest and maybe some Tylenol.  So Joe heads home…..with an ankle that's still broken!

This is an analogy for Long-Term Care Planning the way it's too often done today, where, for whatever reason, a client's advisor allows or encourages poor decision-making.  Addressing Long-Term Care (LTC) is a critical component of comprehensive financial and healthcare strategy, particularly for those looking to secure their future and that of their loved ones.  Having a robust plan requires a collaborative effort among various specialized advisors, as each will contribute unique expertise to craft a successful LTC Planning strategy tailored to a client's needs.

Who SHOULD Be On The Team Roster?

Financial Planner/Advisor:  Like a PCP, a client's "financial health" and subsequent LTC plan fall under the purview of a financial advisor, and similar to the PCP, the financial advisor almost always works with multiple specialists to maintain that financial health.  Once the financial advisor evaluates the client's financial picture, including an analysis of assets, income, and potential liabilities, a variety of specialists, such as investment, tax, legal, and insurance professionals, will be engaged to execute strategies to meet long-term financial goals and ensure financial security.  Simply put, the financial advisor cannot and does not work in isolation…..

Legal Counsel:  While all Elder Law attorneys do estate planning, not all estate planning attorneys specialize in Elder Law, and navigating the legal intricacies surrounding LTC requires that specific proficiency.  From core estate planning to understanding Medicaid and other government benefits, this team member provides invaluable professional guidance as they draft and help execute wills, trusts, power of attorney, and other documents tailored to the client's planning goals and contain the necessary state-specific language.  For clients with broader legal needs, a family or personal attorney may also be needed to integrate LTC Planning into the client's overall legal strategy and ensure that legal contingencies seamlessly align with financial and healthcare plans.

The Tax Professional:   Understanding the tax implications of various LTC Planning options is vital in crafting an efficient plan, and your client's tax profession will help navigate tax considerations, offering insights into strategies that optimize financial resources while minimizing tax burdens.  The tax code is full of ways to create tax-free pools of funds for healthcare, avoid increased Medicare premiums due to IRMAA¹, or take tax deductions for various health and LTC premium expenses.  Thus, their role is vital to providing accurate tax planning that maximizes the benefits of proactive LTC Planning.   

LTC Planning Specialist:  The LTC Planning specialist offers insights into what could become a significant component of a comprehensive plan.  A customized LTC plan requires a data-driven methodology like the HALO system we use to quantify a client's projected longevity and care needs, and this is a crucial planning variable.  Unfortunately, quantifying the LTC goals is the step most advisors fail to complete.  Instead, they try to turn the "average need for care" of a large group into an absolute that applies to the individual.  Setting accurate goals is the LTC specialist's first step in educating your clients, and only then will it be possible to help them navigate the complexities of health qualifications, funding options, and plan designs and align each with a client's needs and financial capacity.  

Orchestrating Collaboration

While each advisor brings specialized knowledge to the table, the importance of a lead advisor is often overstated.  While one advisor might serve as the coordinator, orchestrating collaboration among the team, decisions should not and cannot be made without the input and views of the planning team of professionals.  Remember, even when the Primary Care Physician sends you home, the ankle is still broken……

A collaborative effort will empower your client and must be embraced to ensure the various aspects of LTC Planning are understood so it can achieve the client's comprehensive planning goals.  Only as a team can there be robust Long-Term Care Planning that addresses ALL the financial, legal, tax, and healthcare variables to provide peace of mind for the future and ensure multi-generational security.

¹ Income Related Monthly Adjustment Amounts (IRMAA), SSA.gov, https://www.ssa.gov/medicare/lower-irmaa