Elderly Care Planning

Long-term care is the financial event most retirement plans don’t survive.

The biggest threat to a retirement plan usually isn’t a bear market. It’s a long-term care episode, home care, assisted living, or nursing home, that drags on for years and quietly consumes assets meant for a spouse, kids, or legacy.

The numbers are heavier than most people expect. According to the 2025 CareScout Cost of Care Survey, the national median for a semi-private nursing home room is about $9,580 per month, with private rooms closer to $10,800. Costs vary by state and by the level of care needed.

At BRIA Capital Group, we help you plan for this in advance, while options are still open. Once a diagnosis lands, choices narrow fast.

What care costs in Florida

Florida is roughly in line with national figures, though costs vary widely by region (Naples and parts of South Florida run well above the median; rural counties run below).

• Home care / home health aide. Roughly $5,000 to $5,700 per month for full-time equivalent care, depending on hours and provider.
• Assisted living. Florida median is around $4,800 to $5,500 per month, with higher-cost markets running $6,000 to $8,000 or more.
• Nursing home (semi-private room). Roughly $9,000 to $11,000 per month, often higher in Tampa Bay metro areas.
• Nursing home (private room). Generally $10,000 to $13,000 per month.

These are medians. Memory care, skilled nursing, or specialized facilities can run substantially higher. A three-year stay at these rates can easily consume $300,000 to $500,000, often more.

Funding strategies

There isn’t a single right answer. The right approach depends on your assets, your health, your family situation, and how much risk you’re comfortable absorbing.

• Traditional long-term care insurance. Pays a daily or monthly benefit if you need care. Usually has elimination periods (a waiting period before benefits start) and benefit caps. Best purchased in your 50s or early 60s, when underwriting is friendlier and premiums are lower.
• Hybrid life/LTC policies. Permanent life insurance with a long-term care rider. If you need care, the policy pays benefits. If you don’t, your heirs receive a death benefit. Often a better fit for people who don’t want to pay premiums for coverage they may never use.
• Self-insure. For families with significant liquid assets, setting aside a dedicated bucket for potential care can make sense. We’ll help model what “enough” looks like.
• Medicaid planning. A legal strategy involving asset positioning to qualify for Medicaid coverage of long-term care. Usually done with an elder law attorney. Requires planning well in advance because of the look-back period (see below).

Medicare vs. Medicaid: what each covers

This is where families get hurt by assumptions. The two programs sound similar and cover very different things.

• Medicare. Covers skilled nursing for a limited period (up to 100 days) following a qualifying hospital stay, and only when medical improvement is expected. It does not cover long-term custodial care, that is, help with bathing, dressing, eating, and the day-to-day care most long-term care episodes actually involve.
• Medicaid. Does cover long-term custodial care, including nursing home stays. But Medicaid is a needs-based program with strict income and asset limits. To qualify, most assets have to be spent down first.

Florida Medicaid look-back. Florida applies a 60-month (5-year) look-back period. Any gifts or asset transfers made within the five years before a Medicaid application can trigger a penalty period during which benefits are denied. This is why Medicaid planning is something to discuss with an elder law attorney years before care is needed, not in the hospital hallway.

A common shock for families: Mom is hospitalized, transferred to a skilled nursing facility, Medicare covers her for 80 days, then she’s still not well enough to go home. Medicare stops paying. The family pays out of pocket at $10,000-plus a month until assets are spent down enough to qualify for Medicaid. Planning ahead changes that picture.

Power of attorney and incapacity planning

If you can’t speak for yourself, someone needs to be authorized to act for you. Two documents do that work.

• Durable Power of Attorney (financial). Lets a named agent manage your finances if you’re incapacitated. Florida recognizes both immediate and springing POAs. Immediate POAs take effect when signed. Springing POAs only take effect upon proof of incapacity, which sounds appealing but can cause real delays when a family needs to act quickly.
• Health Care Surrogate (medical POA). Lets a named person make medical decisions if you can’t, including end-of-life decisions consistent with your living will.

Both need successor agents named in case the primary can’t serve. Both should be reviewed every few years as relationships and circumstances change.

How to start

The hardest part of elder care planning is that it has to happen early. Most insurance is much harder to underwrite in your 70s than in your 50s or early 60s.

1. In your 50s and 60s. Get the four estate documents in place. Price out hybrid LTC or traditional LTC coverage while you’re insurable. Model what a 3-to-5 year care event would do to your retirement plan.
2. In your late 60s and 70s. Review long-term care funding decisions. Decide whether to lean on insurance, self-insurance, or Medicaid planning. Update POAs and surrogates.
3. Anytime. Have the conversation with your family. Who would step in. Where the documents are. What you’d want.

We’re glad to walk through any of this with you. Whether it’s looking at the cost-of-care impact on your retirement plan, evaluating an LTC policy quote, or coordinating with an elder law attorney on Medicaid planning, we’ll help you put the financial side in order while you still have options.